In the first 2 parts of this blog we looked at why we were undertaking this project and how we set about doing it. Now, one month after we started, we are in a position to share our early results.
This is only the first stage of this journey and it certainly has not been an easy one. On our first day we had the second most attendances we have ever had (only missing the record by a single patient) and without the patience, enthusiasm and support of our entire team we would have not gotten this far.
So the results:
Our primary outcome was Time to first assessment (1st HCP).
Prior to #PODSquad our median time for first assessment was 105 minutes, this median has now been reduced to 60 minutes. A reduction of 43%
Median time to triage has been reduced from 12 minutes to 8 minutes; a reduction of 33%.
Median Length of Stay for patients has been reduced from 207 minutes to 181 minutes; a reduction of 13%.
Median time to first test has increased from 23 minutes to 36 minutes; an increase of 57%, but as the following charts show this has also resulted in a reduction in the numbers of FBCs and troponins we are performing. This indicates that we are undertaking more targeted investigations in our patients.
Consequently all of these changes have consequently improved our 4 hour performance.
This has improved from a median of 79% prior to the start of #PODSquad to a current median of 89%, albeit with a peak of 93% for the first few weeks of July. 4 hour performance for patients discharged from the ED is now sitting with a median of 95%.
As a consequence of all this our department is less crowded and our conversations at our safety pauses are much more focussed on patience care and experience. We have improved continuity of care for patients and staff are getting breaks more consistently and we are delivering more teaching.
These successes have not been without challenges and there undoubtedly areas of this system that are not working well for either staff or patients. And whilst performance has improved, it still is not as good as it could or should be. We are still yet to fully understand how the system works, especially when we are very busy or areas decompensate and this, understandably, results in increased stress for staff members.
So we are now moving into a process where we will begin to target the areas of the system which could be better with targeted Quality Improvement projects with the intention of refining and improving the processes.
Our family has taken a step in the right direction and now, with continued hard work, patience and enthusiasm we will continue this journey.