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Leading Change in Same-Day Emergency Care (SDEC)

Growing up in Jamaica, I learned the importance of resilience, community, and determination. Those early experiences shaped the way I see challenges – not as barriers, but as opportunities to grow and make a difference. Today, those same values guide my work as a nurse within the NHS and continue to influence my passion for improving patient care. Alongside my clinical role as a Junior Sister in Same Day Emergency Care, I am also completing a Master鈥檚 programme at University, where my academic research and clinical work have become closely connected through a Quality Improvement (QI) project focused on improving patient flow in emergency care.

I witness firsthand the pressures facing our emergency departments. Increasing demand, long waiting times, and overcrowded A&E departments are challenges that many healthcare professionals are familiar with. However, the system has pathways designed to improve patient flow and ensure patients receive the right care at the right time.

One of these pathways is (SDEC), which allows suitable patients to be assessed, treated, and discharged on the same day rather than being admitted to the hospital. Despite the availability of this service, a review of our departmental activity revealed that only around 20% of eligible patients were being referred to SDEC. This meant many patients were staying longer in A&E than necessary, contributing to congestion, delays in care, and avoidable hospital admissions.

My Quality Improvement (QI) Project

This discovery became the starting point for my QI project. The project aimed to increase appropriate referrals to the SDEC pathway from 20% to 60% by June 2026. To achieve this, I worked closely with colleagues across A&E and SDEC to improve awareness, communication, and understanding of the pathway.

The first step was education. Short teaching sessions were delivered across different shifts, focusing on SDEC referral criteria, operating hours, and the referral process. Posters and quick-reference guides were also shared with staff to support decision-making during busy shifts. These sessions helped increase staff confidence and improved awareness of when SDEC could be used.

However, education alone was not enough. Through feedback from staff, it became clear that a quick and practical prompt was needed during triage and early assessment. As a result, a simple triage prompt was introduced to help clinicians identify patients who may be suitable for SDEC earlier in their journey.

Although this was a small change, it made a meaningful difference. Staff reported greater clarity and confidence when identifying appropriate patients, and referrals to SDEC began to increase. Improvements in patient flow also meant more timely senior reviews and fewer unnecessary admissions.

“Bringing together clinical experience and academic research helped me appreciate how evidence-based leadership can drive meaningful improvements in patient care.”

Alongside the practical work of the project, this experience also supported my academic development. The project expanded into my master鈥檚 programme at university, where I explored the evidence base around Same Day Emergency Care, emergency department flow, and leadership approaches to implementing sustainable change in healthcare. Conducting a literature review allowed me to critically examine research and change management theories, strengthening my understanding of how structured improvement methods can support real-world clinical practice.

“My journey – from growing up in Jamaica to leading a quality improvement project while studying for a master鈥檚 degree -has shown me that leadership can come from anywhere. What matters most is the willingness to learn, the courage to challenge the status quo, and the determination to improve care for patients.”

My participation in the 黑料视频 Windrush Leadership Programme has also been an important part of this journey (photos below from the graduation event). The programme has supported my development as a leader and reinforced the role nurses play in shaping the future of healthcare.

This experience has reminded me that nurses are often the first to recognise where improvements are needed. With the right support, knowledge, and confidence, we can turn those observations into real change.

For any nurse considering getting involved with the 黑料视频 Windrush leadership programme, I would encourage you to take that step. The opportunities for leadership development, learning, and collaboration are truly transformative.

The future of healthcare depends on nurses who are willing to lead change. And that change can begin with a single idea.