Health and care partners working together to help patients leave hospital

Great Western Hospitals NHS Foundation Trust took part in a joint event with health and care partners from across BSW recently in a drive to support improved patient flow across the area, recognise and unblock delays and simplify complex discharge processes.

The Multi-Agency Discharge Event (MADE)brought together the local health and social care system. It worked to reduce a patient’s length of stay and increase the number of discharges completed before lunchtime.

Each day, representatives from GWH’s site team, a ward representative, community nursing and therapy services, Swindon and Wiltshire Councils, primary care and the Integrated Care Alliance visited wards to review every patient’s care pathway, identify and unblock any delays to discharges and then ensure these discharges were safe and timely.

Each patient’s journey was critically reviewed to understand what next steps were required to reach discharge and to make sure critical interventions happened without delay.

Patient lists and templates were distributed to MADE partners, to capture issues and actions in real-time, so that individual patients were escalated, if required, to reduce delays.

Taking a multi-agency approach to individual care pathways ensured that patients who are well enough to go home – but are awaiting further support such as a social care package, a care home bed or community care – were able to return home much quicker with their ongoing care needs in place before they leave the hospital.

It was important that the Trust worked closer with partners to help reset the organisation, reduce the time patients attending urgent and emergency care services are waiting for a bed and support patients to continue their recovery outside of the hospital.