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Making our hospitals work
Tania King
Service Improvement
Manager
Lean Summit
2nd November 2010
• 2  hospital  sites  5  miles  apart
• Provide  healthcare  for  over  435,000  
people
• Approx  400  beds  on  each  si...
• FoundaCon  Trust  since  2006
• Financially  sound
• History  of  meeCng  all  targets
• Care  Quality  Commission  raCn...
So  what  have  we  done?
• OperaConal  management  of  paCent  flow  hour  by  
hour.
• Demand  for  beds,  and  capacity  are  visual  and  clear.
...
Update  (17/10)  -­‐  Analysis  of  Medical  PaEent  LoS  Prior  to  ‘Visual  
Hospital’  ImplementaEon  (08/06)  V’s  Pos...
Update  (17/10)  -­‐  Analysis  of  Orthopaedic  PaEent  LoS  Prior  to  ‘Visual  
Hospital’  ImplementaEon  (02/08)  V’s ...
• Maintaining  the  gains  whilst  spreading  quickly
• Reducing  bed  base
• Keeping  staff  on  board
• Resource  to  kee...
Making our Hospitals Work
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Making our Hospitals Work

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tania king - calderdale and huddersfield nhs foundation trust - ls10 - 02.11.10 - pptshown at the Lean Summit 2010 - New Horizons for Lean Thinking on 2/3 November 2010

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Making our Hospitals Work

  1. 1. Making our hospitals work Tania King Service Improvement Manager Lean Summit 2nd November 2010
  2. 2. • 2  hospital  sites  5  miles  apart • Provide  healthcare  for  over  435,000   people • Approx  400  beds  on  each  site • A&E  on  each  site • Medicine/elderly  beds  on  both  sites • Calderdale  Royal  has  only  elecCve   surgery/orthopaedic  beds • In  2007/08  there  were:     110,000  inpaCents,     380,000  out  paCent  aLendances Our  hospitals
  3. 3. • FoundaCon  Trust  since  2006 • Financially  sound • History  of  meeCng  all  targets • Care  Quality  Commission  raCng  of  “good”   BUT…. • A  feeling  of  constant  fire  fighCng  to  manage   daily  admissions  and  achieve  4  hour  target  in   A&E. Our  hospitals
  4. 4. So  what  have  we  done?
  5. 5. • OperaConal  management  of  paCent  flow  hour  by   hour. • Demand  for  beds,  and  capacity  are  visual  and  clear. • Immediate  acCon  can  be  taken  to  fill  empty  beds   thus  leaving  assessment  areas  with  capacity. • We  can  see  at  a  glance  if  paCents  are  off  template  or   outliers  and  repatriate  if  appropriate  and  possible. • Delayed  discharges  can  be  invesCgated  and  acCon   taken  to  move  things  along  (helps  ward  staff  who   don’t  always  have  Cme  for  this). What  is  Visual  Hospital?
  6. 6. Update  (17/10)  -­‐  Analysis  of  Medical  PaEent  LoS  Prior  to  ‘Visual   Hospital’  ImplementaEon  (08/06)  V’s  Post  ImplementaEon Copyright Lean Enterprise Academy Lean Enterprise Academy Bottom Line Results: Mean Medical LoS has reduced by 2 days (24%) from 8.5 days to 6.4 days . The Median Medical LoS has reduced by 1 day (20%) from 5 days to 4 days P-value = 0.000 which means statistically there is a difference
  7. 7. Update  (17/10)  -­‐  Analysis  of  Orthopaedic  PaEent  LoS  Prior  to  ‘Visual   Hospital’  ImplementaEon  (02/08)  V’s  Post  ImplementaEon Copyright Lean Enterprise Academy Lean Enterprise Academy Bottom Line: Mean Emergency Ortho LoS has reduced by 4.2 days (50%) from 8.4 days to 4.2 days. P-value = 0.000 which means statistically there is a difference
  8. 8. • Maintaining  the  gains  whilst  spreading  quickly • Reducing  bed  base • Keeping  staff  on  board • Resource  to  keep  all  this  going  and  move  on  to   the  next  level • Working  with  Social  Services  to  reduce  delays   (parCcularly  packages  of  care)  especially  in   current  financial  climate Challenges

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