Embed Size (px)
Citation preview
Acknowledgements
Conclusiono All project objectives were successfully achievedo Key learning points are summarized below
A major impact on project implementation was the COVID-19 pandemic. This affected the timeline of implementation and caused significant changes in operational delivery of rehabilitation.
There were benefits in the merging of two wards to one. This enabled rehabilitation processes to be consistent and improved ease in implementing change.
Staff have proved themselves to be flexible and resilient which has supported the successful outcome of the project.
Case for change Sustaining changeo The project solutions are now in actiono Early collaboration coupled with strong
leadership were key factorso Working parties generated champions for
each solutionso Standing agenda at GRC operational meeting
Desired outcome
iGO: Improving Graythwaite Outcomes
Alanna Brown, Sharon Fok, Esther Ng and Philippa Wilford, Northern Sydney Local Health District, Graythwaite Rehabilitation Centre (GRC), Ryde Hospital
Method
Contact
Rehabilitation is a vital aspect in the recovery process after illness or injury. A service review in 2019 highlighted that patients admitted to GRC for rehabilitation were staying longer, and functional outcomes were less than those in comparable services within Northern Sydney Local Health District.
Objectives
Patient and/or carers:Listening event (n=23) Interviews (n=11) Questionnaire (n=68)
Staff:Survey (n=55) Tagalongs (n=6)Focus groups (n=30) Working parties (n=16)
Process mapping (n=20)
Root cause analysis, prioritisationmatrix and dot voting
Diagnostics Results
Solutions1.
2.
3.
4.
Innovative grant $45,500 received!
o Heather Gough, GM, Ryde Hospitalo Drew Hilditch-Roberts, DON, Ryde Hospitalo Dr Jennifer Mann, Head of Rehabilitation Medicineo Deb Stewart, Manager Clinical Redesign and Innovationo GRC Staff, patients and carerso Gracia Wiguno, graphic and motion designerIcons made by Becris, Catkuro, dDara, Eucalyp, Freepik, Good Ware, Monkik, Nikita Gobeluv, Pause08, Payungkead, Phatplus, Pixel Perfect, Smalllikeart, Smashicons, Surang, Ultimatearm, Xnimrodx from www.flaticon.com
Patient• Poor communication and clarity
surrounding discharge planning• Mismatch in expectations• Longer hospital stay poorer quality of
lifeStaff• Process variation leading to less
efficient workflow• Frustrated and can lead to lower staff
morale
Organisation• Longer length of stays = Higher costs• Lower credibility as rehab unit of choice
To improve effectiveness and efficiency of the service provided to inpatients at Ryde Hospital, GRC
Aim5% increase in patient experience on the Patient-Reported Experience Measure from 80% to 85%
11% reduction in average length of stay for Reconditioning patients from 19 days to 17 days by August 2020
Improve functional outcomes by 11% increase in average Functional Independence Measure (FIM) score change for GRC patients from 17 to 19 points
On admission Betty and her family were provided welcome information that explained expectations
A member of the team confirmed with Betty her estimated discharge date based on her agreed goals
Betty discharged as planned and fed back that the team coordinated her discharge well and kept her informed
The team met with Betty and her daughter to provide support and discussed discharge options
“The team really helped me through my rehab journey”
Betty’s New Journey
Communication with patient/carers Patients and carers had limited understanding of GRC rehabilitation expectations
Team communicationDisorganisation of rehabilitation processes led to delay in discharge
Functional gainFunctional Independence Measure (FIM) motor score change are below national averages
of patients told us they had insufficient information regarding rehabilitation
of patients did not leave rehabilitation on their estimated discharge date
Almost 1 in 2 outcomereporting forms were found to be incomplete or inaccurate
Estimated Discharge Date set using the AROC Rehabilitation Inpatient Class Calculator for Reconditioning patients
Incorporation of Discharge Criteria Decision Making tool into case conferences
Develop a GRC Patient Welcome Film
Develop a GRC Team Education and Orientation program
Average
length of stay
for
Reconditioning
patients for the
financial year
Average motor
score change
on the
Functional
Independence
Measure scale
Real-time referral entry achieved timely multidisciplinary input
Block booking of face-to-face interpreters discontinued due to COVID-19
Wards merged
Number of patients into GRC
Outpatient services
iGO project on pause
Easier to make changes
Processes consistent
Staff communication
Knowing when to pause the project so it is not competing with more important activities and when to recommence
User-drivenPatient story is powerful
Trust in the Redesign methodology Be adaptable
and flexible
Strong sponsorship
“I feel the staff are not working together or telling me what is happening”
“I don’t know why I’m still here. I thought I was managing OK”
“I was all ready to go home….now nothing is ready”
“I don’t know when I’m going home. It feels like I’ve been here forever”
On average, patients left hospital 6 days earlier!
Patients’ function improved by 18%! Better than our target of 11%
64%
Alanna [email protected] Fok [email protected] Esther Ng [email protected] Philippa Wilford [email protected]
Quick wins
Improved coding accuracy and improved rehabilitation outcomes
