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

1. Making our hospitals work
Tania King
Service Improvement
Manager
Lean Summit
2nd November 2010

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. • 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. So what have we done?

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. 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. 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

9. • 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