Thankyou SCHN Patients and Families & staff involved in patients care on Hunter Baillie and C3W wards.

Home for Lunch Governance Committee and Project Teams members ACI Clinical Redesign Team

Clinical Redesign Lead/ Director of Nursing/ Deputy Director of Nursing - Manly Hospital Clinical Redesign Lead and CCC Project Manager - Shellharbour Hospital

‘never really know when the doctor is coming so you sit

around waiting which can produce a lot of

anxiety’

‘We could definitely have gone home earlier,

there was a lack of communication…’

‘we were told that we could leave and then had to wait another 2

hours for a doctor to come round and officially discharge us’

MethodThe Project was undertaken using the Clinical Redesign Methodology

Data CollectionLength of Stay for the Wards

Waiting for What - Main Root Cause to what patients are waiting for is Discharge Planning

Staff Tag-alongs

Process Mapping SessionsMedical/ Nursing/ Allied Health / Pharmacy/ Domestic Services/ Administration

Patient Experience TrackersCarers and Staff on Hunter Baillie Ward, CHW and C3W Ward, SCHCarer InterviewsDischarge Planning awareness focused questions

Planning and implementing solutionsThrough a series of Solution Design Workshop sessions , literature

reviews, Solution Prioritisation Sessions, Site Visits; it was agreed to implement the following on the medical wards at SCH and CHW.

SCH: C3W Medical Assessment Unit Patients / Time – 8.55am to 9amCHW: All Hunter Baillie Patients / Time – 8.30am to 8.50am

Implemented on 3/11/2015

Phase 2 (Feb to Jun 2016) – SCH and CHW• Structured Interdisciplinary Bedside Rounds (SIBR) (twice a week)• Set Staggered ward round times/ Set roles and responsibilities for ward round

members

Evaluation and ResultsPRELIMINARY FINDINGS/ RESULTS (during pilot phase)SCH 70% of Consultants prefer Post Ward Round IDT meetingsAgreed start time of 8.55am not suitable for medical staff (In ED or at

Handover) = 60% ‘Start on Time’ 80% of staff recognise the benefit and positive impact the process will

have.NO impact on ward round commencement timeCHW 90% of staff involved in the IDT Rounds have provided initial feedback

that the process has improved IDT communication. 80% attendance of all Allied Health specialities every day

(Physiotherapy, Occupational Therapy, Social Work, Dietetics) 100% attendance of Allied Health staff (from 1 or more specialities)Quality Improvement – Medication review and Script Completion

FORMAL EVALUATION REVIEW POINTS (December 2015) Increase in Patient Satisfaction Reduction in Ward LOS/ Earlier Discharge time during day Increased utilisation of Criteria Led Discharge Reduction in referral times Time from referral need identified to entered in Power Chart Time referral entered in Power Chart to patient seen

Increased staff satisfaction(Survey distributed to Staff involved in EPJB IDT Meetings for feedback) Increased Interdisciplinary communication and Documentation

HOME FOR LUNCH Discharge Planning Project

(Initiative of the SCHN Whole of Hospital Program)Goal

Establish a safe, efficient and timely patient-centred discharge in order to improve patient experience, increase bed capacity and decrease costs.

Objectives 1. Increase the admitted Emergency Treatment Performance (ETP) for HB and C3W by 10% by June 2016 (currently 25% for HB and 34% for C3W)2. Reduce ALOS (average length of stay) of inpatients on C3W and HB by

10% by June 2016 3. Improve patient satisfaction regarding the discharge process by 10%

(baseline 66%) by June 2016

Sick Children waiting in ED for inpatient bedsClinically well inpatients on ward waiting to go home

41% of parents surveyed said they felt their Discharge was delayed due to waiting for Clinical

Review

for

WHY?

THE VISION

‘First Impressions are important, but the last impression we leave with the customer,will leave the most lasting impression’. Shep Hyken

Increase education and understanding between disciplines Increase Interdisciplinary communicationImprove efficiency of referral making care planningImprove interdisciplinary careMinimises interruptions and paging throughout the dayMore accurate information of Estimated Discharge dates to families.

Conclusion The implementation of this project has had significant positive impact on the

interdisciplinary care provided to patients and the communication between the care teams focussing on discharge planning.

There is interest to rollout the concept and solutions to other clinical settings

Project TeamSharon Roumanos, Project Lead and SCHN Whole of Hospital Program Officer

Lydia Garside, Project Team and SCH Staff Specialist

ContactSharon Roumanos, Project Lead and SCHN Whole of Hospital Program Officer

Ph: 9845 0548 or sharon.roumanos@health.nsw.gov.au

Diagnostics

ETP Performance – Objective 1

Objective 2

‘It was excellent to receive a script from the Dr immediately following the meeting’ Pharmacist

‘I am identifying patients to see earlier on in the day which helps prioritise work’ AH Staff

Sustaining Change• Development and incorporating business rules for new processes into

orientation Programs for Junior Medical Staff.• Empower and development of local future champions by current

champions.• Continuation and spread of the Home for Lunch Project to other areas

within SCHN continuing promotion of Discharge Planning• Continuation of the Home for Lunch Project Governance Committee.• Reinforced management expectation for staff relief and attendance during

planned / unexpected leave – succession planning.

Daily Discharge Date Discussions

4-SCHN

-home-for-lunch.pdf 1

20/11/2015 2:44:24 PM