HDFT DSU

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HDFT DSU

• Brian Withington

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HDFT - DSU

• The situation 2 years ago
• Linda Tunstall improvements and ongoing
  developments
• Introduction of a new service Laparoscopic
  Cholecystectomy

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2004

• Low priority in hospital
• Overspill ward
• Low morale and high sickness rates

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Developments

• New appointments
• DSU project group meetings
• DSU removed from escalation plan
• Increased training of staff
• Increased integration with PAAU

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Delivering Quality and Value in DSU

• Linda Tunstall
• Harrogate and District NHS Foundation Trust

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Background

• PAAU opened 2004
• Reduced bed occupancy and changed culture
• Development of pre-operative assessment
• All General Surgery, ENT, Urology and Gynaecology

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Changing Culture

• DSU the norm-staff accounting
• Day surgery for might haves
• Recognise hours saved in DSU and PAAU- reduces
  cancellations
• Acknowledge patients would rather go home and
  give good explanation
• Closer/partnership working
• Restructure meant introduction of can do
  culture!

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Trust Wide Sign Up

• Trust has a strategic vision at all levels
• Good processes in place
• Good communication collaborative working
• Breaking down boundaries
• Input in theatre lists eg/Day cases go early
• Anaesthetists reviewing protocols and supporting
• Told the surgeons!

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What Next?

• Consider putting all pre-operative assessment
  together with admissions
• Assess patients direct from clinic
• Manage booking and theatre lists
• Utilisation of theatre lists by assessment nurses
• Learn lessons from current trial

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What Next ? cont

• Expanding basket to BADS Directory
• Pressure on specialities not complying
• Multi-skilling of DSU
• Flexing capacity in DSU
• Extending CAT Team to Surgery
• Sharing success internally and externally

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What does all this achieve?