Innovation team of the yearBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h1749 (Published 08 April 2015) Cite this as: BMJ 2015;350:h1749
- Nigel Hawkes, freelance journalist, London, UK
Home for lunch
“A lovely doctor told me at seven o’clock this morning I could go home today, and I’m still here at five,” is a complaint that will ring a bell with many a patient. For University College Hospital in London it was one of a number of complaints made about delays on the day of discharge that helped prompt a new approach.
The project, called Home for Lunch, began with orthopaedic consultant Sam Oussedik’s unhappiness over delays to elective operations because no beds on a ward were available. Tara Donnelly, director of quality, efficiency, and productivity at UCLH, explains. “You can’t generally start an elective operation until a bed has been identified as available for that patient. You can have a full team ready to go, the patient prepared, and then you have to wait. It’s a huge waste of prime operating time.”
This could be avoided by making sure patients ready for discharge leave earlier in the day, but arranging that isn’t straightforward. The answer found at UCLH was to hold a daily meeting of a large team—doctors, therapists, pharmacists, nurses, and others—every day at 2 pm, for a quarter of an hour. At this meeting patients ready for discharge the next day are identified, and doctors encouraged to get on with prescribing the medicines they will need to take away with them, since the biggest delay identified was patients waiting for the pharmacy to deliver their pills.
The scheme reduced operating delays to zero, cut costs for …