Case Studies

Reducing length of stay and helping patients get home more quickly

Added 02/09/2007


Acute services at a large community hospital with just under 100 beds were coming under pressure as a result of increasing emergency admissions and high numbers of delayed transfers of care. Patients were not receiving the best possible service as a result.
The situation began to attract negative coverage in the media and intense scrutiny from local politicians and needed addressing as matter of urgency. Coupled with this, the provider faced the additional challenge of making a significant cost improvement saving of £3m.
Sustain was called in to help dramatically increase the hospital’s productivity while simultaneously reducing its expenditure.

Key challenges
It became clear relatively early that a lack of integration between community services and social care was having a huge impact on the efficiency of the community hospital. As a result, the average length of stay was running at 31 days.
In addition to this, the constant media and political attention was placing staff under increasing strain. Coupled with pressure from the acute trust and PCT to make short term decisions which would reduce delayed transfers of care, morale among staff was low.
The management team at the hospital was also relatively new, having only worked together for six months. As a result, one of Sustain’s first tasks was to strengthen these relationships to help successfully drive the project.

Main actions

To tackle the problems faced by the hospital, Sustain put together a structured team with the appropriate skills to manage such a complex and multi-faceted project. By bringing in senior PCT staff and working closely with key stakeholders such as social services, we ensured buy-in from across the healthcare spectrum as we developed practical solutions to increase the productivity of the unit.
We used established project management tools and principles to structure the turnaround. We delivered rapid training to the management team, which was then given responsibility for providing additional education for ward staff. This gave them the additional skills required to improve the flow of patients through the health system.
In addition, Sustain proactively tackled the reputation issues faced by the hospital by coordinating and delivering face-to-face engagement with local politicians

Outcomes and achievements
Sustain’s carefully-managed approach to tackling the problems faced by the community hospital helped reduce length of stay to 19 days – a 38% improvement. As a direct result of this success, we secured funding to carry out further work with GPs on preventing future unnecessary admissions in the future.
This gave us the opportunity to revise the care pathway so that patients could be discharged from a hospital environment back to the comfort of their own homes more quickly. The change led to a significant increase in activity among community outreach teams, in turn reducing demand for inpatient beds and allowing the hospital to reduce its bed count by 30. All of this was achieved with the support of local politicians.
The savings made by reducing the beds, taken alongside an increase in income, helped the hospital to deliver its ambitious cost improvement plan of £3m.

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