Transcript QVH ANNUAL ACCOUNTS 2009/10

Streamlining The Care System –
Improving the Patient Experience
Mary Sherry, Director of Performance
Streamlining Care – Where are we?
• Systems Thinking principles being applied by the leadership teams
and starting to embed throughout the organisation
• This means looking end-to-end at our processes to redesign and
improve the patient pathway
• Changes are happening in various ways across our pathways
• Whole hospital metrics focus our attention on stages of patient
journey as well as mandatory measures
• Whole hospital transformation plan developed to realise benefit to:
– Patient experience
– Cost
ANNUAL GENERAL MEETING, 29 JULY 2010
Streamlining Care – What has changed?
Work is underway in the following areas:
• Referral to Clinic (Diagnosis)
• Elective Admission to Surgery and on to Discharge
• Trauma Pathway
• All work is directly with teams ‘on the ground’ using work place
metrics to identify issues and plan and test solutions
• Further work streams are planned from September onwards
ANNUAL GENERAL MEETING, 29 JULY 2010
Streamlining Care – What has changed?
Referral to Clinic (Diagnosis)
• Appointments are being booked more quickly
• Patient waiting times have reduced – a 15 steps reduced to 5, time
reduced from 40 days to 10, flexible hours to contact patients more
conveniently
• Majority of patients requiring surgery are now pre-assessed on the
same day as clinic
• As administrative processes have reduced, so have costs
ANNUAL GENERAL MEETING, 29 JULY 2010
Streamlining Care – Referral to Clinic
Time Elapsed from OP Referral to Booking
Time Elapsed from OP Referral to Seen
50
100
45
90
40
80
35
70
30
60
25
50
20
40
15
30
10
20
5
10
0
Nov-09
New Booking Process
Implemented
0
Dec-09
Jan-10
Feb-10
Booked - Upper Limit of Variation
Mar-10
Apr-10
May-10
Nov-09
Booked - Mean Waits
ANNUAL GENERAL MEETING, 29 JULY 2010
Dec-09
Jan-10
Seen - Upper Limit of Variation
Feb-10
Mar-10
Apr-10
Seen - Mean Waits
Streamlining Care –
Central Pre-Assessment Department
Pre-Assesment Department Activity
Number of Patients seen in
PreAssessment on same
day as OP appointment at
QVH is being tracked in the
Quality Dashboard / CQUINS:
Number of PAC Appointments
350
300
17
250
198
200
221
150
209
207
161
100
116
50
50
65
Jan-10
Feb-10
59
96
2009/10 Average
18.5%
2010/11 April
22.0%
2010/11 May
37.4%
0
PAC - Same Day
Mar-10
PAC - Delayed (onsite)
Apr-10
May-10
PAC - Delayed (trf from offsite)
Measurement:
Data extracted from PAS. Excludes telephone assessment activity. Offsite numbers only collected wef April 2010.
If there isn’t a New Outpatient appointment on QVH PAS (i.e. seen offsite) or it took place before the Pre-assessment appointment, Pre-Assessment is assumed to
have been delayed.
ANNUAL GENERAL MEETING, 29 JULY 2010
Streamlining Care – What has changed?
Elective Admission to Surgery and onto Discharge
•
Work place metrics in place on ward and in theatre to show staff what is
actually happening and drive change – good example is start times
•
Admission lounge opened in order to increase patients being admitted on
the day – more convenient to patients
•
Theatre start times tackled and new process implemented – to increase
patients treated per list and reduce cancellations/overruns
•
Planning of lists being reviewed with consultants – to increase use of
theatres, shorten waiting times
•
Review of admission and discharge process – to improve planning of
admissions and discharges, giving more certainty to patients
ANNUAL GENERAL MEETING, 29 JULY 2010
Streamlining Care – Theatres: Same Day
Admission to C Wing, Elective Inpatients
March 2010
Feb 2010
PS Waiting List form
Revised
Measurement
Data collected form ORSOS. Data includes admissions from 1st April to 31 May 2010 to M Duncombe & Ross Tilley Wards only.
Rowntree Admissions Lounge opened fully at the end of May, further improvements expected.
Streamlining Care – Theatres: Admission to
Theatre – PS & MF Elective Inpatients
ANNUAL GENERAL MEETING, 29 JULY 2010
Streamlining Care – What has changed?
Trauma Pathway
• Key objective set that trauma patients, once fit for treatment, will be
operated on within 24 hours, plus time elapsed from injury to
treatment to be key focus
• Trauma Co-ordinator appointed, to improve the management of
patients through their pathway
• Electronic Trauma board being designed, with process changes to
improve the planning of trauma theatre lists
• Reasons for cancellations being focussed on the drive change,
potentially increasing availability of trauma operating time
ANNUAL GENERAL MEETING, 29 JULY 2010
Streamlining Care – Trauma Pathway:
Admission to Theatre PS & MF Inpatients
3.1
3.1Streamlining
StreamliningCare
Care––Trauma
TraumaPathway:
Pathway:Admission
Admissionto
toTheatre
TheatrePS
PS&&MF
MFInpatients
Inpatients
March
April
May
February
Measurement
Data collected form ORSOS. Data includes admissions from 1st February to 31 May 2010.
ANNUAL GENERAL MEETING, 29 JULY 2010
Streamlining Care – What happens next?
• Realignment of Executive role to focus on redesign
• The establishment of a dedicated team to take this work forward
September 2010 to March 2011
• New work streams to commence in September including cancer
pathway and new : follow up appointments
• The roll out of key metrics to management team so that patient
experience is at the heart of management action to drive change
ANNUAL GENERAL MEETING, 29 JULY 2010