Enter and view: Calderdale Royal Hospital's discharge areas
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Healthwatch Kirklees and Healthwatch Calderdale undertook an enter and view visit of the discharge areas at Calderdale Royal Hospital as their data shows that discharge from hospital can often be a negative experience for people. They are currently engaging with people about their experience of intermediate care and reablement services following discharge from hospital, so this Enter & View visit supports this work. They visited on three separate occasions during the period 11 - 18 June 2024. Overall, they engaged with 22 patients, 1 relative, and 17 staff members; 40 people in total.
The Enter & View visits revealed a number of insights into the discharge process, patient experience, and the overall environment of the wards visited. Ward 2, the Medical Assessment Unit, often felt chaotic due to high traffic and noise levels. Patients experienced discomfort with the noise, especially at night, and the discharge holding areas were not very private. Ward 6 had a slightly calmer atmosphere but was cluttered with equipment. In both wards, there were delays and inconsistencies in the discharge process, leading to patient frustration.
The Medical Same Day Emergency Care (MSDEC) unit provided a more calm and organised environment, but patients sometimes felt reluctant to leave the waiting area for food or drinks, fearing they might miss their call to be seen and discharged. Delays in discharge from this area tend to arise when there is a shortage of doctors to review tests and scan results.
Overall, the areas being used for discharge do not feel fit for purpose. This is not just concerning in terms of the physical aspects of the areas, but the potential impact on patients’ emotions, as they may be anxious about their discharge and next steps.
All wards were generally clean, well-maintained, and equipped with necessary infection control measures. Staff were observed to be professional, caring, and committed to patient care.
Discharge is often more problematic than it should be at this hospital due to the lack of a designated discharge lounge. Without this type of ‘hub’, discharge can feel chaotic and uncoordinated. Patients are sat in holding areas which are little more than a hospital corridor with chairs, often in high-traffic areas, which is not conducive to comfort and good patient safety.
Patients want better information about the timing of their discharge. They are sometimes not given an accurate picture of what needs to happen before they can be discharged from hospital, so end up frustrated by long waiting times.
Staff commented on the pressure they often feel to discharge patients quickly which they say can compromise patient safety at times. It’s clear that complex discharges, for example where patients require a social care package, medication and transport, are incredibly time-consuming. These discharges are more challenging when new, inexperienced staff have this task and when a discharge co-ordinator and ward clerk are not available to support with the process.
Delays in providing medication in a timely way can cause significant delays to the discharge process which is frustrating for staff and patients.
The recommendations highlight several areas for improvement around the discharge process and patient communication.