The SAFER-f patient flow bundle is a combined set of best practices for adult in-patient units to use to prevent unnecessary waiting for patients and improve patient flow. The SAFER-f elements are as follows:
• S = Senior Review. All patients will have a senior (Most Responsible Physician) review before midday by a clinician able to make management and discharge decisions.
• A = All Patients and their families will be involved in setting the Estimated Date of Discharge based on clinical and functional criteria.
• F = Flow of Patients. Flow of patients will commence at the earliest emergency departments to inpatient wards.
• E = Early Discharge. More than 33% of patients will be discharged from inpatient units by midday.
• R = Review. A systematic multi-disciplinary team review, including patients and their families for those with extended lengths of stay (more than 6 days) with a clear “home first” mindset.
• f = Frailty. Frailty is assessed and considered in care/discharge planning.
When undertaken together on a regular basis, these elements or practices will result in the following:
• Better multi-disciplinary collaboration and care coordination
• Support well planned, informed, and timely discharge
• Reduce patient de-conditioning and deterioration
• Enable patients to feel a sense of partnership with clinical staff
• Ensure patients feel they know what is happening with their care
• Reduce health care provider and patient exposure to risks, errors, and omissions
Across Nova Scotia Health, units from each zone are participating in the SAFER-f Quality Collaborative “learning by doing” approach to plan, implement, measure, and adapt processes to allow for successful implementation of the six SAFER-f elements. Lessons learned will be shared with the goal to expand use the SAFER-f Bundle on Nova Scotia Health inpatient units.
