A Consultant in a Foundation Trust attended our Service Line Leadership programme and consequently he decided to apply for the role of Clinical Director.
He realised that despite working for the Trust for 6 years he was not aware of any clear goals, a common theme or a direction of travel and having attended the programme he felt that he should take the lead on this. His desire was to have a greater influence on the future of his service.
Previously there had been many projects attempting to address many things and they had dissipated the teams focus and momentum leading to poor conclusions.
With our coaching support, he prioritised down to a few things that he felt would have the most impact.
- Flow
- Emergency System
- RTT
Initially the focus was on Flow. From the ED 4 hr target through to discharge from the wards.
The Consultant set about sharing his vision with the key influencers in the process. Supported by our work with Senior Clinicians he was able to deliver significant outcomes that took the Trust from being in the bottom 10% of the country for the 4hr ED target to the top 5%.
At Beffective we pride ourselves in sustainable solutions, 2 years later they remain in the top 5% of Trusts nationally.
It has been suggested that these improvements have been achieved due to ED being quieter, however ED attendances have increased, ED majors/ambulances have also increased.
These improvements have contributed to the department coming out of special measures and gaining a ‘Good” CQC rating in 2017. The team were also awarded the HSJ value in Healthcare award in 2017 for Emergency, Urgent and Trauma care.
The major results of our programme
| Description | Before | After |
| 4 hr target | Failed for 15 months 2nd worse in country Jan 15 |
Top 5% in the country sustained. May 17 96.67% . Best performer in October 16 |
| Sepsis compliance | 46% | 95% |
| Number of patients with length of stay of 14 days plus | 290 Nov 15 | 180 August 16 – aim to reduce to 130 |
| Number of occupied bed days for patients with length of stay of 14 days plus | 11,000 Nov 15 | 6,000 August 16 |
| No of patients discharged from Short stay unit | 25 per week | 90 per week |
| 3 wards closed since November 2014 | Cost saving of £6m | |
| Utilisation of discharge lounge | 55 patients per week | More than 100 patients per week |
| Mean length of stay | Reduced by 2 days | |
| AEU beds | Beds not always available | Beds available every day |
| Staff sickness | Reduced | |
| Staff morale | Significant increase |