New discharge planning project aims to reduce lengths of stay

Branwell Ward, Cygnet Hospital Wyke’s acute inpatient service for men, is running a six month pilot project with the aim of offering service users and customers a planned and predictable date of discharge or transfer. This is being done by utilising a robust process of discharge planning called Planning Appropriate Discharges (PAD).

PAD is based around the “IDEAL” discharge planning, DOH guidelines (2010), ten step discharge planning process and the Achieving Timely Simple Discharge toolkit (2004). This approach also embodies the Plan for Every Patient (PfEP) currently being used as an operational management tool within the NHS.

Branwell Ward works with a variety of different NHS Trusts. With this in mind, there is a real need to offer a consistent approach in terms of effective discharge planning and utilisation of all services available with an agreed threshold, for Intensive Home Treatment as an appropriate alternative to continued or prolonged admissions to hospital.

PAD will provide a robust method for ensuring tasks are completed by allowing multidisciplinary staff to agree an appropriate plan for discharge. Each service user has a predicted date of discharge established as early in their admission as is possible with a plan of actions required in order to meet this deadline.

It is suggested that the granting of Unescorted Leave (UL) is a consistent feature of a service user’s journey through hospital, and it is only granted when considerable thought has gone into the service user’s engagement with treatment plans and risk management plans. We have agreed that the granting of ‘Unescorted Leave’ (UL) should be considered the ‘threshold’ where the possibility of home treatment should be actively considered.

“Since the commencement of this pilot the activity in terms of throughput has increased dramatically with service users returning to the care of their home teams in a timely manner. This has allowed Branwell Ward to offer our customers bed capacity when it is most needed. Over the last year the ward has had an average length of stay of 21.5 days. We hope that this new pilot project will help reduce lengths of stay even further.”Paul Donaldson, Branwell Ward Manager

An essential element to the success of this project will be the maintenance of effective communications with our Home Teams. Branwell has approached a number of the home teams requesting their referral criteria for IHTT input in order to effectively utilise these services.

The documentation Branwell Ward uses, such as weekly reviews, discharge plans/checklists and data collection methods in terms of maintaining the predicted discharge date and follow up arrangements, have essentially become live documents enabling staff to have a clear picture as to the progress of each service user.

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