1. Patient Flow A Bird’s Eye View

2. Without additional resource
Bed Bureau
Western General Hospital
Discharge Lounge
GP’s
Without additional resource
Through communication and collaborative working
By breaking down organisational and system barriers
Lothian Unscheduled Care Service
Social Work
Royal Infirmary Edinburgh
Transport Hub
NHSL Patient Transport
Discharge Hub
Integrated Joint Boards
Outpatients Departments
Pharmacy
St John’s Hospital
Scottish Ambulance Service

3. PATIENT FLOW GP’s Flow Centre Royal Infirmary Edinburgh Discharge Hub
Integrated Joint Boards
Discharge Lounge
Integrated Joint Boards
Outpatients Departments
Western General Hospital
Lothian Unscheduled Care Service
Scottish Ambulance Service
Pharmacy
St John’s Hospital
Social Work
Social Work
PATIENT FLOW

4. Key Goals THE VISION Whole system approach Community based services
General Practitioners
Third Sector
Alternative to admissions
Scottish Ambulance Services
Secondary Care
Improve patient flow by breaking down boundaries
Direct and manage flow from a bird’s eye view of services
Early detection of pressures in the system
Efficient use of current resource
Gold Standard

5. Background Hospital sites working in silos
Bed Bureau for GP admissions
Transport Hub for transfers /discharges
Arrival curve of patients late in the day
Limited transport options for GPs
Long delays waiting for ambulances
No Lothian wide overview of flow
No extra resources available

6. What we did Stakeholder events Development of steering board
Integration of existing services
SAS/H&SCP/THIRD SECTOR partnership
Single point of contact for all urgent GP referrals
Increased transport options
Streamlined / created pathways
Technological overview of Lothian wide patient flow in real time
Early identification of pressure points

7. Outcomes Increasing alternatives to admission
>100 patients per month treated in their own home
66% of patients now make their own way to hospital
All GP urgent patients on Flow Centre vehicles wait <4 hours
32% patients who previously travelled by SAS emergency
ambulance now arrive by FCV saving 380 ambulance days per year
Patients arriving at hospital earlier in the day to hospital
Expected patients lists for each site so they can plan for demand
Flow Centre taking 9200 calls/ month with 95% of calls answered within 60 seconds

8. Future Further increase alternative to admissions
Flatten the admission attendance curve
100% GP / IJB urgent referrals are admitted
Improve overview of OOA urgent referrals and repatriations
Joint working with 3rd sector
Work to break down barriers between organisations

9. Any Questions?