The “Flying Squad” – saving over 700 inpatient bed days by facilitating discharge home: An observational study of a novel, bespoke, allied health hospital-wide initiative at the Royal Melbourne Hospital
Aruska D’Souza1, James Fitzpatrick1, Kate Palmer1, Jane Jolley1, Genevieve Juj1 1The Royal Melbourne Hospital, Parkville, Victoria, Australia
Abstract
Background
The Flying Squad was established in November 2021 as a mechanism to address complex hospital discharges and decrease length of stay. Flying Squad clinicians (Senior Allied Health Professionals) work alongside the multidisciplinary team and employ creative solutions to facilitate discharge. The aim of this study was to evaluate the feasibility (demand, implementation and limited efficacy) of this service.
Method
A prospective, single-site, observational study. Data were collected regarding time to referral, patient barriers to discharge, interventions provided and estimated bed days saved in all patients referred to the Flying Squad at the Royal Melbourne Hospital from February to November 2022. Data were analysed descriptively and are presented as mean (standard deviation) and frequency (%).
Results
Data were collected on 115 participants (aged 64 (18) years, female=69 (60%), length of stay 38 (35) days) who were referred 21 (22) days after admission. Key barriers to discharge included insufficient support at home (n=99, 86%), falls history (n=79, 69%) and cognitive impairment (n=69, 60%). Bespoke interventions to facilitate discharge included home visits with security and medical consultants, complex equipment provision or collection (such as passport retrieval to enable repatriation) and creative problem solving to facilitate rapid, safe home access (such as mowing lawns, installation of temporary ramps and facilitating industrial cleans). It is estimated that 761 bed days were saved.
Discussion
This novel Allied Health initiative is feasible and improves length of stay. Further exploration of readmission rates, cost analysis and interventions to improve timely referral to the Flying Squad is required.
Biography
Dr D’Souza is an early-career researcher and physiotherapist with over 11 years of clinical experience in acute care. She was awarded her PhD in 2023 (Predicting Discharge Destination in Acute General Medicine). Dr D’Souza has published four papers and obtained over $160,000 in competitive grant funding. She currently works as the Allied Health Knowledge and Research Translation lead at the Royal Melbourne Hospital and leads multi-disciplinary projects across allied health that investigate a broad range of important clinical areas including Outcome Measurement in acute, COVID-19, Trauma, LGBTQIA+ Patient Liaison Service, General Medicine and staff digital health capability.