making our hospitals work
DESCRIPTION
tania king - calderdale and huddersfield nhs foundation trust - ls10 - 02.11.10 - pptshown at the Lean Summit 2010 - New Horizons for Lean Thinking on 2/3 November 2010TRANSCRIPT
Making our hospitals work
Tania KingService Improvement ManagerLean Summit 2nd November 2010
• 2 hospital sites 5 miles apart
• Provide healthcare for over 435,000 people
• Approx 400 beds on each site
• A&E on each site
• Medicine/elderly beds on both sites
• Calderdale Royal has only elecCve surgery/orthopaedic beds
• In 2007/08 there were: 110,000 inpaCents, 380,000 out paCent aLendances
Our hospitals
• FoundaCon Trust since 2006
• Financially sound
• History of meeCng all targets
• Care Quality Commission raCng of “good” BUT….
• A feeling of constant fire fighCng to manage daily admissions and achieve 4 hour target in A&E.
Our hospitals
So what have we done?
• OperaConal management of paCent flow hour by hour.
• Demand for beds, and capacity are visual and clear.• Immediate acCon can be taken to fill empty beds thus leaving assessment areas with capacity.
• We can see at a glance if paCents are off template or outliers and repatriate if appropriate and possible.
• Delayed discharges can be invesCgated and acCon taken to move things along (helps ward staff who don’t always have Cme for this).
What is Visual Hospital?
Update (17/10) -‐ Analysis of Medical PaEent LoS Prior to ‘Visual Hospital’ ImplementaEon (08/06) V’s Post ImplementaEon
Copyright Lean Enterprise Academy 2010
Lean Enterprise Academy
Bottom Line Results:
Mean Medical LoS has reduced by 2 days (24%) from 8.5 days to 6.4 days .
The Median Medical LoS has reduced by 1 day (20%) from 5 days to 4 days
P-value = 0.000 which means statistically there is a difference
Update (17/10) -‐ Analysis of Orthopaedic PaEent LoS Prior to ‘Visual Hospital’ ImplementaEon (02/08) V’s Post ImplementaEon
Copyright Lean Enterprise Academy 2010
Lean Enterprise Academy
Bottom Line:
Mean Emergency Ortho LoS has reduced by 4.2 days (50%) from 8.4 days to 4.2 days.
P-value = 0.000 which means statistically there is a difference
• Maintaining the gains whilst spreading quickly
• Reducing bed base
• Keeping staff on board
• Resource to keep all this going and move on to the next level
• Working with Social Services to reduce delays (parCcularly packages of care) especially in current financial climate
Challenges