Nurses Day! - Birmingham Children's Hospital

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Listening to Patients and Families: Tertiary Inpatient Referrals
When a child or young person needs to come to
BCH for urgent inpatient care from home or from
another hospital, it’s important that their admission
is not delayed as this could have a negative impact
on their care. In 2010/11 we decided to make sure
delays did not happen and put processes in place
to meet our goal.
Figure 10: Number of patients not offered a BCH bed within 24 hours 2010/11 - 2012/13
GOAL:
all children
referred for
urgent inpatient
care will be
admitted
within 24
hours
MEASURE:
number of children
per month not offered
a bed within 24 hours
of urgent referral
30
25
20
15
10
5
2010 - 11
2011 - 12
2012 - 13
Listening to Patients and Families: Cancelled Operations
Patients, families and staff have told us that when
an operation has to be cancelled by the hospital
this can have a huge impact. It might mean travel
arrangements and time off school and work have to
be rearranged and could also mean that tests and
assessments have to be done again. We know this
can be very stressful and inconvenient.
There are times when we can’t avoid cancelling
operations because of emergencies like transplants
which can’t wait, or when another operation is more
complex than expected, so it takes longer than
planned. Sometimes an operation can’t go ahead
because there aren’t enough beds that day on PICU
to care for the patient after the operation.
Over the last few years we have been working hard
to try to reduce the number of operations that we
cancel, especially those that we cancel on the actual
day. At the same time we have been finding ways to
make the experience better for patients and families
when we can’t avoid cancelling their operation.
0
A M J J A S O N D J F M
Figure 11: Monthly cancelled operations 2010/11 - 2012/13
How have we done?
With more people than ever before wanting
to access our services, 2012/13 was a really
challenging year and our staff had to work very
hard to meet our goal.
What are we doing to improve?
Meeting our goal while demand for our services
increases means we need to increase the capacity
in our hospital. This does not necessarily mean
creating physical space for more beds. It’s also
important that we find ways of reducing the time
that people need to spend in hospital, and the
number of times they need to be admitted, so that
more beds are available. Some examples of what
we are doing to achieve this are:
l Developing services like Hospital @ Home so
some children can be discharged earlier
l Improving discharge processes so that once a
child is ready to be discharged this happens
much quicker
l Developing our outpatient services so that
children with long-term conditions like Diabetes
and Asthma are less likely to deteriorate and
need admission to hospital
l Improving flow through the hospital so that
people can get into wards quicker and can be
discharged earlier
l Establishing new services like our Paediatric
Assessment Clinical Intervention and Education
(PACE) team (see page 99) which supports high
dependency patients on wards and allows earlier
access to PICU for children and young people
who need it.
Other examples can be found on page 99 in the
section about cancelled operations.
GOAL:
no more
than 0.8% of
operations
cancelled
on the day
MEASURE:
number of operations
cancelled on the day
per month
60
50
40
30
20
10
How have we done?
We have not met our target, with 1.68% of
operations cancelled on the day. We have been
experiencing our highest ever activity levels, which
has put pressure on our theatres, PICU and wards,
and we were therefore unable to meet our goal
in 2012/13. Opening our new PICU extension in
November 2012 helped us improve, and in January
2013 we launched our new (PACE) team which
frees up more beds for our sickest children when
they have had an operation.
0
A M J J A S O N D J F M
Whoever told us was
very nice, supportive, and
apologetic.
98 99
You learn to understand that
emergencies come first. You put
everything back into perspective a
little while afterwards but at the time
we were really upset.
2010 - 11
2011 - 12
2012 - 13
When you’ve been told how
important it is to get the
operation done you start to
get really worried that it’s not
happening and you get more
and more worried that she
will be getting worse.