Ward 402 staff are making sure that Every Day Counts for our patients
A UHDB respiratory ward has nearly doubled the amount of patients that it’s been able to safely discharge home in the morning each day – in the space of just one month.
Staff on Ward 402 at Royal Derby Hospital have all banded together to follow a Japanese improvement method, known as ‘kata’, to enhance our patients’ experience by ensuring they don’t spend any more time in hospital than they need to.
The team set themselves a challenge to discharge three patients before midday every day and have been working towards this end goal by coming up with different changes to practice to take several small steps towards this target over time.
One of these changes has seen the ward start to invite pharmacist technicians to attend the ward’s morning board round, to help reduce the amount of time that patients have to wait to receive their drug prescriptions (TTOs) before being able to go home.
Since adopting the kata approach in December 2019, the numbers of Ward 402 patients discharged in the mornings have increased from 11, to 19 in January 2020, with this figure also representing a massive 375% increase on the same period in 2018 and 2019.
Dr Aklak Choudhury, Respiratory Consultant, said: “On Ward 402, we have been focusing on allowing more of our patients to be safely discharged before midday, as part of UHDB’s Every Day Counts project. Every day is an experiment, and that is what we’re trying to do here, we’re trying to experiment, so that we can find out the best way of getting patients safely discharged before midday.
Ward 402 staff making sure that Every Day Counts for our patients from UHDB Communications on Vimeo.
“What’s really good about the kata improvement approach is that it’s really up to the people on the ward, with staff nurses, doctors and pharmacists contributing by coming up with different ideas to work towards that end goal. I’m very proud of the whole team.
“Because we have been making beds available earlier in the day, our patients are now in the right clinical area and have the opportunity to see a specialist sooner on the ward. The patients are very thankful for that, because they’re more likely to get the right treatments and we’re also more likely to move them through that process and hopefully get them home.”
In keeping with the Trust’s Every Day Counts campaign, Ward 402 has introduced a ‘My Hospital Journey’ booklet, which staff update to make patients aware of their diagnosis, what’s going to happen to them next and when they can go home.
As part of the kata improvement approach, the next step will see the ward work towards nurse-led discharge, whereby nurses will be empowered to discharge patients identified as ready to go home, without a consultant needing to be present.
Vanessa Middleton, Ward 402 Senior Sister, said: “When deciding what our main challenge was, we thought ‘wouldn’t it be great if we could get three empty beds on the ward before 12 o’clock and facilitate this every day?’
“Taking these little steps has enabled us to go towards this main focus, and this has helped us to organise the discharge process earlier, get TTOs ready earlier and send them down to the Pharmacy earlier, so that we’re getting discharges at 9am, rather than at 2pm or 6pm.
“As a result of this project, we’ve developed a better working relationship with the wider multi-disciplinary team, particularly the Pharmacy department, while we’ve also created a booklet, updated specifically for our ward, to help keep patients in the loop with what’s going on in their hospital journey.”
Dr Choudhury added: “We’ve had some fantastic feedback from the patient journey forms, which we’ve been filling in for our patients on the ward rounds. Patients have told us that it’s nice to know that someone is actually writing what their diagnosis is; what’s going to happen to them next, and when they’re going home, so as to keep them more informed.”