A major programme of improvement at Caithness General Hospital has led to shorter waits in the Emergency Department (ED) and a better experience for patients.
Over recent months, the number of patients waiting more than 24 hours in the Emergency Department had been increasing. While demand for emergency care continued to rise, pressures on patient flow through the hospital sometimes meant patients who required admission were waiting longer than staff wanted.
Determined to address the issue, teams from across the hospital came together to better understand the factors contributing to delays and identify where changes could make the greatest difference. By reviewing patient flow, capacity and demand across the hospital, staff were able to test and implement a range of improvements designed to help patients receive the right care, in the right place, at the right time.
Key changes included the introduction of new escalation plans based on the Operational Pressures Escalation Levels (OPEL) framework. OPEL provides a structured approach for responding to increasing pressure within a hospital, helping teams identify issues early, coordinate actions and maintain safe patient care. The hospital also introduced a new triage area, developed an appointment-based system within the Minor Injuries Unit, strengthened multidisciplinary working and enhanced communication through regular operational "huddles".
Eddie Gilmartin, Rural General Hospital Manager for NHS Highland, said: "This has been a huge piece of work involving colleagues from right across the hospital, and I'm delighted to see the positive difference it has made for our patients.
"We have seen Emergency Department performance improve significantly, including a marked reduction in the number of patients waiting more than 24 hours.
Importantly, these improvements have been achieved while attendances at the department have continued to increase."
The work, which has also included the introduction of a new management approach and increased leadership capacity, has delivered sustained improvements. From a peak of 22 patients waiting more than 24 hours in a single week, the hospital has consistently reduced that number to fewer than 10 patients each week since May, with some weeks seeing as few as one patient waiting longer than 24 hours.
Alongside reducing extended waits, the team has also improved performance against the national four-hour Emergency Department standard, ensuring more patients are assessed, treated or admitted within the target timeframe.
Eddie added: "This has required a real culture change in how we work together, but the commitment from every team involved has been outstanding.
"Everyone shared the same goal of improving the experience for our patients, and that collective effort has delivered real results. While we are pleased with the progress made so far, we remain focused on eliminating 24-hour waits and continuing to improve waiting times across the service.
"I'm incredibly proud of everyone involved. We have shown that these improvements can be sustained, and there is real enthusiasm to build on this success."
He also highlighted the important role the public can play in helping ensure emergency services are available for those who need them most.
The Emergency Department is designed to provide urgent care for patients with serious illness or injury. However, many less urgent conditions can be treated more quickly and appropriately through other services, including NHS 24, community pharmacies, GP practices, optometrists and Minor Injuries Units.
Eddie said: "We occasionally see people attending the Emergency Department with conditions that could be treated elsewhere. We are here to help everyone who needs care, but we also want patients to receive treatment in the most appropriate setting.
"By choosing the service that best matches their needs, people can often receive care more quickly while helping us keep emergency services available for those facing the most serious and urgent health problems."