INVESTNET
PROJECT
Model Wards West North West Region
TEAM:
West North West Region: Helene Horsnell Unscheduled Care Lead;
West North West Region: Laura Connolly Data Analyst;
GUH: Maria Molloy DGM, Deirdre O Brien ED ADON Patient Flow;
LUH: Andrea Kelly Patient Flow ADON and Maureen Harkin ED ADON Patient Flow;
Mayo: Lynsey Divilley ADON Patient Flow;
PUH: Geraldine Talty ED ADON Patient Flow;
RUH: Anne Smyth ADON for Medicine;
SUH: Roisin Molloy ADON Patient Flow;
There were multidisciplinary team members in all hospitals involved in this project.
Eileen Kelly (General Manager Women’s and Children’s MCAN) was involved in the initial roll out of Model Wards in 2019
LOCATION:
Large scale project across all wards in the six hospitals in the West North West Region.
THE PROBLEM:
Patient care and discharge planning not integrated leading to poor planning and gaps in communication among the interdisciplinary team.
THE SOLUTION:
An integrative approach involving all staff involved in patient care on all wards was implemented. The key theme was safe patient-centred care and flow.
The whiteboard is central focus on the ward with patient journey from admission to discharge mapped out. Standardised whiteboards were put in place across all wards, incorporating Red2Green (R2G) columns on boards with a clear escalation process in place to reduce delays/waste thus generating inpatient capacity.
The ward drumbeat was developed to ensure that processes occurred at the same time daily to improve ward efficiency. Daily ward huddles were established, focusing on R2G and actions to progress efficient patient flow. Once weekly HSCP whiteboard rounds were put in place to ensure timely referrals for all patients. Weekly integrated >14 LOS rounds focusing on reducing the >14 LOS hospital target using a standardised tool. Weekly deep patient flow dives are now in place to ensure all patients have clear plans and require acute hospital care.
BENEFITS:
This project demonstrates that implementing processes that facilitate structured communication improves integrated patient care and discharge planning. Elements of Model Wards are entirely unique e.g. ward drumbeat which reflects the daily operational processes on the ward.
• Ward processes structured
• Improved communication within interdisciplinary teams
• Improved team collaboration
• Improved patient care planning
• Improved PDD compliance – using the operational whiteboard
• Reduction in LOS, RUH Medical AvLOS went from 15 days in Jan 2024 to 9.6 days in June 2024
• Increased bed occupancy
• Reduction in >14 LOS hospital targets
• Red2Green playing a significant role in the day-to-day operations of patient flow
• Staff felt more supported.
This project has generated inpatient capacity and as a result when we compare the West North West Region UEC KPIs in 2023 versus 2024 from January – September YTD there a 20% reduction in the 8am Trolleygar. There has also been a 40% reduction in PET times for the >75 Yrs >24Hrs and a 33% reduction in the >24HR PET for all patients. A 7% reduction in surge capacity used.
PROJECT CONTACT DETAILS:
• helene.horsnell@hse.ie – USC Lead West North West Region