progress of individual medical and surgical teams throughout the implementation timeline (Figure 1 ). Our secondary outcome measure was the percentage of patients discharged within 2 hours of meeting their medical discharge goals. Results The percentage of patients whose discharge process included medical goals increased from 25% to 76% in 3 years. The progress of individual teams is displayed in Figure 2 . For patients who followed the process, the percentage of patients discharged within 2

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... rs of meeting medical discharge goals increased from 42% to 85% ( Figure 3) ; however, this overestimates success, as patients are only included in this measure if all parts of the process are followed. Conclusions We successfully spread discharge efficiency based upon medical goals to a majority of hospitalised acute care patients; however, we continue to identify improvement opportunities with process adherence. Abstract 920 Figure 1 Case note review identification of sub-optimal care Abstract 920 Figure 2 Cardiac arrest rate per 1000 deaths/discharges SPC-U chart Abstract 920 Figure 3 Reliable implementation of observation bundle Abstract 920 Figure 4 Target saturations documention on clinical obs chart Abstracts A14 BMJ Open Quality 2017;6(Suppl 1):A1-A39