1. Patient Flow ‘Partnerships to Success’
Liz Moore
Health Care Director
Integrated Care and Emergency Services

3. Everyone has a part Key partnerships Acute Services Community Services
Local Authorities, GPs, NHS 24, SAS
Patients, Relatives and Carers

4. What have we done? Acute partnerships
Improved escalation procedures / patient flow handbook for managers
Embedded clinical escalation triggers
Strengthened system wide reporting and communication / new templates and visual triggers
Applied LEAN methodology to reduce waste and streamline flow eg MDT Ward Rounds
New Acute Medical Day Clinic
Reduced boarding by getting the patient to the right bed at the right time <<ALOS
3rd Bullet point - visual triggers used for EDD and 2X12 using MDT. Bullet point 4 – MDT board ward rounds short sharp 15 minutes each. Bullet point 5 – acute Medical Physician intercepting some GP calls and preventing admission. Bullet point 6 – working with fewer beds and taking more admissions 4

5. What have we done? Community partnerships
Community linked escalation triggers
Early identification of community hospital bed availability
Promoting use of EDDs and AM discharge in community hospitals
Organisation-wide use of SPARRA data
Bullet point 2 – getting this info every morning prior to 9 o’clock. Bullet point 3 – done as part of LEAN. 5

6. What have we done? Partner Agencies
NHS 24, GPs, SAS and LA all actively involved in LEAN transformation programme
LAs participation in new MDT Ward Rounds
LAs integral partner in SPARRA development
LAs and SAS working in discharge teams to align resources around discharge planning 6

7. What have we done? Patient, Relative & Carer Partnerships
Co-creating health projects to build patient confidence in self management
GP condition led pathway prescribing empowering patients, relatives and carers to manage conditions at home, eg COPD
Early joint understanding and agreement around EDD – expectations managed and families prepared
Last bullet point – patients are informed on admission or as soon as possible afterwards. 7

8. Conclusions Patient flow complex Constraints addressed at key gateways8

9. … and relies on strong partnerships!