Innovation Delivers Extraordinary Developments

Delivering improvement support to one of the largest NHS Hospital Trusts in England, with one of the busiest Emergency Departments (E.D.) in the UK.


The Trust’s Emergency Department (E.D.) needed to improve and sustain performance in order to achieve and maintain the government 4 hour treatment target.

The improvements were required quickly and needed to align with an overarching organisation transformation programme.


Facilitate an offsite innovation workshop with the E.D. Team (comprising clinicians, nurses, administration staff and management) to identify challenges, quick wins and longer term solutions.

Develop an innovative approach focused on improving efficiency and achieving best practice across five key focus areas:

  • Role & purpose of ED
  • Relationship with inpatient specialities.
  • Minor injuries.
  • Clinical Decision Unit.(C.D.U.)
  • Teaching and training.

Analyse patient attendees to each of the specialities, to understand key areas of opportunity.

Encourage environmental improvements to support workplace efficiency.

Introduce Point of Care Testing (P.O.C.T.) to reduce pressure on pathology and manage bottlenecks.

Introduction of single point of triage in minor injuries to considerably reduce waiting time, manage variation and improve efficiency.

Create clinical intranet site to aid knowledge transfer, best practice and general communication.


Co-location of GP services within the E.D. unit which significantly reduced demand on ED services.

Development of patient guidelines and protocols which improved clinical safety and collegiality between departments.

Numerous clinical pathways redesign to significantly reduce the number of performance breaches.

Average Length of Stay (A.L.O.S.) reduced by 34% to less than 9 hours in C.D.U.

Government 4 hour target continually overachieved.

Many thanks indeed for your enthusiasm and organisational skills in the initiating of this important project. This improvement in the clinical environment will be of significant benefit to patients and is greatly appreciated by us all.” Consultant Emergency Medicine




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