The document discusses issues with long wait times and late consultant involvement at Calderdale Royal Hospital's emergency department. It found that over 60 minutes of wait time before initial assessment and 10% of patients did not wait. New processes were implemented like early streaming, removing unnecessary steps, and having senior decision makers at the front end. This reduced did not waits to 0.5% and complaints while also reducing patient hours. Challenges included senior staffing levels, hospital-wide flow, resistance to change, and escalating and addressing problems.

1. Dr Paul Jarvis
Calderdale Royal Hospital

2.  >60 mins wait before initial assessment
 10% of patient Did not wait
 High number of complaints
 Last minute decision making
 Late consultant involvement

3.  What we thought was not true!
 11am busiest time of day not 6pm
 Takt time 6.5 mins

4.  Early streaming
 Remove unnecessary steps
 Remove/reduce waiting
 Senior decision maker at front end

5.  Did not waits drop from 10% to 0.5%
 Complaints down
 9-5 sees a reduction of 40 patient hours

6.  Senior staff numbers
 Flow in the rest of the hospital
 Resistance to change
 Escalation and action

7. Thanks
Any Questions?