Ten steps to implementing criteria-led discharge

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Steps that your multidisciplinary team can take to implement criteria-led discharge (CLD) in your service.

  1. Use the NHS Sustainability Model to identify areas to address to safeguard your change in the long term.
  2. Engage with staff when planning criteria-led discharge (CLD), and gain buy-in from an executive sponsor who will be able to help facilitate implementation and remove barriers.
  3. Collect baseline data on metrics such as length of stay, time of discharge, number of weekend discharges and patient satisfaction.
  4. Use our guidance to make sure you have a robust policy and design your CLD ‘sticker’ for lead clinicians to record the clinical criteria for discharge (CCD).
  5. Train multidisciplinary team (MDT) staff conducting CLD. This will increase their confidence and reassure lead clinicians of their competence in the process.
  6. Start small! Introduce CLD on one ward or even for one patient, reflect on how the process went, tweak it and try again (see the quality improvement section in our guide for information on plan, do, study, act cycles).
  7. Maintain good communication with staff and address concerns as they arise.
  8. Keep collecting data and plot the dots in a run chart. Once you have 25 data points, put them into a statistical process control (SPC) chart for a more insightful look into your improvements.
  9. Spread CLD to other areas, little by little, using your data and the story of your improvements to get others on board.
  10. Celebrate your successes and keep the momentum going. Tell us and others about your project and spread the word of CLD.

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