SAFER-f Patient Flow Medicine Bundle

MRPs will:

• Complete an initial assessment for newly admitted patients within first 24 hours.
• Include inter-disciplinary team members.
• Include frailty, mobility and delirium assessment tools.
• Ensure assessment findings are understood, documented and accessible to all unit team members.

Rounds are crucial to decision-making and care coordination.

• Should add value, leading to clear actions, written up in notes and acted upon
• Should be undertaken daily, in the early morning, to enable teams rapidly to assess the progress of every patient in every bed
• Patients and their Essential Care Partners should be informed of progress, and any delays to treatment or discharge be addressed
• Use checklists to reduce variation and prevent actions being omitted
• Always include a qualified nurse, other members of the IDT, including therapists and community staff, and involve the patient and / or their family from the outset
• Use a ‘dedicated member of staff’ to lead on the management of ward patients
• Let specialty colleagues focus on elective and other activities
• Complete most tasks (e.g. writing take-home medications (TTOs) or ordering tests) while in rounds, if possible, to avoid overloading junior staff, batching tasks and creating delays
• A second afternoon board round is best practice to review progress
• Consider use of the SHOP method to facilitate order of patient rounding