The Patient Flow Improvement Programme (PFIP)

The Patient Flow Improvement Programme (PFIP) launched in July 2022 with a clear remit to oversee the hospital led improvement initiatives specific to patient flow. The programme foundations are based upon developing networks to address difficult and complex challenges together, identification and application of good practice and enhanced system resilience.

The Trust recognises the dedication and commitment from all colleagues to provide the best possible care for our patients, the patient flow improvement programme builds on the strengths of our teams to drive change and deliver the improvements that we all believe are important to enhance patient experience and outcomes, and staff wellbeing. Through effective teamworking, centred around respect, civility and trust we will move forward together and succeed together.

The PFIP workstreams have been benchmarked utilising the Getting it Right First Time (GIRFT) Summary Emergency Department Indicator Table (SEDIT) and a review of national best practice in order to focus our efforts on where the greatest improvement opportunities can be achieved. There are five core workstreams:

  • Same day emergency care (SDEC) – the new facility opened on 5 September, our aim is to provide same day care for patients who present at hospital with relevant conditions to be rapidly assessed, diagnosed and treated without being admitted to a ward, and if clinically safe to do so, will go home the same day their care is provided. The secondary benefits of the SDEC model are a release of hospital bed capacity and will be the start of our ambition to reduce system pressures.
  • The ward processes workstream is led by the quality improvement team and focuses upon sustainable improvements. The ward processes workstream aims to deliver a consistent approach to board rounds that will encourage timely MDT conversations. Effective ward processes with open, honest and focused communication will generate priority work lists, prevent duplication and rework and expedite patient care and discharge.
  • We are currently working with eight wards across the IMPF, SACCT and Tertiary divisions at BVH, plus all wards at Clifton Hospital with the support of ECIST. We are engaging with staff through key forums (eg ward managers, junior doctors, clinical leaders, AHP forums) as we have an ambitious plan to include all wards in the QI project throughout the year.
  • The frailty expansion will see the current frailty model go from strength to strength, working closely with the established and highly skilled multi-disciplinary team to expand the workforce to meet the growing needs of our patients and to develop the ‘end to end pathway’ to support our patients to maintain their independence.
  • Our medical leaders are working together to update the trust medical operational standards.  The standards will promote safe, effective and timely care. The medical operational standards will be a clear, unambiguous description of the core standards expected from all clinical staff and centered on patient care.
  • The virtual care workstream will implement virtual wards through new staffing models and clinical pathways within Respiratory, Care of the Elderly, Palliative and EOL Care and Cardiac.  They will ensure that patients who previously would have been admitted to hospital are able to receive care in their home, facilitate safe and timely discharge and avoid admission where possible.

We can all be leaders for change, and we are keen to hear from all colleagues who would like to learn more about the programme, please contact Natalie Rixon, Urgent and Emergency Care Programme Director: for further detail. We also plan to provide regular updates through the bulletin and are developing our SharePoint page.

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