Making sure there is the right care, in the right place, at the right time is at the heart of a project to improve quality at Tonbridge Cottage Hospital.
The aim is to improve patient flow and the quality of hospital discharge – which means making sure there is a smooth and seamless journey for patients and that all of their needs are addressed.
To this end, a new role of flow co-ordinator was created in September 2019. Four band 4 associate practitioners share this role, acting as the co-ordinator once every four weeks.
The role of flow co-ordinator includes attending board rounds, attending multi-disciplinary meetings, being a first contact for patients and their families, making sure there is a timely discharge, making sure patients have necessary medication on discharge and organising patient transport.
It means one person knows all that is going on and there are fewer opportunities for things to be missed and for duplication.
The quality improvement project was the idea of Matron Caroline Essenhigh, supported by assistant practitioners Lucia Morse, Lorraie Brend, Jestina Thomas and Sneha Lalan.
Caroline said: “The new role has seen many benefits, most importantly, a positive discharge experience for patients and increased registered nurse time with patients.
“Re-admission rates and average length of stay were both down in October and November 2019 and this is something we will continue to be monitor.”
As well as making sure discharges are smooth and efficient and that patients have all their needs covered, Caroline also wanted to develop the skills of her team, to empower them and to create a dynamic and vibrant place to work.
She said: “There was a potential issue as existing colleagues were being used for the new role. The team being flexible and enthusiastic is key to making it work.
“The impact of the new role is being measured and monitored. The idea could be rolled out to the trust’s other community hospitals.”
It also supports registered nurses not being interrupted so often. If the role is established at another site within the trust, the amount of nurse interruptions will be recorded, so that improvement can be measured.
Caroline is doing the Kent Community Health Foundation NHS Trust (KCHFT) five-day quality, service improvement and redesign (QSIR) practitioner course. Next she plans to look at an acuity/dependency scoring tool, in view of increasing numbers of patients with cognitive impairment.