INTEGRATED DISCHARGE TEAM

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INTEGRATED DISCHARGE TEAM

• Rehabilitation Assessment Directorate
• Acute Hospitals Division

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Working in partnership with
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(No Transcript)
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Why an Integrated Team?

• Provides a visible structure with clear aims and
  objectives across all agencies.
• Brings together and builds on existing knowledge
  and expertise which promotes effective joint
  working.
• Reduces barriers between organisations and
  agencies.
• Promotes collective ownership of service and
  performance
• Encourages and embraces innovation.

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Our aims?

• Provide a whole systems approach to Discharge
  Management for all patient groups within Glasgow
  Acute Hospitals.
• The Integrated structure ensures smooth , safe
  and seamless patient journeys, minimising gaps
  and delays and providing clarity of roles within
  the single team framework.
• Improve and monitor performance across the raft
  of discharge activity (including the reduction in
  delayed discharge) and to set agreed joint
  performance targets within the team framework.
• Streamline and strengthen links across the
  internal and external discharge network.
• Provide a significant contribution to overall
  joint service planning and development within
  current agendas.
• Further develop policy and practice for the whole
  range of discharge activities which will be fully
  inclusive to all patient groups.

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Our challenges ?

• Reduce delayed discharges in line with current
  Scottish Executive targets.
• Manage Acute admissions and patient flow in line
  with current Unscheduled Care Collaborative
  (UCC).
• Engage with Community Health Care Partnerships
  (CHP/CHCPs) to deliver a consistent approach to
  admission discharge service delivery.
• Develop and monitor protocols for sharing of
  information and create a single framework of data
  collection, collation and analysis of discharge
  information (including delayed discharge) that
  can be shared with all partners with resultant
  action plans.
• Develop patient, carer and staff information
  which assists and advises on all aspects of the
  discharge process. Monitor and meet best practice
  guidelines i.e. SIGN and NHS Quality Improvement
  Scotland.
• Monitor and manage Choice of accommodation on
  discharge from Hospital process.
• Working across different organisations

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Key to our success?

• The Team (willing, enthusiastic, flexible,
  innovative).
• Talking
• Knowledge and understanding of partner
  organisations.
• Promoting evidence of best practice through
  audit education
• Blurring of roles that reduce duplication,
  particularly in assessment process.
• Senior management support.

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Work in progress

• Pan Glasgow approach within new structures.
• Promoting effective multi-disciplinary working
  at ward level within acute settings.
• Continual quality improvement of Discharge
  planning.
• Moving nearer the front door!
• Unscheduled Care Collaborative (UCC)