Yes, there are many problems "downstream" from our departments, but it's
this area of culture that's hardest to change. We've also highlighted
delayed discharges due to shortage of imaging slots for inpatients, so we've
directed funds towards enhancing this area rather than towards the ED x-ray
department; just one example of improving our use of beds rather than simply
creating more. Expediting dispensing of TTOs is another example; many units
are now getting nurses to do this rather than doctors, but the smarter ones
are getting pharmacists to do it. And an earlier discharge, even by a few
hours, allows an earlier admission from the ED. The more you look into these
areas, the more you begin to see innovative solutions.
But there remain many examples of bad practice with respect to discharge
planning as Phil has just highlighted (and we ought to think of near-patient
testing on the MAU, for example, and not just in the ED). But fixing these
problems requires breaking down traditional barriers and changing cultures,
it's not rocket science but it can be damned difficult in the conservative
environment that health care is steeped in today. And very few changes are
completely resource neutral.
But if it wasn't for these targets, we wouldn't have any funding or backing
to help us reach them. I welcome the targets as long as we're supported to
reach them and as long as we can find our own solutions to our local
problems, rather than having someone else's solutions imposed upon us.
Adrian Fogarty
> I hope Adrian F approves of the spelling and punctuation
Only one or two missing apostrophes and spelling mistakes, but I'll live...!
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