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London hospital adopts two patient-friendly initiatives

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Hillingdon Hospital says it is among the first in London to implement two measures aimed at improving inpatient care and ensuring patients are safely discharged at the earliest possible time.

Staff across the Hillingdon Hospitals NHS Foundation Trust are putting into place measures to tackle so-called “PJ Paralysis”, which has been the recent focus of a national campaign on social media.

From now on, staff at the trust in West London will be expected to encourage patients to get out of bed and dressed during the day.

Ward staff will also help patients to sit up for meals in their armchair or on the edge of their bed, to take walks around the ward and to do gentle exercise if possible – even if seated.

The trust cited research showing that 10 days of bed rest for someone over 65 years old could lead to 10% loss of aerobic capacity and 14% loss of muscle strength.

In addition, a Red2Green protocol has been introduced this week on four wards at the trust’s main site on Pield Heath Road, with all wards scheduled to have adopted the measure by the autumn.

Hillingdon Hospitals NHS Foundation Trust

London hospital adopts two patient-friendly initiatives

Professor Brian Dolan (second left) meeting staff – some in their pyjamas – during a tour of Hillingdon Hospital as part of the launch day of its #endpjparalysis and #red2green initiatives

Under the protocol, patients will be discharged to their home or to onward care through a series of “green days” – when acute care is required, or when a patient receives an intervention or when all planned procedures are delivered.

Conversely, “red days” are deemed to be when planned interventions do not take place or the patient is no longer in need of acute care, but is otherwise stalled in their “care journey”.

At Hillingdon, senior managers will act as Patient Champions, helping to remove any obstacles and smoothing progress toward discharge, such as driving liaison with local social services.

Dr Michele Cruwys, the trust’s divisional director of medicine, rehabilitation and emergency care, noted that unnecessary delays in the discharge process were “frustrating”.

“Red2Green will enable us to understand for the individual patient and the organisation where these delays are, so that we can make sustainable changes to ensure that each and every patient has the most appropriate care pathway,” she said.

The trust was visited earlier this week by Professor Brian Dolan, the nursing academic who pioneered the #endPJparalysis twitter campaign. He addressed staff at Hillingdon on 7 August as the new initiatives were rolled out.

During a tour of some of the hospital’s wards, Professor Dolan commended staff on their “genuine desire to make things better for patients”.

“I’ve seen people who want to make it better and are passionate about care and who have a respect for each other and for their patients, and the way they speak about, to and of, patients, speaks volumes about Hillingdon,” he said.

The implementation and effectiveness of both initiatives will be closely monitored by a team of trust staff and the results fed back to its board.

Red2Green protocol

Red Day defined:

  • A planned diagnostics is not undertaken as requested
  • A planned therapy intervention does not occur
  • Medical management plans are not reflective of interventions and required outcomes to progress the patient’s pathway of care
  • The patient no longer requires an acute level of care
  • A Red Day is of no value to a patient

Green Day defined:

  • A patient receives an intervention that supports their pathway of care through to discharge
  • All that is planned or requested took place on the day that it was requested, equalling a positive experience for the patient
  • A day when the patient requires an acute level of care
  • A Green Day is a day of value to a patient

 

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