Trust Board papers November 2012 - Barking Havering and ...

Delayed transfers of care (DTOC) - The closure of Foxglove ward has necessitated greater
focus on complex discharge support and to that
end a rotational training programme has been
implemented to improve the timeliness of this
process. As yet there has not been a matching
decrease in LoS due to DTOC patients remaining
on their base wards but as outliers reduce this is
expected to follow. This work has been
implemented as part of the Ernest & Young Cost
Improvement Plan (CIP) work-streams with the
outcomes now business as usual.
The 7 day Consultant ward cover starts at the beginning of November and this is expected to
support a reduction in DTOC by more timely completion of the medical reports required for
discharge. In order to improve the discharge interface across the whole health economy the Trust
is working in partnership with the local Boroughs and Community Services, facilitated by
McKinsey, to reduce handover delays.
% Patients discharges between 6am and 11am - these have reduced slightly from August.
This measure is to ensure availability of beds and there has also been work undertaken to reduce
the discharges between 6am and 11am.
Goal directed fluid therapy (GDFT) for planned colorectal and emergency abdominal
patients –To increase performance the follow actions are being taken:
When reviewing the notes to identify when the GDFT method has been used the Enhanced
Recovery Program (ERP) Facilitator will escalate to the General Manager and Lead Anaesthetist
immediately where this is not the case. Performance in emergency has increased from 33% to
57% but the elective pathway has deteriorated. This was raised at the recent audit meeting where
it was agreed that the profile of GDFT needed to be raised further within the Trust.
DNA rates for first and follow-up appointments –
The trust is carrying out three key projects to reduce DNA rates. They are:
• The text reminder service
• Phoning patients who have DNA’d to understand why they did not attend the appointment.
• Exploring additional approaches for appointment reminders
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