List the measures you will put in
place | Describe the expected impact of the measures | Describe how the measure will achieve the zero target |
1. Review of Community Hospital Provision across Fife | The intention of the Review is to ensure that Community Hospitals provide a local and responsive service. This should enable older people to move in and out of Community Hospitals for appropriate treatment and rehabilitation freeing up Acute Hospital beds and keeping people at home for longer. | Prevent unnecessary emergency admissions. Reduce the number of delays over 6 weeks to zero by 2008. Reduce the number of delays in short stay beds. |
2. Estimated Date of Discharge | The EDD is being introduced across the Acute hospitals within the intention of reinforcing the principle of planning for discharge from the moment of admission. We anticipate clearer and better planning for discharge. | Speed up assessment process and discharge planning. Reduce delays over 6 weeks and in short stay beds. |
3. Discharge Nurses | 3 nurses are funded across Fife to support discharge. Their roles are being refocused to enable them to have input to admission wards. This should give increased support to Discharge Planning and a faster turnaround for patients. | Speed up assessment process and discharge planning. Ensure quarterly sustainable reductions are made. |
4. Review of Expenditure of Delayed Discharge Monies | It is intended that this Review will encourage the 3 Fife Localities to take ownership and stocktake in terms of the services provided within their community which maintain people at home/facilitate discharge. | Ensure quarterly sustainable reductions are made. Prevent unnecessary emergency admissions. |
5. The EMPTAYDD System will be purchased for Fife and operational by September 2006 | The system will provide live recording of Delayed Discharges which will enable Fife to pinpoint problems as they arise. This should help us to reduce delays. | Ensure quarterly sustainable reductions are made. Speed up assessment process and discharge planning. |
6. Review Clinical Model of Care for Older People | More Consultant Geriatrician support available in the community which should provide better assessment and treatment for older people within their own homes. Fuller use of rehabilitation opportunities is also envisaged to ensure appropriate destination, i.e. home/care home. | Prevent unnecessary emergency admissions. Ensure quarterly sustainable reductions are made. |
7. The appointment of 3 new Consultant Geriatricians | These additional Consultants are fundamental to the review of the model of care and the increased visibility of Geriatricians in the community. Their expertise should assist in maintaining older people in the community. | Prevent unnecessary emergency admissions. Speed up assessment process and discharge planning. |
8. Introduce the Theory of Constraints Methodology | This methodology will identify problems and bottlenecks and ultimately find a resolution. | Speed up assessment process and discharge planning. Ensure quarterly sustainable reductions are made. |
9. Provide Delayed Discharge Data by Postcode | The provision of Delayed Discharge data by postcode to CHP General Managers and Social Work Senior Managers will enable the active involvement of same with a view to refocusing local services to overcome problems. | Ensure quarterly sustainable reductions are made. |
10. Active Involvement in the Unscheduled Care Collaborative for Fife | The work of Flow Group 5 will heighten awareness of the importance of reaching the Delayed Discharge targets. The work will also actively support better discharge arrangements/ maintenance of people at home. | Speed up assessment process and discharge planning. |
11. Close monitoring of the implementation of the Choice Policy | Monthly monitoring of the number of people exercising choice and the active involvement of key staff across Social Work and NHS Fife in encouraging the uptake of interim placements will reduce the number delayed for this reason. | Number of people delayed over six weeks will reduce. Achieve quarterly sustainable reduction in delayed discharge. |
12. Review the Joint Hospital Discharge Protocol and re-launch, involving key staff within NHS Fife and Social Work Service | The revised document will take account of recent changes in legislation, e.g. AWI. In addition, will reinforce the elements of effective discharge planning. | Achieve quarterly sustainable reduction in delayed discharge. |
13. Increase the number of hospital based Social Worker | By increasing the number of Social Workers in the Queen Margaret Hospital and Victoria Hospital site waiting time for allocation of referrals will reduce. In addition, Social work presence at ward meetings and case conferences will increase. This will speed up assessment process and discharge planning. | Waiting time for allocation for assessment will reduce. Number of people waiting over six weeks will reduce. |
14. Develop alternative solutions for people experiencing lengthy delays in hospital awaiting re-housing or major adaptations | We will arrange temporary admission to care home settings for people delayed over six weeks awaiting re-housing or major adaptations. This will reduce the number of people delayed over six weeks. | Number of people delayed over six weeks reduced. |
15. Redesign of the Intermediate Care Service Model in West Fife | We will locate three intermediate care beds within a sheltered housing unit in West Fife. This service will be part of the wider Rehabilitation Service in West Fife and will prevent emergency admissions to hospital and facilitate early discharge. | Number of admissions prevented. Number of early supported discharges. |
16. Develop direct access to services | Following the relaunch of SSA, it is planned to enable all assessors to directly access a range of Home Care and Support Services, including M.O.W., Community Alarms, and the collection and delivery service. This will speed up the assessment process and discharge planning. | Reduction in number of people delayed over six weeks. Reduce the number of people delayed in short stay specialities. |
17. Falls Response Team | Early intervention to prevent unnecessary admission/re admission to hospital. | Numbers and nature of interventions are recorded. Full evaluation of effectiveness of interventions to be completed. Prevent unnecessary admissions. |
18. Whole Systems Approach Levenmouth | Develop early intervention process. Prevent unnecessary hospital admissions through contingency planning. Agree base line tool for assessing risk, identifying level of need and developing preventative services. Review current services to ensure seamless service to service users with no duplication. More people receiving care in their own homes. Care offered in peoples homes for longer period. | Incorporate within SSA tool and guidance notes. Refocus current provision to enable more people to remain at home. Statistical analysis of hospital admissions/re admission figures and community teams statistics. Prevent unnecessary admissions |
19. See and Treat Pilot Project. This service will consist of a crew of paramedics, emergency nurse practitioners and urgent care practitioners. They will respond initially to priority B and C calls to the Scottish Ambulance Service with the aim of assessing and treating patients at home without the need to bring them into A&E. | This service should enable more people to receive treatment and follow up at home rather than coming to hospital with possible admission. | Prevent unnecessary emergency admissions. |
20. Discharge Lounges in the 2 main Acute Hospitals | This will allow patients to move out of the ward into a comfortable and monitored lounge to wait for their medication/transport home. In doing this, beds on wards will be freed up more speedily to accept new patients. | It will build capacity and speed up discharge. |
21. The development of an Acute Medical Admissions Unit at Queen Margaret Hospital | This focussed assessment ward, with dedicated staff, should improve patient flow and reduce numbers of patients boarded in alternative wards. (we know that patients who are boarded out often take longer to become fit for discharge). | Speed up assessment process and discharge planning and will reduce the number of delays in short stay beds. |