The six steps cover the key priorities for improving flow, offering in-depth guidance and best practice to address:
- Protecting Same Day Emergency Care (SDEC) capacity and function, by ensuring that SDEC units are never bedded, and avoiding using SDEC staff to cope with demand elsewhere in the hospital.
- Best practice for ward rounds and handover, including advice for achieving twice daily review on AMUs, seven days a week.
- Measures for pharmacy services which can help to facilitate discharge.
- Ensuring availability of, and access to, diagnostics for teams in AMU, SDEC and the emergency department (ED).
- A range of measures to optimise the workforce, making best use of all members of the multi-professional team.
- Ensuring the provision of, and access to, Allied Health Professionals (AHPs) and acute frailty services.
The guidance also stresses that any interventions should be supported by the development of a local comprehensive strategy for achieving flow in acute medicine.
Useful links are provided to further reading and supporting documents, such as the Royal College of Physicians’ toolkits for effective handover and for delivering a 12-hour, 7-day consultant presence in Acute Medical Units.
The guide also links in with GIRFT’s recent collaboration with the British Geriatrics Society (BGS) aiming to support hospital teams to improve care of older people living with frailty – another piece of guidance in the ‘six steps’ series, called Six Steps to Better Care for Older People in Acute Hospitals.
"We are aware that one size won’t fit all for AMUs across England, but we have worked with a group of acute physicians from different clinical settings to capture their views and offer the six best possible solutions for managing the acute medical take during the winter months. They may not solve all of the issues that winter demand brings but, if adopted and followed in a comprehensive way, we hope they will help to reduce some of the burden.”
Six to Help Fix for acute medicine forms the basis of GIRFT’s ongoing work focused on medium and long-term strategies to provide consistent high-quality care, improve flow through the hospital and achieve better outcomes.
