Homerton University Hospitals Foundation Trust (HUHFT) provides integrated acute and community services to the very diverse London Borough of Hackney and surrounding communities. Like virtually every acute hospital in the NHS in 2015 the hospital faced a winter crisis as growing demand, constrained costs, and insufficient beds collided. After the winter bed crisis of 2014, the Chief Operating Officer initiated a workshop with a group Consultant Physicians to explore what could be done.
The Tricordant Approach
From a position, where most clinicians saw the hospital’s problems as management’s and the solutions laying with others, the clinically led ‘Enhancing Acute & Emergency Care – Improvement Programme’ was started. The focus was improving medical productivity and patient flow. A series of key process changes were implemented supported by a project manager, underpinned by key metrics, and overseen by the Divisional Management team. Initial improvements led to the winter of 2015 being easier for all, and this gave further impetus for a quality improvement programme which developed into 4 phases, punctuated by a series of facilitated workshops. Over time, the consultants and managers working together, grew in their shared understanding, belief, and capability to improve the system.
The process that Tricordant took us through made a real difference. It kickstarted a transformation and helped us get the systemic changes we needed.
As demand continues to grow, year by year, the improvement programme has significantly reduced length of stay, improved flow, and productivity. This has allowed beds to be closed and resources reinvested in ambulatory care. Clinicians, managers, and patients have all benefitted.