This week Blackpool Teaching Hospitals is participating in the #TeamFyldeCoast improvement week in collaboration with health and care partners across Lancashire and South Cumbria.
The exercise will build on what has been learnt responding to the pandemic, test new ways of working and ensure people have the best possible experience of health and care services.
Today’s focus is on turning Red to Green
We spoke with Lisa Horkin, Divisional Director of Nursing for Integrated Medicine and Patient Flow, who talks in detail about Red Beds and Green Beds.
“Throughout this #TeamFyldeCoast Improvement Week we have looked at the systems and tools which can assist us in ensuring smoother flow and allow patients to arrive at the Discharge Lounge in a safe and caring manner.
“One of the key processes we should be all aware of is Red and Green Bed Days, a valuable visual management system which can assist in the identification of wasted time in a patient’s journey. The basic principle is that ideally, we would like to see fewer Red Days with the aim to move towards our patients having Green Days only.
“A Red Day is when a patient receives little or no value adding acute care. When thinking about this we should consider the following questions –
- Could the care or interventions the patient is receiving today be delivered in a non-acute setting?
- If I saw this patient in out-patients, would their current ‘physiological status’ require emergency admission?
“If the answers are 1. Yes and 2. No, then this is a ‘Red Bed Day’.
“An example of a Green Bed Day is when a patient receives value adding acute care that progresses their move towards discharge. A Green Bed Day is when everything planned or requested gets done and receives care that can only be in an acute hospital bed.
“It is important that at every stage of acute care that the patient has an expectation of what will happen to them during their care at the hospital. Could your patient answer these simple questions?
- Do I know what is wrong with me?
- What will happen next to make me better?
- What do I need to do to get home?
- When should I expect to go home?
“Lack of clarity on any of these four questions can result in delays, with frustration and confusion for the patient.
“Please let’s work together to turn those Red Bed Days to Green Bed Days. You can find out more about the Red to Green system on the NHS Improvement website.”
With much of the focus this week on reducing unnecessary delays, Clinical Head of Patient Flow, Gemma Latham-Geall recalls a patient experience in which it appears that discharge could have been made much sooner.
This Patient Experience is based on conversations Gemma had with the patient and is told from the patient’s point of view.
“I was admitted with increasing shortness of breath and chest pain and I was terrified. The emergency department staff were very friendly but the department was beyond busy, staff running around and doing their best, the waiting room was full of people but I still received excellent care.
“I was given medication to stop the pain and oxygen and was told it was because of my heart, I have a strong family history of heart problems and to say I was terrified at this point is an understatement I really did feel I was going to die. I was eventually moved through to an assessment ward where I was given more medication though a cannula and was told I needed an echo which is a scan of my heart to see what was happening, I was on day 2 starting to feel a lot better. I stayed another night waiting for my scan taking new medication and was moved through to a medical ward.
“By this point I was starting to feel somewhat of a fraud, I looked round the ward and all the patients seemed to look a lot sicker than me and I continued to wait for the scan of my heart and was told by the consultant I couldn’t go home until I’d had it. I waited another day and by this point just wanted to leave, be at home in my own comforts and I would come back for the scan. I asked if this was possible and they told me they would chase the scan today and I would probably have it, I was told this all day so I waited. The scan never happened so I asked if I could go and they said my medication would need prescribing to take home and it was then after 5pm so they wouldn’t be able to arrange my medication so would have to wait another night.
“The day after I was finally scanned, I then had to wait again for this to be reviewed, then I had to wait again for my medication that I had asked for the day before. I waited until nearly 7pm to be told I could go home as I’d had to wait for my medication and then my son collected me.
“I can’t help but think my stay was a lot longer than it needed to be. I also can’t stop thinking about all the staff that are working tirelessly with a smile on their face when I could have been one less person for them to keep, if my scan had been sooner and if they had let me go home to wait for the scan which I would have preferred to do. I have since found out you have a discharge lounge and I wasn’t sent there, I could have been off the ward letting a patient come up off the corridor in the Emergency Department. The nursing care was second to none, but surely I could have left sooner?”