Department of Human Services in collaboration with Peninsula Health

Patient Flow Collaborative

Eddie Dunn Operations Director, Rosebud HospitalFacilitator – Peninsula Health PFC

PresentationPresentation

A WHOLE SYSTEM APPROACH TO PATIENT FLOW MANAGEMENT

AimsAims

• 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 startedHow we got startedThe first six monthsThe 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 - How we got started - The first six monthsThe 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 startedHow we got startedThe second six monthsThe 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 - How we got started - The second six monthsThe 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 StrategiesKey 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 StatementGuiding Statement

“A delay in the discharge of

one patient means a delayed admission for another.”

Guiding PrinciplesGuiding 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 Peninsula Health PFC Executive TeamPFC 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 AreasPriority 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 ApproachWhole System Approach

Peninsula Health

Services

FrankstonAcute

Rosebud,RAPCS & Allied Health

Psychiatry Community

Optimise patient flow from the Emergency Department

Eliminate delays for patients awaiting surgery

Optimise bed utilisationacross all sites

Facilitate consistent systems andProcesses across Peninsula Health

Whole System ApproachWhole System Approach

Priority Areas Priority

Area 1Priority Area 2

Priority Area 3

Priority Area 4

PA1 - Projects

PA2 - Projects

PA3 - Projects

PA4 - Projects

Challenges – Challenges – Co-ordinationCo-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 – Key Strategies – Co-ordinationCo-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 -Challenges -CommunicationCommunication

• 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 -Key Strategies -CommunicationCommunication

• 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 -Next steps -CommunicationCommunication

• Develop a PFC Intranet site with a “Score Chart”

• Update Internet site

• Road show

• Maintain the central point of documented evidence

• Orientation programme presentation

CommunicationCommunication

“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 AchievementsEarly 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 dateActivities to date

• ED / Radiology

• Emergency Streaming

• Direct RAPCS admissions from ED

• Allied Health Pre-discharge Home Visits

• Patient Transfers and Transport

Activities to dateActivities to date

• LOS and Early Discharge

• Volunteers

• Incident Management

• Theatre Utilisation Project

Future ActivitiesFuture Activities

• Communication and referral processes between ED and Inpatient Units

• Orthopaedic Streaming

• Neuro Streaming

• Weekend Discharges

Future ActivitiesFuture Activities

• Multiple patient assessments

• High Risk follow up

• Transfer of Medical Records across sites

• Ward Clerk and PSA roles

Future ChallengesFuture 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 SuccessCritical 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

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