Abstract
Introduction
The Same Day Emergency Care Older Person’s Unit (SDEC OPU) provides urgent holistic care, complementing acute and community services to deliver comprehensive geriatric assessment. In October 2022, we introduced a new clinical coordinator role with the aim of improving patient flow. Prior to this role existing, one clinician per day was assigned to take referrals alongside reviewing their own patients, without having an overview of the processes and outcomes of the day. The new clinical coordinator role included taking referrals, vetting patients in A&E, assigning tasks to clinicians, leading regular ‘huddles’, reviewing results, preparing notes and discharge letters, and requesting specialty referrals. The role was introduced to reduce the waiting time of patients within the unit and to reduce waste through the Leeds Improvement Method.
Method
Data was analysed from a 13 week period both before and after the role was implemented, with the main focus being patient length of stay. 454 patients from before the clinical coordinator role was introduced, and 360 patients following its introduction were included.
Results
Mean length of stay was calculated at 5hr 11minutes before the role introduction and 4hr 45minutes afterwards. This reduction in length of stay was statistically significant (p=0.015), with a 95% confidence interval where length of stay was reduced between 8 and 43 minutes (p=0.0029). The percentage of patients discharged within 4 hours of arrival was 30.4% before the implementation and 36.7% after it. This was not statistically significant (p=0.0593). The percentage of patients discharged over 7 hours after arrival was 19.8% before the implementation and 13.3% after it. This was statistically significant (p=0.0143).
Conclusion
The introduction of a bespoke clinical coordinator role within SDEC OPU significantly reduced patients’ length of stay. It has also provided leadership to the team, increased efficiency, and improved patient experience.