Bed Management

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Bed Management

• Paul Labourne
• Deputy Director of Nursing

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Powys Local Health Board

• 10 Community Hospitals
• 293 Generic beds Consultant or GP
• 43 EMI beds
• 28 AMI beds
• 10 Psychiatric Rehabilitation
• 3 LDU beds
• 17 GP Practices
• 540 Registered Nurses
• 265 Health Care Assistants

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Bed Management

• Demand
• Capacity
• Leadership
• Performance Management
• Policy Support
• Future Direction

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Demand

• Demand management
• Chronic Disease Management
• Patient Flows
• Discharge Liaison Nurse
• Unified Assessor Nurse
• Continuing Care Nurse
• Integrated Care Pathways
• Falls Pathway
• End Days of Life
• Catheter Register

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Capacity

• Capacity is our ability to meet Demand
• Capacity is limited by
• Number of beds
• Number of Staff
• Dependency of patients
• Skill mix of staff
• Other factors are
• Bed occupancy
• Length of stay
• Levels of Delayed Transfers

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Leadership

• At each of the 10 Community Hospitals a key
  leadership role has been developed.
• This clinical leader Matron is responsible and
  accountable for the strategic leadership of that
  Hospital its performance and the standard of
  care delivered.
• Having a clearly defined leader has ensured that
  local issues are tackled within a Powys wide
  context.

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Performance Management

• Each Community Hospital has been set performance
  targets that are monitored monthly
• Bed occupancy rates 85-90
• Reduction in the average length of stay 18 days
• Reduction in DTOC 1 per site Max 14 per LHB
• The Matrons at each Community Hospitals are
  looking at ways they can achieve these targets

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Policy Support

• Admission Policy
• Audited admission standards
• Discharge Policy
• Audited discharge standards
• Bed Management Policy
• Internal transfer/repatriation
• 17 GP practices NGMS Consultant beds
• Escalation Policy
• Internal between Community Hospitals/Shires/Powys
• External interface with 5 main DGHs

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Future Developments

• Chronic Disease management, Complex Care Managers
• Further pathways local/interface/patient flows
• Admission routes to Community Hospitals
• Potentials NGMS
• OoHs Primary Care Provider
• DGH Direct access from AE/AAU
• Bed utilisation, predictive bed management