Cadinouche Azad, Chitewe Auzewell, Khan Kehkashan, Lamin Sylvester, Ratneswaran Kajanesh, Shah Amar, Aurelio Marco
East London NHS Foundation Trust, London, UK.
BMJ Open Qual. 2017 Nov 8;6(2):e000160. doi: 10.1136/bmjoq-2017-000160. eCollection 2017.
A quality improvement project was initiated on Ivory ward, a functional older adult psychiatric inpatient ward at Newham Centre for Mental Health, part of the East London NHS Foundation Trust. The project was started by staff on the ward after it had come to their attention that their ward had the highest bed occupancy and length of stay across similar wards in the trust. The mean bed occupancy in the 9 months before the project started was 87.7%. The mean length of stay on the ward in the 9 months before the project started was 70 days. The team used the model for improvement, which is the trust's methodology of choice for quality improvement projects, to reduce bed occupancy and length of stay. The focus was on running small-scale tests of change to see whether these could lead to improvement. These change ideas were refined, scaled up or discontinued as appropriate to help achieve the aim. The project's aim was to promote quality of care by reducing patient length of stay on Ivory ward to 45 days and bed occupancy to ≤70% or by 1 January 2016. The project team managed to reduce bed occupancy to 58% and length of stay to an average of 35 days.
在东伦敦国民保健服务基金会信托基金旗下纽汉姆心理健康中心的一个功能性老年精神科住院病房——象牙病房，发起了一项质量改进项目。该项目由病房工作人员发起，此前他们注意到，在信托基金内类似病房中，他们的病房床位占用率和住院时间最长。项目启动前9个月的平均床位占用率为87.7%。项目启动前9个月该病房的平均住院时间为70天。该团队采用改进模型（这是信托基金在质量改进项目中首选的方法）来降低床位占用率和住院时间。重点是进行小规模的变革测试，以查看这些测试是否能带来改进。这些变革想法会根据需要进行完善、扩大规模或终止，以帮助实现目标。该项目的目标是到2016年1月1日，将象牙病房的患者住院时间缩短至45天，床位占用率降至≤70%，从而提高护理质量。项目团队成功将床位占用率降至58%，住院时间平均缩短至35天。
