Turning red days into green days

United Kingdom, National Coordinator, Mrs Tracy Lonetto

The presenters were Rikke Gravlev Poulsen, Denmark, Caroline Lancian, Germany, Kerstin Hinz, Sweden, Antonio Garcia Blanco, Spain, Fariza Hassam Habibi, Portugal, Tuija Ikonen, Finland, Gerda Reithofer, Austria and Roman Lewandowski, Poland.

They said that one of the innovations which had impressed them was the red to green improvement process. a visual management system which reduced waste of time. If things which should be done were not done, that was a red day, otherwise it was a green day. For example, if a CT scan was requested for a particular day and was not done on that day, then it was a red day and the reason for that had to be identified. Multidisciplinary bed meetings were held each day focusing on patient needs and on turning “red days into “green days.” The objective was to provide the right patient with the right care at the right time.

The key principles were that patients were seen every day. The day before they were due to be discharged, transport was pre-booked, medicine prescribed. “They focused on solving problems preventing patients getting home and since it was started they have had a reduced length of stay, they have optimised the use of acute beds and in the first year the number of patients n hospital who did not need to be there was reduced by 20%.

The second innovation they presented was on extending the scope of health professionals’ roles and transferring working tasks between different healthcare professionals.   “Some registered nurses, technicians and physiotherapists have trained to become clinical practitioners. They have the experience and training for their new roles, work for a while under supervision and are then accepted by the medical profession to perform their work independently.

“The UK doesn’t have sufficient physicians or nurses and we believe this is a way to improve quality of service and give personnel a way to develop their careers. There are acute nurse practitioners in EDs sharing the workload of junior doctors and providing continuum of care when the junior doctors move on.”