1. Seaton Hospital Pursuing Perfection Discharge Project Pursuing Perfection means raising standards to ensure patients have the right care at the right time in the right place. Discharge pathway

2. Discharge planning and the results How we reduced the length of stay. How this increased the number of admissions. How this created capacity. How this impacted on other hospitals. The advantages and disadvantages. The future.

3. Whole systems Community Community Hospital Acute Hospital

4. Community Hospitals N&E Devon has 18 community hospitals, of which : Exeter has 2 community hospitals North Devon has 5 community hospitals Mid-Devon has 4 community hospitals East Devon has 7 community hospitals (Seaton is one of these 7 community hospitals serving a local population of just over 13,300). Seaton Hospital has 28 beds

5. Discharge planning process Goal setting by discharge team – ie, what we plan to achieve and by when. (Team; physiotherapist/ social worker/OT/Ward staff) - Take account of admission form - Knowledge of home circumstances

6. Planning the pathway The plan is based on : How long it will take for certain goals to be achieved. Who will do what tasks. We then set an estimated discharge date and discuss with the patient.

7. Review of the pathway The discharge process is reviewed daily by the team. Reviewing means we are constantly taking into account of the clinical planning process. Involving the GP.

8. Doing well with predicting discharge (42 patients)

9. Reducing length of stay at Seaton Hospital (Excludes transfers to RD&E and deaths)

10. Improving the flow of patients through Seaton Community Hospital

11. Admissions to Seaton Hospital since the start of the project

12. Improving the flow of patients (admissions to Seaton Hospital)

14. Discharges from Seaton Hospital

15. A faster pace of turnover …...problems Outliers (increased no. of outliers) Staff (more work) Patient expectations (wanting to stay longer) GP expectations (re; who decides to discharge ) Culture change (re; shared care)

16. Advantages for the Patient Bed available locally Shorter stay Psychological benefit Motivating environment for the staff Patient involvement in their care

17. Goals for the future Sustainability Roll out to other hospitals Identifying gaps in the community Checks on why discharge was delayed

18. Pursuing Perfection means raising standards to ensure patients have the right care at the right time in the right place.