Transforming how we discharge patients
We talked to Ash Halkhoree, head of complex discharge, about the pioneering work his team of 13 has been doing via the virtual wards and how this work started.
Ash and his team have been working closely with Waltham Forest in pioneering the work of the integrated discharge hub at Whipps Cross. Their work has allowed them to accelerate the number of patients being discharged more promptly and safely through the use of virtual wards.
The team has been working with local GP and senior leader, Dr Sheraz Younas since the first Covid wave back in May 2020.
“One of the first things we asked the community services was, can we do something else and bring a patient’s discharge forward? And that’s how the virtual wards started.”
Ash was keen to demonstrate how reducing the patient’s length of stay in a safe but prompt way would mean freeing up a bed for another patient in need.
“Dr Sheraz and his team started to work with my team and we started to proactively go around the wards evaluating and identifying patients who meet the criteria to remain in the hospital and also identifying those that were able to leave earlier and could be monitored remotely and cared for at home.
“The idea was to have a change of culture. If the community GPs are prepared to take on those patients earlier with our support and reassurance, then we can make the virtual wards work more efficiently. The local GPs were very supportive of this and we started working together.
“Once the patient is discharged and at home they continue with medication, the virtual ward will call them to see how they are doing and review their pain level and if the GP needs to see the patient in person they can do,” explains Ash.
Having functional and efficient virtual wards bring a lot of benefits to the patient, hospital and wider community.
“If you can shave off hours or even half a day in the patient journey, we are helping the emergency department to decant. Then there’s also a better flow, the pressure will go down and performance figures can go up”.
Changing the culture
Ash, who has been in the Trust for seven years, was keen to change the culture around discharging patients.
“For me, it was around bringing a change of attitude, thinking how the community can support us and how we can work together in reducing the length of a patient’s stay. If we can reduce their stay that’s the best thing we can do for them, as long as they are healthy enough to go back home and their community.”
“It’s all about integrating the discharging process and working together with the local community and the local GPs.”
"Other boroughs nearby have started asking us to expand our virtual wards, they like what we’ve been doing with the virtual ward.”