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A Newton-Clarke, M Atkinson, K Shelton, S McDaniel, 2765 Reducing avoidable discharge delays on an elderly admissions Ward, Age and Ageing, Volume 54, Issue Supplement_1, January 2025, afae277.032, https://doi.org/10.1093/ageing/afae277.032
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Abstract
Our aim is to improve clinical efficiency by reducing avoidable discharge delays, increased number of discharges and availability of specialist Frailty beds. We intend to undertake 8 PDSA cycles with a new idea.
23 bedded Acute Frailty Short Stay Unit (AFU). Patient group defined as those admitted to the unit from April ‘24 to current. Our initial spot-audit analysed 18 patients; the mean total avoidable delay was 31.52 hours (range 4.73–123.3 hours). Initial analysis demonstrated that delays became longer throughout the course of the day.
We evaluated staff opinions on the discharge process with a survey. Outcome measure identified as number of weekly discharges and appropriate patient flow to the AFU. Balancing measure identified as number of readmissions within 48 hours. PDSA cycle 1 allocated a doctor to write discharge letters during MDT. PDSA cycle 2 allocated a suitcase symbol to a potential discharge in the next 24 hours. We then adapted the suitcase with colours to differentiate between ready and awaiting investigations/aim home in 24 hours. The next involved allocating a discharge doctor to review patients with an amber suitcase from the previous day first.
Initial staff feedback has been positive. Data demonstrated an increase from the baseline (from below 20 to an average of 25 discharges a week). This then dipped throughout May, during which time there was an unusual level of escalation, staff absences and annual leave. The data has begun to recover to a high of 27 discharges in the week of the start of June.
Utilising the MDT has been vital in the sustainability of the project. On-going staff surveys and regular meetings will help to ensure sustainability. Ongoing focus and further cycles are on encouraging junior members of the team to be involved with the intervention.
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