1. Safer Start 8am Monday 08 th February – 8am Monday 15 February

2. The Need to Change  Challenges in relation to patient flow both within the hospital and across the whole Health and Social Care system.  Fire fighting daily with issues such as high bed occupancy levels, delayed discharges, outliers and long bed waits.  Overcrowding in ED becomes the norm.  Consistently declaring ‘Black’ status This is detrimental to patient safety, quality of care and negatively impacts on the patient experience.

3. The Components of Safer Start Safer Start Reduce Email Traffic and meetings Exec daily walk rounds Twice daily ward rounds Direct patient care only Full External participation Non clinical staff on wards SAFER discharge bundle Command and control Use of SOPs

4. Command and Control: Summary of Gold Actions:

5. Command and Control: Summary of Silver Actions: Task Rotate into Silver Command Lead (in order to chair Silver Command Meetings) Receive Bronze Control Escalations and aim to resolve Be available and present within the Control Room (Ops Room) at the agreed times Make notes of any issues to report back at the scheduled meetings and attend meetings. Assist with the resolution of issues reported where possible to facilitate patient flow.

6. Command and Control: Summary of Bronze/WLO Actions: Task Work with Ward Managers at resolving issues identified at board rounds or reported by wards which are blocking flow. Escalate to the nominated Silver Command any issues that are unable to be resolved at this level Collect KPI data for specified time. Make notes of any issues to report back to Silver in time for the scheduled meetings.

7. Your Role:

9. Structure of the Day: Morning

10. Structure of the Day: Afternoon

11.  Based on the SAFER discharge bundle for each area  Will be reported against at each Silver Command Meeting  Will be added onto Kitbag under a specifically set up for the week to allow us to track performance  Performance against these will determine plans for each CBU for the following day KPIs:

12. SAFER Discharge Bundle (key components): S - Senior Review. Consultant on ward for board handover at 0800 hrs A - Assessment. All patients will have a Planned Discharge Date and management plan within 24 hours of arrival to ward. F - Flow of patients. Wards will commence ‘pull’ the correct patients to their ward before 10am. Pull to beds will occur within 30 mins of declaration. E – Early discharge. Discharge targets commence from 10am and patients should leave ward within 2 hours of decision to discharge made R – Regular review. A systematic review of patients with extended lengths of stay. Review of every patient by Consultant.

13. Questions…..