944 Outliers: The Forgotten Patients

Aim It was recognized that surgical wards often have a large number of patients outlied to them. Unfortunately, it was also noted that they often were not regularly seen and so had no daily medical plan. Evidence shows outliers have: The aim was to develop a means of increasing outlier reviews, plans and awareness of outlier parent speciality. Method Medical outliers and outliers from other surgical specialties were included looking at how often care plans were updated and if the nurses knew who and how to contact the patient's named consultant/team. Brightly coloured posters were created to highlight the importance of a patient plan and how to escalate a request. Stickers were created for the notes to highlight outliers and their last plan and their named consultant/team. The effect of the interventions was tracked for just under 6 weeks. Results Initial assessment showed care plans were only updated twice a week and nurses were largely unsure who to contact for an individual outlier. With the increased awareness the nurses achieved three reviews a week with patient plans. Importantly, during the review period there were no adverse events, and the nurses reported increased confidence in who to approach. Patients were also discharged earlier and not moved to another ward. Conclusions The nurses were empowered, and the patients benefitted from more regular reviews and up to date plans, importantly resulting in fewer adverse events and quicker discharges.