Centre for Healthcare Redesign (CHR) Graduation Project Summaries

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Centre for Healthcare Redesign (CHR) Graduation Project Summaries
April 2014
Physiotherapy Clinic Redesign
Western Sydney Local Health District
The Physio Clinic Redesign Project was borne out of a pressing need to redesign the delivery of
outpatient physiotherapy services at Westmead Hospital to meet rapidly growing demand without
any foreseeable increase in resources. A high number of booked appointments were not attended
by patients – resulting in a level of wasted time and resources.
The project implemented changes to the appointment structure and used new technology such as
SMS appointment reminders for patients in order to address these issues. The redesign will enable
the Physiotherapy Clinic to better meet the need for outpatient physiotherapy in Western Sydney
and empower patients to take responsibility for their healthcare and attend their appointment.
Contact:
Caleb Teh
Physiotherapist, Westmead Hospital Physiotherapy
[email protected]
Pathways to Health, General Practitioner referral to Nepean Hospital
Nepean Blue Mountains Local Health District
The Nepean Blue Mountains Medicare Local (NBMML) together with the Nepean Blue Mountains
Local Health District (NBMLHD) is working collaboratively on the project Pathways to Health:
General Practitioner referral to Nepean Hospital.
The project initially focussed on GP referrals to the Emergency Department (ED), with the final aim
to enhance the delivery of quality care to patients by streamlining the current referral process from
General Practitioners (GPs) to Nepean Hospital Outpatient services.
A high level of engagement by both GPs and Hospital staff (clinicians and clerical staff) enabled the
project to identify a number of barriers which are now being addressed to provide better patient
care.
The 5 key solutions being implemented are:
1. Creation of a Database Directory of Outpatient Clinics for GPs
2. A Standardised Referral to Outpatient Clinics
3. Message Delivery Solution (SMS reminders) for Outpatient Clinic appointments
4. A Standardised Referral to Community Health
5. Promotion of Community Health Services to GPs
Contact:
Danielle Xerri
Clinical Redesign Project Officer
[email protected]
Centre for Healthcare Redesign - April 2014 Graduation Projects
“Connections” Chronic Care Clinical Redesign
Sydney Local Health District
Extensive consultation has occured with patients, clinicians, managers and primary care providers in
the Sydney Local Health District (SLHD), to redesign their health system to deliver better care for
patients with chronic disease.
The project aims to achieve an integrated and sustainable Chronic Disease Management model of
care that connects the patient and their carer with the most appropriate health professional by
providing a single point of contact and referral.
Working in partnership with General Practice, the project also aims to implement initatives such as
triage of patients at the time of referral, case conferencing to support integrated care and follow up
phone calls once patients are discharged from hospital.
Contact:
Julie Finch
[email protected]
RPA Hospital
Type 2 Diabetes (T2D) - The Road to Self-Management
South Eastern Sydney Local Health District
Patients who are diagnosed with Type 2 Diabetes require access to education to enable them to selfmanage their disease and maintain optimal health. Investigation of the pre-existing pathway for
those newly diagnosed with type 2 diabetes in SESLHD revealed variability in practice and a lack of
standardised, validated self-management education.
The solutions, which will result in a standardised approach to education are:
•
•
•
Provide an integrated directory of services in partnership with Eastern Sydney Medicare
Local
Educate nurses to facilitate a diabetes education program ‘ComDiab’
Provide a single point of referral and standardise correspondence.
Better enabling patients to self-manage this chronic disease has been shown to improve their ability
to live healthier lives.
Contact:
Tom Chapman
SESLHD Chronic Care Redesign Manager
[email protected]
More holistic and efficient health care for people with Mental Health concerns
Illawarra Shoalhaven Local Health District
This project was undertaken to address delays in treatment for Mental Health Consumers presenting
to the Emergency Department (ED) at Wollongong Hospital.
Centre for Healthcare Redesign - April 2014 Graduation Projects
Diagnostics revealed that delays were often due to unavailability of medical officers to conduct
assessments and order pathology tests, which led to stalling receipt of medications, treatment and
admission to mental health units.
Through this project, the Wollongong Hospital developed a model where ED Mental Health, Clinical
Nurse Consultants (CNCs) could initiate Standing Orders for Pathology and Medication and admit
patients directly to mental health units.
Evaluation of the project indicates National Emergency Access Target (NEAT) has improved by up to
a 45%. Consumer feedback conveys 83% of consumers are very satisfied or satisfied with the care
provided by the Mental Health Clinical Nurse Consultant within this new model.
Contact
Lynne Blanchette
Mental Health, Wollongong Hospital
[email protected]
Clinical Redesign of Aged, Chronic and Complex Care Services
Southern NSW Local Heath District
A Clinical Redesign of Aged, Chronic and Complex Care services has been undertaken by the
Southern NSW Local Health District. The goal of the project is to develop an integrated system of
health services across the continuum of care which best meet the needs of consumers with aged
related, chronic and complex health issues.
Prior to this project, a number of hospital and community services, tailored to the needs of this
consumer group, were being underutilised. Optimal use of these services is expected to deliver
shorter hospital stays for this consumer group and reduce returns to hospital for conditions related
to their age and chronic disease. This will give them more quality time, in their own homes and
prevent early admission to Residential Aged Care.
The driving principles of this system redesign will include care coordination & navigation, seamless
transition, restorative care and a single point of entry to services.
