Making sure patients experience a smooth
journey of care through the hospital and into the community or
Around one in three people attending the
Emergency Department need to be admitted onto a hospital ward, in
addition to the many who are admitted straight onto a ward via
One of our biggest challenges is discharging
patients who no longer need care in a large acute hospital, so we
can make space for those who do.
Since January we have:
1. Introduced electronic white boards
Electronic display boards are now being used in our unscheduled
care wards and departments, including the Emergency
Having key patient information visible in this way is helping
staff to plan the patient journey.
Similar boards will be introduced to other wards and departments
across the Trust by the end of the year.
2. Introduced a new safety check list in the Emergency
We are using a new patient safety check list in the Emergency
Department to help standardise and improve nursing and medical care
while patients are waiting for a decision to be made regarding
either their admission into hospital, transfer to another
healthcare provider or discharge home.
The checklist, endorsed by the West of England Academic Health
Science Network, is a list of tasks to prompt busy staff. It
includes actions such as basic observations and basic nursing and
medical care which needs to be provided to each patient every
3. Asked local people to support us where they
Work is on-going with our health and social care partners, as
well as our colleagues in the local media, to remind local people
of actions they can take to support their local hospital, such as
looking out for elderly friends and relatives, preparing for
leaving hospital, seeking medical help early on and choosing the
most appropriate healthcare option.
4. Increased use of the Discharge Lounges
We are making better use of our Discharge Lounges, as waiting areas which help
to free up beds, so other patients can begin treatment sooner.
The lounge for medical patients is open 8am until 6pm, Monday to
Friday and the surgery lounge is open 7am until 7pm, Monday to
They are a great service that supports patients who are well
enough to leave hospital.
For more information about leaving hospital which can support your
conversations with patients, please visit the Leaving Hospital section of the website.
5. Improved initial nurse assessments in the Emergency
Made changes to the way the team works in the Emergency
Department, to help ensure patients receive an initial assessment
within 15 minutes of arrival.
This helps us to ensure that patients are seen in order of
urgency and are as comfortable as possible while waiting.
Nurses who triage patients within the Emergency Department have
also been given extra training.
A new electronic patient tracking system in the Emergency
Department is also giving staff a clear overview of the department
at a glance, helping to manage the flow of patients and
6. Expanded our ambulatory care service
We've extended the opening hours of our Ambulatory Care and
Triage Unit which is now open 24/7, seven days a week and this
month will be going one step further with Hot Clinics.
The team already assesses, diagnoses, and starts treating and
then discharging patients within 72 hours.
Hot Clinics involve a dedicated consultant visiting patients in
ambulatory care as part of a Hot Clinic, so that decisions can be
made even sooner and fewer patients need to stay overnight.
Ambulatory care helps to reduce pressure on our Emergency
Department and our ward staff, by providing a service for patients
who have arrived via the Emergency Department or have been referred
by their GP for urgent care, yet can be safely treated without
being admitted to a ward.