Improving the Discharge Pathway / Process

What was the issue you were addressing or working on?

The financial cost of delayed discharges in P&K to NHS Tayside is estimated to be over £1.5 million.  Aside from the financial implications of delayed discharges, evidence suggests there are many other risks associated with being in hospital longer than is necessary, a delay in the opportunity to restore a persons independence and potentially the loss of independence and mobility.

Delayed discharges can potentially also cause further problems within the wider community through delayed urgent admissions, cancelled operations and overall problems with emergency and elective access to beds.  Consequently any delays in discharge are bad for patients, their families, the NHS and the Council.  Minimising delayed transfers of care is therefore fundamental to ensuring capacity and flow through the system as well as ensuring a person-centred, outcome focussed approach to health and social care.


What you did?

The delayed discharge workstream 1 of the change fund focuses on reducing bed days lost to delays in hospital settings across Perth & Kinross.

The workstream commenced in April 2011 with the setting of a baseline to measure performance over the following years.  This allowed measurement of the input, outputs and outcomes of the projects governed by this workstream.

The workstream undertook process mapping of the current state discharge pathway which enabled them to develop and implement a new joint discharge pathway with comprehensive training provided to all ward staff involved in the discharge process.  I

In addition the team were able to identify gaps in service provision to support discharge and obtained approval for investment into the following services:

  • Stepdown
  • Immediate discharge team
  • Social worker capacity
  • Direct access by health staff to social work services
  • 7 day working for AHPs
  • Generic Rehab Assistants (OT and Physio)

What were the outcomes - benefits or otherwise?

  • Active, integrated, multidisciplinary discharge planning taking place throughout the whole patient journey until we reach the point where the patient is clinically fit to leave hospital.
  • Reduction in the average length of delay for people in a delayed situation.
  • Increased choice in service provision and capacity of the teams.
  • Streamlining of processes that impact on discharge.

Contacts - to find out more

Sue Muir,   sue.muir@nhs.net  01738 473115

Colin Johnston,  ColinJohnston@pkc.gov.uk  01738 476754