Transcript Document

Patient Flow
Collaborative
Eddie Dunn
Operations Director, Rosebud Hospital
Facilitator – Peninsula Health PFC
Department of Human Services in collaboration with Peninsula Health
Presentation
A WHOLE SYSTEM APPROACH TO
PATIENT FLOW MANAGEMENT
Aims
• How we got started
• Challenges to date and in the future
• Key strategies
• Early achievements & activities to date
• Lessons learned
• Next steps
How we got started
The first six months
• Key stakeholders chosen from the quality area
• Multiple collaboratives underway at same time
• Facilitator could not provide a focussed effort due to
workload commitments
• Minimal communication about the PFC
• Brainstorming sessions across Peninsula Health
• Small project focussed
How we got started The first six months
Who was involved?
− Peninsula Health wide brainstorming
• Patients
• Frontline staff
• Departmental Managers
Reactions?
– Have done it before
– Good, let’s get this right
How we got started
The second six months
• Change in key stakeholders
• Executive Sponsor Vision – Major Change Initiative
• A facilitator that could provide a focussed effort
• Increased co-ordination & communication
• Regular meetings with new PFC Executive Team
• Multiple project teams built
• Gained increased PH Executive support
How we got started The second six months
• Collation of Brainstorming results into Priority Areas
• Identifying Priority Area Leaders
• Refining Priority Areas
• Re-aligning Priority Area Leaders to Priority Areas
• Turning major trends into projects
• Linking into work already done for quick wins
• Submerge PFC into Day to Day Business
Key Strategies
• Have a vision
• Build an Executive Team from multiple disciplines
• Agree on a direction and Priority Areas
• Meet regularly and empower PALs
• Encourage accountability through regular reporting
Guiding Statement
“A delay in the discharge of
one patient means a delayed
admission for another.”
Guiding Principles
• Patient focussed
• Improved patient outcomes
• Right patient, place, resource, time and clinician
• Prompt access
• Optimal flow
• Enhance professional networks and relationships
• Efficiency
Peninsula Health
PFC Executive Team
Executive Sponsor - Siva Sivarajah
Facilitator - Eddie Dunn
Priority Area Leader’s (PALs)
• Priority Area 1 - Dr Susan Sdrinis & Shamala Jones
• Priority Area 2 - Jane Poxon & Robert Barker
• Priority Area 3 - Di Jamieson & Kate MacRae
• Priority Area 4 - Jan Child & Lyn Jamieson
Priority Areas
• Optimise patient flow from the Emergency
Department
• Eliminate delays for patients awaiting surgery
• Optimise bed utilisation across all sites
• Facilitate consistent systems and processes across
Peninsula Health
Whole System Approach
Peninsula
Health
Services
Frankston
Acute
Rosebud,
RAPCS
& Allied
Health
Psychiatry
Priority Area’s
Optimise patient flow fro m the
Emergency Department
Eliminate delays for patients
awaiting surgery
Optimise bed utilisation
across all sites
Facilitate consistent systems and
Processes across Peninsula Health
Community
Whole System Approach
Priority
Areas
Priority
Area 1
Priority
Area 2
Priority Area Projects
PA1 - Projects
PA2 - Projects
PA3 - Projects
PA4 - Projects
Priority
Area 3
Priority
Area 4
Challenges –
Co-ordination
• Needed to bring all PFC info to date together
• Needed to provide up to date information
• Needed to develop consistent tools for all to
use
• Needed to “Pinch with Pride” and share
Key Strategies –
Co-ordination
• Have a central point for all information and make
available all information from all projects
• Disseminate information
• Format tools that could be used across multiple
projects
• Communicate, communicate, communicate
Challenges Communication
• Needed a co-ordinated approach
• Needed to use the same language
• Needed a signature / design
• Needed to be simple, understandable & effective
• Needed to be targeted
• Needed to be planned
Key Strategies Communication
• Develop a Public Folder for all PFC Teams/participants
• Executive Sponsor – “Paving the way for success”
• Standing Item on Operational Executives meeting
• Fortnightly PAL meetings
• Engaged Peninsula Health’s Public Relations Unit
• Quarterly four page newsletter and monthly update
Next steps Communication
• Develop a PFC Intranet site with a “Score Chart”
• Update Internet site
• Road show
• Maintain the central point of documented evidence
• Orientation programme presentation
Communication
“This is bureaucratic gobbledegook to
clinicians. I have NO IDEA what a patient
flow collaborative is, something to do with
Urology perhaps?”
(Peninsula Health Medical Officer December 2004)
Early Achievements
• Focus on quick wins
• Identified established work that could link with PFC
• Targeted projects from Brainstorming Analysis
• High Level Executive Support
• Team approach
Activities to date
• ED / Radiology
• Emergency Streaming
• Direct RAPCS admissions from ED
• Allied Health Pre-discharge Home Visits
• Patient Transfers and Transport
Activities to date
• LOS and Early Discharge
• Volunteers
• Incident Management
• Theatre Utilisation Project
Future Activities
• Communication and referral processes between ED
and Inpatient Units
• Orthopaedic Streaming
• Neuro Streaming
• Weekend Discharges
Future Activities
• Multiple patient assessments
• High Risk follow up
• Transfer of Medical Records across sites
• Ward Clerk and PSA roles
Future Challenges
• Gaining participation of medical officers
• How to involve more frontline staff in the process
• Keeping staff motivated
• Managing the growth of activity
Critical to Success
•
•
•
•
•
High level management support
Clinicians fully engaged
Clinical Leadership
Team work
Communication & mass involvement of staff and
healthcare partner organisations
• Improvements must involve structures, processes &
patterns/systems
Questions