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Using the SAFER principles to manage hospital flow

What does SAFER stand for?

SAFER stands for Seen, Aim, Flow, Early Discharge and Recovery. 

 

Seen

Seen before midday.

Key staff questions:

  • Clear actions and accountability with a timeframe?
  • Patient waiting for a diagnostic/treatment? Can this happen today, if not, why not?
  • Is the patient clinically optimised for discharge or transfer?
  • A senior support structure in place for escalation.

Aim

What matters to me?

Key patient questions:

  • What do you think is wrong with me? (Diagnosis)
  • What is going to happen to me today? (Tests, interventions etc.)
  • What is needed to get me home and is there anything I can do to help? (Clinical criteria for discharge and recover plan.)
  • When can I go home? (Estimated Date of Discharge EDD) Patient, family, carers involved in care planning.

Flow

Right bed first time.

Prepare for early morning transfer to wards.

  • Front door, can admission be avoided?
  • All patients on correct D2RA pathway?
  • Identification of patients requiring supported discharges.
  • Review discharges daily.
  • Are tomorrow's discharges planned?
  • Patients discharged at earliest opportunity. Each day a green day.
Early discharge

Home for lunch / ASAP

Ward battle rhythm set?

  • Prioritise patients being discharged today.
  • Pharmacy to be on board round to review medications.
  • Link with family, friends, carers to arrange transport.
  • Key/key code available.
  • Book patient transport service if no alternative.
  • Identify clear actions and accountability with a timeframe to avoid delays.
Recovery

What matters to me?

  • Discussion with patient on recovery goals and expectations and plan updated regularly?

Can they go home?

  • Stakeholder communication: Think GPs, district nursing, third sector, community services, social workers.
  • Right support for recovery? Think AHP, social worker, carer and volunteer support.

 

SAFER Enablers:

 

 

 

Rydym yn croesawu gohebiaeth a galwadau ffôn yn y Gymraeg neu'r Saesneg. Atebir gohebiaeth Gymraeg yn y Gymraeg, ac ni fydd hyn yn arwain at oedi. Mae’r dudalen hon ar gael yn Gymraeg drwy bwyso’r botwm ar y dde ar frig y dudalen.

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