Contact:
Anka Radmanovich
Manager Aged Care and Rehabilitation Programs
[email protected]
Patient Safety Starts with ME project
Mid North Coast Local Health District
The Patient Safety Starts with ME project was initiated after a below state average result for
understanding patient safety culture was identified in the annual Quality Systems Assessment (QSA)
and Network Staff surveys.
The project, which identified a poor understanding of the link between quality care and direct
patient outcomes, resulted in the development of a “Patient Safety Board” which not only
Centre for Healthcare Redesign - April 2014 Graduation Projects
engages ward staff in the process, but also allows patients and visitors to see how clinical
practice impacts on safety and quality.
The outcomes to date have been a 22 % improvement in the QSA patient safety culture result,
improved staff understanding of what constitutes a safe patient environment and an active
involvement of staff in the process.
Contact:
Christoph Groger
Clinical Quality, Redesign and Innovation Manager
[email protected]
Coast Care Project
Central Coast Local Health District
The COAST Care project investigated opportunities to improve service linkage between acute, subacute and community care in the Central Coast Local Health District (CCLHD).
The aim was to facilitate reduced inpatient bed days by enhancing and streamlining discharge
transfer of care processes to improve the patient journey. Patients, carers and staff across CCLHD
were consulted and assisted in identifying issues and developing solutions.
Key issues included:
• A lack of knowledge regarding availability and appropriateness of services to meet client’s
needs.
• Inconsistency and duplicated processes for transfer of care decision and service linkage.
• Service access delays.
Solutions that were developed include:
• Developing a centralised contact point to support decision making and appropriate service
linkage for patients requiring subacute and/or community care.
• Developing tools and processes to support improved identification and classification of
subacute care types.
Contact:
Wendy Moir
Project Officer- Clinical Redesign
Gosford Hospital
[email protected]
Child and Adolescent Mental Health Services (CAMHS)/Youth: A Seamless Journey
South Eastern Sydney Local Health District
CAMHS/Youth: A Seamless Journey focuses on increasing access to evidence based models of care
and improving the patient journey for Child and Adolescent Mental Health Services (CAMHS) clients
who experience emotional stress and self-harming difficulties.
Interviews with patients, carers and staff highlighted the inequity of access to treatment, and the
sometimes jagged, frustrating, inconsistent and inappropriate care these young clients receive whilst
transitioning between services.
Centre for Healthcare Redesign - April 2014 Graduation Projects
Solutions endorsed using the ACI Redesign Methodology include:
• Standardised and accessible management plans
• Evidenced based treatment models
• Liaison Initiative Programs
These are being implemented to help reduce the crises clients experience and provide smoother,
consistent and more appropriate treatment pathways.
Contact:
Liz Mason
Redesign Manager
[email protected]
Seamless Transitions: The Pathway Home
Northern Sydney Local Health District
The goal of this project was to streamline access to Primary & Community Health Services (P&CH) for
patients being transferred home from the Royal North Shore Hospital (RNSH) via the Health Contact
Centre (HCC).
Significant improvement was achieved by the provision of updated Transfer of Care Resources for all
inpatient wards, the implementation of a trial Risk Screening Tool, development of the Hospital
Liaison role and the streamlining of HCC software. The combined result of these initiatives is a more
coordinated and robust transfer of care process.
On a broader scale, the most significant achievement of this project has been the recognition and
commitment of the Acute and Community Executive, for a more collaborative, ongoing approach to
addressing and improving Transfer of Care.
Contact:
Paula Harman
CNC Discharge planning
[email protected]
Turbo Charging Patient Transport
Illawarra Shoalhaven Local Health District
The Turbo Charging Patient Transport project was established to enhance the experience of
patients, their carers, and staff by improving the inter hospital transfer process in Illawarra
Shoalhaven (ISLHD). An internal review of the ISLHD Transport Department’s operations revealed
that there was variability when patients were transferred across the LHD, in the accuracy of
transport booking information and patient readiness for transfer, leading to delays, rework and
frustration for patients and staff.
The project targeted areas of variability and worked with transport staff, clinicians and managers to
systematically develop controls such as business rules, guidelines and performance metrics. This has
achieved positive results to deliver a consistent and high quality transport service for patients, carers
and staff in Illawarra Shoalhaven (ISLHD).
Centre for Healthcare Redesign - April 2014 Graduation Projects
Contact:
Steven Porter
Illawarra Shoalhaven Local Health District (LHD)
[email protected]
Establishing Goals in End of Life Care
St Vincent’s Health Network
St Vincent’s Hospital End of Life Care Steering Committee was established to develop an approach
for optimising care at the end of life. The aim was to ensure all patients at risk of dying could benefit
from a consistent approach which incorporated methods for communicating goals of care and
addressing social, spiritual and cultural needs of patients, their families and carers.
A Pilot study was developed – Establishing Goals in Serious Illness: Strengthening the Engagement of
Patients and Families in Collaborative Decision Making and Care- which aims to facilitate two aspects
of providing best practice care:
• Timely engagement of patients and/or their care givers in determining their preferred goals
of care, and
• Timely identification of their supportive care needs.
This had led to the development of a resource kit and prompt sheet to be trialled and assessed on
one ward in the hospital during April 2014.
The Pilot study has Ethics approval to allow sharing of results with ACI, CEC and other external
organisations, with the aim to publish the results.
The Pilot will inform the next phases of the project which include refining the strategy with a
standardised and accepted approach, imbedding into routine practice and organisation-wide
implementation.
Contact:
Andrea Lock
Project Officer, St Vincent's Hospital Sydney
[email protected]
Centre for Healthcare Redesign - April 2014 Graduation Projects
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