Table 4

Summary of strategies for change and lessons learnt during the learning sessions

Cycle noStrategy for changeKey learning from the cycle
First learning session
  • Establish hospital flow teams.

  • Implement SAFER bundle.

  • Emergency bed huddle.

  • Improvement in boarding time.

  • Multidisciplinary team review procedure not clear.

  • Slow referrals from inpatient to home care and long-term facilities.

  • Emergency bed huddle procedure not clear.

Second learning session
  • Implement bed utilisation visual management and tracking system.

  • Detail procedure for multidisciplinary review team and emergency bed huddle.

  • Establish pull system for home care and long-term facilities.

  • Further improvement in ED boarding time.

  • Reduction in 30-day outliers.

  • Further improvement in boarding time.

  • Variable fidelity between the hospitals in implementation of the change package.

Third learning session
  • Implement corrective action audits.

  • Some hospitals are still struggling with 30-day outliers.

  • ED, emergency department.