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Stranded Sam to the Rescue of Long Stay Patients

St Vincent's Hospital
Project Added:
13 July 2012
Last updated:
30 September 2014

Stranded Sam to the Rescue of Long Stay Patients

by LZ Kershaw, B Gardiner, A Morgan, R Smith, C Tsang, S Whalen
St Vincent's Hospital, NSW


Large numbers of patients with length of stay greater than 21 days, triggered a program of work to improve patient flow and improve patient safety at St Vincent’s Hospital, Darlinghurst commencing in May 2011. In 2010, 2.7% of the patients consumed over 30% of the bed days.


A diagnostic approach was instigated that included individual patient review and data collection, establishment of a registry of issues, stakeholder consultation, and a daily status review. A "stranded patient" team was established to plan interventions.

An organisation wide communication strategy "Stranded Sam" was established. The strategy aimed to:

  • build understanding of factors that keep patients in hospital longer than their acute illness and the impact on the patient and the hospital when care is not coordinated
  • increase the visibility and transparency of waste within the hospital
  • engage key stakeholders and support the change management project.


A number of key issues were identified including:

  • a culture of not valuing an inpatient bed as a scarce resource
  • deficiencies in the identification of patients at risk of longer stay
  • problems in communication between and within teams
  • inconsistent discharge planning practices

An 8% reduction in the length of stay for overnight admitted patients, with release of an equivalent of 18 beds capacity has been achieved, improving elective and emergency patient access to inpatient beds.

The time patients wait in Emergency Department for an inpatient bed decreased by an average of 1.5 hours (15%). This has occurred at the same time as there has been 6% increase in Emergency Department admissions.

Lessons learned

An organisation wide communication strategy and creative branding can greatly assist ongoing identification of an issue, challenge cultural barriers to efficiency and link together multiple redesign strategies.


Project Officer Decision Support
St Vincent's Hospital
390 Victoria Street Darlinghurst, NSW 2010
Phone: 02 8382 2076

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