Transcript Document
Winter planning in Dumfries and Galloway Surge in demand outstrips capacity • Multi agency escalation policy signed off by CHP in 2010. • Fully worked up and tested Flu Pandemic plan • Fully worked up major incident plan • Business Continuity Plans in place Demand for Critical Care exceeds capacity Winter 2010-11 - greater numbers of H1N1 patients requiring ventilation with demand peaking at 2.5 times capacity. • HDU used for additional ventilation capacity. • Consideration being given to expand Non-Invasive Ventilation Capacity within the newly reconfigured respiratory ward The added challenge: reduction of beds in DGRI Oct 2011 • • • • • • Development of a short stay unit for both medical and surgical procedures - opens Sept 2011 Extension 23 hour approach to surgery Introduction of enhanced recovery - major joints, colorectal, # NOF MDT huddles Capacity Management – over 7 day stays flagged and investigated 12 bedded ward closed but available as surge capacity Maintaining patient flow • Criteria led discharge – in place in Orthopaedics • Optimisation of pathways to community beds • Working closely with SAS to maximise ambulance capacity for transfer and discharge Community Teams • Exploring opportunities to extend the working week. • Exploring opportunities to extend the capacity of our Short Term Augmented Response Team (STARS). • Exploring opportunities to work more closely with our social services and social care partners. Detailed analysis – a suite of measures • Length of stay – DGRI – Specialty – CIS • • • • • Health acquired infection Sleepers/ boarders Overall activity Readmissions – 7 days and 28 days 4 hour target Detailed Planning • System watch • Elective admission list available for the capacity managers 2 weeks in advance • Planning meeting 1 week ahead – Capacity Manager – Manager Day Surgery – Waiting list team Patient flow compromised by lack of key staff • Staff Flu Vaccination • Consultant presence for discharges throughout festive period • Community Hospitals fully staffed throughout festive period • 4x4 vehicles available within NHS and OOHs fleet used to transport key staff Norovirus • Maintain focus upon hand washing • 12 bedded ward closed but available as surge capacity • Altered hours for domestic services 8.30 – 16.30 • Clear escalation plan for domestic services • Outbreak team maintain good communication. Service resilience Transport – joint working with Council • NHS transport routes have been shared with Council and input into their electronic navigation system • Bank of drivers within the council pool available to NHS should major staffing difficulties arise • Gritting major routes access routes to hospital facilities will be considered a priority Flow of information is interrupted • KWTT • Be Ready for Winter Campaign supported and enhanced by local communications team • Strong partnership working with all emergency scheme parties ensures early alert of major events, adverse weather warning etc. • Communications team manage internal communication links Heating for DGRI is interrupted • Base load is delivered by Biomass boiler supported by contract with Scottish Gas and oil tanks • Last year Scottish Gas supply interrupted • Oil and woodchip supplies kept topped up.