UHDB's Discharge team's been vital in improving patient experience
Our Discharge Business Unit oversees the discharge of patients, aiming to provide the most seamless experience to patients within our care from the moment they are admitted until they leave our hospitals to go home or to their next place of care.
The integrated team, which works across all five of our hospitals, plays a key role in making sure patients leave our hospitals ready for the next step in their recovery. They work with colleagues on the wards to ensure the transition through to discharge is as easy as possible and pride themselves on being “the second pair of eyes” before patients head home or to their next place of care.
Hannah Timms, Matron for Discharge and Integration, said: “We’re here to support the patients and our colleagues on the wards and make it easy for their patients to get a safe discharge in a timely manner. It’s our role to support the wards so they can look after the acute patients in more urgent need.
“We are the last line for those patients to make sure they are as optimised as they can be before they leave the hospital and that is one of the proactive ways that discharge works.
“About 25 per cent of all the discharges go via the Discharge Assessment Unit (DAU) which means for a quarter of the patients being discharged, DAU is their final impression of UHDB and the last part of their patient journey so we want to make it a good one.”
More recently, Hannah and her team have been hard at work implementing many changes in the way they do things so that the unit has become ‘less of a waiting room’ for patients.
She said: “The reality is there are issues with flow in the hospital and bed shortages and pressures. If a patient comes via DAU that frees a bed up for someone who is acutely unwell to go into so essentially that’s the main purpose. However, we also want to make it as nice as possible for the patient and instead of them being sat on the ward hopefully the patient will come and have a more relaxed, comfortable experience here instead while they wait to be discharged.
“We’ve changed what we do as a unit. Before it was more of a waiting room but now we can offer dressing changes and support with critical medication, such as insulin, which is better for the patient and the district nurses as it takes the pressure off them and we can keep things moving.
“We also have social services on site so we’ve got immediate access to and advice on social care. This means the patient can be given equipment and confidence which reduces demand and allows for the patient to feel more supported following their discharge.”
One of the key things the team has adopted is ‘admission avoidance’ which aims to minimise the chances of the patient needing to be readmitted to hospital.
Fiona Styles, who is a Matron for the team, said: “We take patients directly from A&E, whereas traditionally they might have come in, especially if they are elderly, and because of time or family commitments, might not be able to go home or to their next place of care straight away and they would have gone on to an acute bed. Instead, we bring these patients to DAU and quite often because we’ve got more connections and more speed with social services, we can get them turned around and safely discharged within the day.
“We will take up to 70 patients a month that way which is much better for the patient because they can get home sooner.”
Key to the improvements being made are the relationships the Discharge Business Unit makes with other agencies in the community and the flexibility of long-term colleagues who have had to adapt to the changes.
Fiona said: “The two DAUs have developed massively since the start of the pandemic and changed from being a Monday to Friday service to being a 24-hour ward.
“It has changed at such a fast pace and is very different to what the DAUs were originally designed for, so it’s been a case of having to develop along the way before communicating that to the team. It is a big change especially for colleagues who work on both DAUs and we do our best to give them the support and the confidence and training to change their role and the way they work.
“In the background, Hannah and I have also been doing a lot of Quality Improvement work and we have multi-integrated groups so colleagues attend from the wards, and we also link in with the CCG, colleagues in different disciplines and the wider community.
“We really want to give more joined up care and once we know what more we can offer to patients, carers and wards as opportunities to get people discharged quicker and safely, hopefully this will continue to improve the discharge process for everybody.”
Despite Hannah saying there are further improvements to come, the team has worked incredibly hard to help change the shape of discharge in Derbyshire and Staffordshire and their efforts were recently recognised in this year’s Annual Making a Difference Awards.
The team was shortlisted in the Chair’s Team of the Year category and were delighted to be nominated.
Hannah said: “When we look back we’ve done a lot but we’ve still got loads to do. It’s been a very difficult, challenging time and to be shortlisted for an award was a real morale boost. We’ve printed additional copies of the certificates for across the five sites and they are all pride of place so everyone can carry on the celebrations.”