Clinical service achievements

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UHDB patients spending less time in hospital, thanks to major discharge improvements

Discharge Assessment Unit

UHDB has “revolutionised” the way it discharges patients to ensure that they are the ones to benefit from not spending any more time in hospital than is absolutely necessary.

The Trust has changed the way that it discharges patients from hospital during the Covid-19 pandemic to help speed up the process of helping patients go home or on to their next place of care safely.

More emphasis has been placed on staff to quickly identify those who are medically fit to leave hospital and ensure the patient is transferred to our discharge areas within one hour, where they can then be assessed and arrangements can be made to have them picked up within a two hour window.

Nearly quadruple the number of patients are now being discharged in this way each day from Royal Derby Hospital to before, while around double the amount of applicable patients are now also coming through the Discharge Lounge at Queen’s Hospital Burton, compared to before.    

A larger Discharge Assessment Unit (DAU) replaced the Discharge Lounge at Royal Derby Hospital at the start of April, and the team have made some amazing improvements to patient experience, with an average of 58 people being discharged each week day.

The DAU, which mainly cares for patients who are being discharged back home and not onto further care in the community, also sees an average of 26 patients a day at weekends, with most spending just an hour and a half on the unit in total.

The Integrated Discharge Team, which is made up of community assessment nurses, discharge support officers, social services and community therapists working within the DAU, have played a key role in speeding up the process for those patients who need to be transferred to their next point of care in the community. 

By completing discharge assessments from the unit and enabling patients to be transferred from the wards as soon as they are clinically stable to do so, lengthy delays that may have taken place before have now been reduced, resulting in a better experience all round for our patients.

Lisa Marshall, Discharge and Integration Manager, said: “This new model has revolutionised the way that we assess patients for discharge. Due to the two-hour target set by the Covid-19 discharge guidance, it was clear that we needed to radically change how the usual processes for discharge worked, so that we ensured our patients didn’t spend any more time in hospital than absolutely necessary.


“The success of the Discharge Assessment Unit would not have been possible without the buy in from the Integrated Discharge Team and our partners in Derbyshire Community Health Services, and Adult Social Care in Derby and Derbyshire. Our integrated team of nurses, porters, pharmacy, admin and medical colleagues have also been key to helping ensure we meet the highest standards of patient care and experience – it truly has been a team effort.

“We’ve seen a huge improvement to the way we discharge patients and it is our patients who have been the ones to benefit from this, which we’re extremely proud about.”

The Discharge Lounge at Queen’s Hospital Burton has also been relocated to a bigger site to provide extra space and capacity for patients and staff, with the changes resulting in patients spending an average of less than an hour and a half in the lounge waiting to be discharged.

Separate Covid-19 and non-Covid-19 areas have been set up within the discharge units across both sites to limit the chance of the virus being spread, with the move helping the Trust to discharge more than 660 Covid-19 patients since 1 April.

This change to UHDB’s discharge process was originally introduced in response to Covid-19 but, having seen the extremely positive impact it has had on patient care, the new model could now be retained by the Trust going forward.

Gavin Boyle, Chief Executive, said: “The Covid-19 pandemic has required us all to work differently in so many ways; some for the better, which we’ll definitely want to keep. The way we’ve transformed our discharge processes to reduce our patients’ stay in hospital is a great example of this and we’re delighted with the results we’ve seen so far.

“The Discharge Assessment Unit has now nearly quadrupled the numbers of patients discharged using this new process with most leaving our hospitals in under an hour and a half. Anyone who has worked in the NHS will understand that this is quite an achievement. To see the teams completely change how they work to improve the experience for our patients is fantastic and makes me very proud to be able to work alongside such dedicated and forward-thinking colleagues.”