‘300 HOURS A WEEK SAVED’ BY PLAN TO CUT AMBULANCE HANDOVER DELAYS
New strategy has impact at Royal Stoke – but ‘still work to do’
HOSPITAL bosses say a scheme to create more space in A&E by moving patients waiting on trolleys to wards is starting to cut ambulance handover delays.
University Hospitals of North Midlands introduced Your Next Patient (YNP) at the end of September as part of efforts to reduce the lengthy waiting times in the emergency department.
The scheme involves patients being moved to ‘risk-assessed spaces’ in already full wards to wait for a bed to become free, which speeds up the flow of patients through A&E.
UHNM board members were also told that in October, YNP had helped reduce ambulance handover delays by a total of 300 hours, while six and eight hour waits had been eliminated.
The board also heard that there had been only one formal complaint from a patient in relation to YNP so far, with no serious incidents.
Chief operating officer Paul Bytheway told the board meeting that YNP, combined with other initiatives, was starting to have an impact on A&E delays, although there was ‘still work to do’.
He said: “What we’ve seen with Your Next Patient is a gradual increase of the number of patients leaving AMU [acute medical unit] and going to the wards, and the number of patients leaving the emergency department for AMU throughout the course of the day. That’s gone from late-20s pre-your Next Patient, to mid-40s or late-30s consistently.
“During October, that has resulted in about 300 hours a week saved on ambulance handovers. That isn’t to say this is solved. But the work we have done has had a significant impact on returning ambulances back to what they should be doing, which is treating patients out in the community.”
In October UHNM rearranged the Royal Stoke’s emergency department, with the creation of eight extra cubicles to support the offload programme.
The hospital also opened a dedicated area aimed at dealing with older patients more quickly so their conditions do not deteriorate.
Mr Bytheway added: “During October – and this isn’t an accolade – we have seen the gradual elimination of eight-hour waits and six-hour waits for ambulances.
“The fact that we’re measuring in terms of those numbers shows you the size of the problem.
“We are now looking at how we eliminate four-hour waits.
“It isn’t just YNP that’s made this happen, it’s a small change in a number of areas, like simple discharges, complex discharges and moving people more quickly.”
During the board meeting NHS campaigner Ian Syme quizzed the trust executives on how UHNM was ensuring the safety of patients sent to wards under the YNP scheme.
He said: “YNP is the continuous flow model, first trialled in the USA. The singular main concern is it results in overcrowding on wards, and increases the workload on the ward’s stretched clinical abilities.
“Overcrowding is universally recognised as increasing mortality and decreasing quality and safety for patients.”
Trust chief executive Tracy Bullock acknowledged these were valid concerns. She said that while YNP was not a ‘silver bullet’ for solving the problems with A&E, it would help reduce risk across the system as a whole.
Ms Bullock said: “Every single ward has been risk-assessed in terms of their ability to take an extra patient, and if so, have they got a space that is appropriate.
“And there are one or two wards that don’t have a space for that, so they won’t be taking a patient.
“What I can say is that no incidents have led to serious harm. However, we know there are patient experience issues as well, so we’re monitoring complaints. And to date, as far as I’m aware, there’s been one complaint.”