Removing barriers to discharge in Burntwood Villas
Our Trust is working together in lots of different ways to provide better care for our patients, ensuring we work on our four key principles - that care:
• Is purposeful
• Avoids crisis
• Is timely and least restrictive
• Is recovery focused
A number of projects across our adult services are working to test ideas on a small scale, and evaluate outcomes and benefits to patients, before making permanent changes to the way we care for our patients.
Burntwood Villas rehabilitation service cares for people who may have spent a long time in inpatient services. It is designed to empower people to live as independently as possible before they rejoin the community.
However, sometimes people spend longer than expected at Burntwood Villas, even when they are clinically ready to do so. This means that our length of stay is longer than it should be, which is restrictive for our patients and does not support them purposefully towards recovery. It also means there is not space for others who need the service.
Sometimes these barriers to discharge are outside our control. But team manager David Denteh was determined to tackle those within his
power. David felt he could improve the way he worked with colleagues each week to assess each patient’s readiness for discharge. He was using two different processes, which could risk inaccuracy and took too long. And the process was carried out by him alone, making it hard for others to use in his absence.
David formed a Quality Improvement working group to help his team work better together, including their use of digital tools - a single system on Rio and no duplication on a spreadsheet. He empowered several colleagues to deputise for him to build resilience and his processes are now more robust, saving him time each week which he can spend with patients instead.
David is also working on changing the way patients are discussed in multidisciplinary team meetings, ensuring that the meeting’s structure sees each member bring and discuss the right information about each patient. The aim of this is to make sure everyone considers the right moment to discharge service users to the next stage of their care, onwards in their recovery journey.
David says that the project has not only helped him discharge three patients in just a few months, but also has helped those who are still in the facility. “We are able to provide better updates to our service users, for example, how their future accommodation is being fixed up ready for them to move in,” David said. “This helps reduce the stress on the patient as they understand where they are with their care.
“Previously we were not talking enough discharge,” David added. “But now, because the MDT is better at keeping each other updated, and we prompt the right questions, we can think more purposefully about the plans for each patient, including the right time for them to rejoin the community.”
Lived Experience Practitioner Marta has been an inpatient several times at the Trust. She said:"Obviously when people need inpatient care, like when they are in crisis, it is important to work with them to make them feel safe, so there are people there to support them. But being on a ward when you are better doesn't help patients, and it's important to help people move to the next stage in their recovery.
"This could be supported accommodation, or another place that can support and manage their balance, and prevent crisis so patients do not have to be readmitted. It's really important to get this support right and discharge patients at the right time to ensure they do not have to return to hospital."
