The challenge
A national request to redefine the purpose of admissions prompted a mental health hospital to review how its wards managed patient flow. One ward in particular was experiencing significant variability in admissions, with bed occupancy as low as 64%, despite ongoing pressure on services. The team was working at pace, reacting to daily demands, with little time to step back and reflect on how the system was actually functioning.
Our approach
I was invited to facilitate team coaching for this ward, working alongside staff involved across the admissions pathway. The focus was twofold:
- To create a structured, psychologically safe space where the team could think together
- To build practical Quality Improvement (QI) capability, without overwhelming people
Alongside coaching conversations, I introduced bite-sized learning on QI, explaining how the Model for Improvement could be applied to real challenges such as improving the timeliness and reliability of admissions.
Slowing down to move forward
Through regular, well-structured meetings, the team analysed a rich mix of intelligence:
- System and performance data
- Anecdotal and lived experience from staff
- Qualitative insights from day-to-day practice
This created permission to slow down the work, map the admissions process as it was actually experienced, and examine how fit-for-purpose it was against current demands.
From insight to action
Using root cause analysis, the team identified key barriers within the system. These insights generated multiple change ideas, which were then tested rigorously using Plan–Do–Study–Act (PDSA) cycles — applied as originally intended, not rushed or superficial.
Crucially, the team invested time in learning from each cycle, refining their approach before scaling what worked.
The impact
After six months:
- Admissions processes were in tight statistical control
- Average bed occupancy consistently exceeded 95%; this represented a major shift from 64%
What made the difference
The results were not driven by a single intervention, but by:
- The team’s commitment to structured thinking
- Willingness to engage collectively across roles
- Correct use of PDSA cycles as learning tools, not tick-box exercises
Want to know more?
We’d love to share more detail about this work and what made it successful.
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