Nurse Led Discharge

2. Presentation Overview Background & methodology Training & Pilot study Findings of NLD audits Sharing and sustaining improvement

3. Drivers for Change Strategic drivers Local drivers Ward managers Patient experience Drivers for change Strategic Dhssps compulsory discharge actions EDD recorded for all patients within 24 hours of admission Discharge patients by 2pm 7 day a week discharge Local Drivers Ward managers identified a lack of multidisciplinary discharge planning Senior nursing time was being wasted chasing after medical staff to get discharge decisions made Patients were remaining longer in hospital that was appropriate Discharge decisions were being made at the last minute and were often made in response to pressures on beds Patient experience Believed that improved planning, communication and co-ordination would enhance patient safety and their discharge experience ILL A&E patients waiting for long periods for admission Drivers for change Strategic Dhssps compulsory discharge actions EDD recorded for all patients within 24 hours of admission Discharge patients by 2pm 7 day a week discharge Local Drivers Ward managers identified a lack of multidisciplinary discharge planning Senior nursing time was being wasted chasing after medical staff to get discharge decisions made Patients were remaining longer in hospital that was appropriate Discharge decisions were being made at the last minute and were often made in response to pressures on beds Patient experience Believed that improved planning, communication and co-ordination would enhance patient safety and their discharge experience ILL A&E patients waiting for long periods for admission

4. Aim To enhance the patients discharge experience by streamlining discharge processes for all patients with simple discharges

5. Defining NLD The nurse initiating and leading the discharge process with the patient, family and multidisciplinary team to expedite appropriate discharge and assist patient flow management across the Trust.

6. Methodology Literature Review Survey Steering Group Manchester Visit Protocol & Proforma MD Discharge Planner Staff Training Pilot Study

11. Discharges By Time Of Day

12. Discharges By Day Of The Week

13. Overall Outcome Dramatic change in discharge culture Dramatic change in discharge culture across the organisation far transcending nursing. Dramatic change in discharge culture across the organisation far transcending nursing.

14. Sharing & Sustaining Rolled out across the Trust to all hospitals. Local hospital champions supported by Trust Integral part of all staff induction programmes. Ongoing education programme Shared with other Trusts Roll out Rolled out to four of the trusts six hospitals. Plan in place to roll out to remaining trust hospitals Local Champions UCIM=Nurse unscheduled care improvement manager Induction NLD concept is part of all new of experienced nursing induction programmesRoll out Rolled out to four of the trusts six hospitals. Plan in place to roll out to remaining trust hospitals Local Champions UCIM=Nurse unscheduled care improvement manager Induction NLD concept is part of all new of experienced nursing induction programmes