Danish Regions, the Danish Society for Patient Safety, and the TrygFonden Foundation are working together on the The Danish Safe Patient Flow Collaborative. The program runs from January 2014 to December 2015, and is based on internationally recognized and accepted best practices.
Denmark is divided into five regions, which administers the hospitals. Lately the regions have merged small acute care hospitals into bigger hospitals with a higher degree of readiness for emergencies and for patients with multiple diseases at one time.
After the mergers however, some hospitals and patients have experienced crowding and delays in the emergency departments. Safe Patient Flow is about creating safe and cohesive patient treatment using huddles in all departments and a joint bed-meeting at hospital level. Based on the results from 12 acute care hospitals the methods will be spread to all acute care hospitals in Denmark.
Watch this video about Safe Patient Flow:
12 acute care hospitals from the five regions participate in the Danish Safe Patient Flow Collaborative:
- The Capital Region of Denmark: Hvidovre Hospital, Nordsjællands Hospital
- Region Zealand: Køge Hospital, Slagelse Hospital, Holbæk Hospital
- Region of Southern Denmark: Kolding Hospital
- Central Denmark Region: Horsens Hospital, Randers Hospital, Vest Hospital, Midt Hospital
- The North Denmark Region: Vendsyssel Hospital, Thy-Mors Hospital
The hospitals have all formed teams that include a member of the board of directors, leaders at department level and frontline staff from relevant departments. Furthermore, each hospital has a local project manager.
Beside the local work in the 12 hospitals, the program includes learning sessions, webinars, feedback on monthly reports and site visits.
Real Time Demand Capacity
The program provides the health professionals with tools to establish the burning platform, analyse waste, analyze bottlenecks and collect flow data. The methods are inspired by Real Time Demand Capacity Management (RTDC), which has been successfully implemented in numerous hospitals in the U.S.
Real Time Demand Capacity Management is a system based on unit huddles and hospital bed-meetings that on a daily basis collects data from each unit on expected admissions and discharges. The aim is to make the overall operation of the hospital more predictable and safe. By handling discharges on an hourly basis instead of just ‘today’ the hospitals increase their ability to accept new patients during the Day. By adding a measure for predictability of discharges, the units will also improve their ability to predict discharges, which will give the patients going home a better experience.
Methods and Measurements
The collaborative is based on exchange of experiences among the 12 hospitals.
Central theories are queueing theory, Theory of Constraints, relational coordination and organizational learning theories.
The Collaborative is based on the Model for Improvement (MFI), which is a powerful method for accelerating improvements. The MFI is used with success in health care organizations worldwide to improve quality.
The collaborative introduces a systematic and sequenced approach for health professionals to use data to track their improvements.