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This article describes how the introduction of the productive ward programme has empowered one ward team to work collaboratively to introduce sustainable change. This has benefited patients and staff at University Hospitals Coventry and Warwickshire NHS Trust.

Background: Two audits were conducted by a small team of nurses to measure the effectiveness of discharge management and planning in a four-ward orthopaedic and trauma unit. Co-ordinating this process is an important part of the nurse's role, as discharge planning is a vital component of effective bed management. This work focused on changing practice and measuring change, rather than on the effects of length of stay in hospital., Conclusion: The findings showed that some wards were proactive: planning started on admission and patients were given realistic planned discharge dates and a list of probable capabilities. However, discharge planning varied from ward to ward, and there was no shared common practice. Both audits reflect the need to raise the profile of discharge planning and audit, to increase staff co-operation with the planning process.