105 Beyond the Bleep: Exploring Alternate Methods of Communication in the Multidisciplinary Team to Facilitate Efficient Discharge

Introduction On the surface discharging a patient seems a simple a simple process, but delays due to coordination and communication in preparing medication, transport and discharge summaries are all to common. This results in delayed discharge, which is unfair on patients and their families, adds to the risk of hospital acquired infection and increases NHS expenditure and bed pressures. This quality improvement project investigates alternate systems for coordinating this process to make it more efficient and easier for the relevant stakeholders, with the added advantage of being “bleep free” as is the Health Secretary’s target for 2021. Method We started with process mapping and summarising the challenges faced by stakeholders in the current system, which uses bleeps for communication across six older people medical wards and ten medical teams. We progressed to iterative PDSA cycles using Medxnote for one medical team across all wards and then Microsoft Teams on one ward with ten medical teams. New process maps for each were created and circulated to stakeholders to explain the roles and responsibilities of each team. Results Both Medxnote and Microsoft teams subjectively made communication easier. However, Medxnote was hampered by the inability to have a three-person conversation and the required use of personal phones. Microsoft teams overcame these obstacles and was able to demonstrate objective improvements with a 42% increase in medication screened before 1 pm and 72% increase in medications prepared on the day of discharge, suggesting better prioritisation. Team feedback was that it decreased workload, made team members more accessible and minimised interruptions to working day. Conclusions The initial PDSA cycle suggests Microsoft teams is a promising tool for improving the discharge process and aiding bleep free communication amongst members of the multidisciplinary team. The next step will be a trial across all wards with all teams.