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Reducing length of stay and improving ward flow at James Paget University Hospital
James Paget University Hospital partnered with Xyla’s Strategic Improvement Service to improve ward flow and reduce length of stay. The work focused on standardising daily routines and giving teams clearer, real‑time visibility of patient progression.
Key outcomes
17% reduction in length of stay across five ward cohorts
Average improvement of 3.6 days in length of stay
9,326 annual bed days released
Equivalent to 25.5 effective beds of operational capacity
Optica training completion increased from below 10% to up to 85%
The challenge
James Paget University Hospital wanted to improve patient flow and reduce delays linked to inconsistent discharge planning unclear roles and reactive daily routines. Although staff were committed to delivering high quality care the lack of standardised processes meant tasks such as therapy referrals, pharmacy requests, discharge summaries and transport bookings were often completed later than required.
Differences in working practices and long-standing routines also contributed to delays. Teams often approached discharge tasks in different ways which created variation in priorities and in how existing systems were used.
Variation in board rounds, inconsistent use of Optica (the hospital’s patient flow and discharge system), and limited real time visibility of discharge progress made it difficult for teams to spot barriers early or plan proactively. The Trust needed a simple, sustainable operating model that helped teams plan earlier, work more collaboratively and move patients through their journey more efficiently.
Why Xyla
James Paget chose Xyla because of our proven experience improving patient flow and the positive outcomes already delivered through our discharge support work. Having seen the impact of our practical, hands-on approach, the Trust was confident that Xyla could help them build consistent ward routines, improve visibility and deliver sustainable reductions in length of stay.
The solution
Xyla worked with James Paget University Hospital to design and implement a ward based operating model that strengthened daily flow routines. This began with a deep dive across five wards, reviewing delays, validating data and observing how board rounds, therapy input, pharmacy processes and discharge planning were working in practice.
Using these insights, Xyla co-designed a simple visual management system to give teams real time visibility of patient progression and outstanding tasks. Daily routines were standardised, with clearer board rounds, action tracking and structured huddles to support earlier planning and escalation.
Xyla’s improvement consultants coached ward teams to embed the new routines, build confidence and create consistency across daily practices. Xyla played a key role in facilitating and coordinating Optica training delivered by internal JPUH teams, ensuring sessions were planned at appropriate times and encouraging ward staff to take up the training as it was offered.
Impact
Reduced length of stay and increased capacity
All five wards saw meaningful reductions in length of stay, ranging from 15% to 21%. These gains released an estimated 9,326 bed days per year, equivalent to 25.5 effective beds, creating real operational capacity without additional staffing.
More consistent and proactive ward routines
The introduction of visual management systems and structured daily routines helped teams plan earlier, identify delays sooner and sequence tasks more effectively. Wards reported clearer roles, stronger alignment between nursing, medical and therapy teams and a more predictable day to day operating rhythm.
Improved staff capability, confidence and ownership
Coaching from Xyla’s Strategic Improvement consultants helped staff build confidence in proactive planning and constructive challenge. Optica training significantly increased system adoption from fewer than 10% to up to 85% on some wards, improving documentation quality and enabling better real time decision making. Behaviours such as discharge planning from admission, early escalation and daily task ownership are now consistently embedded across supported wards.
Contact our patient flow and community transition team
If you are looking to improve flow and embed sustainable discharge routines in your organisation, Xyla can help. Contact us to explore how we can support your hospital or system.
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