Prepared by Susan Patterson & Darryl Mackender G Shannon, R. Devlin Orange Health Service In Safe Hands Patient as Partners

Prepared by Susan Patterson & Darryl MackenderG Shannon, R. Devlin

Orange Health Service

In Safe Hands

Patient as Partners

Western NSW LHD Health Awards

Aim

Create an integrated care model inclusive of patient and family

Structured format for interdisciplinary bedside rounding

Integrate a shared quality and safety checklist

Focus on comprehensive care / patient-family focussed

Aim for ‘zero’ hospital associated unexpected morbidity

Reduce unexpected deaths / unexpected deterioration


Nature & Extent of the Problem

De coupled integration of clinicians

– Medical staff rounds

– Allied Health patient care

– Nursing care delivery

Patient and family non engagement

Focus on key clinical criteria


Geographically located clinical team

Team values

Platform of accepted standard of care


Structural Resilience

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Planning & Implementing solutions

IMET approval for geographic based teams

Team values and Ward leadership statement

EOC and IPSE

Development of scripted parameters

Bedside patient journey board

In line with Whole of Hospital & NEAT


Use this slide for additional for diagrams, tables, graphs or photos

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Outcomes & EvaluationPatient & Family engagement

“… have to say that the experience was far superior to any hospital experience I have ever had. While I was up there I was so well looked after, and the doctors were doing 'cyber' visits daily, where all the medical staff involved in your recovery come in and had a mini conference with you daily to assess you and make plans/goals.”

“my sisters and I felt mum was safe for the first time……………… there was just something different about this ward…………we knew what was happening”


Between The Flags


Increasing Efficiency

By examining each patient that came through Ward MED-B* and following their progress:

This time last year Last financial year Post SIBR(274 days) (2011/12 366 days) (273 days)

Number of patients 629 791 811 ↑(Mean average (69.0) (69.6) (68.3)

Hospital Stays 716 915 922 ↑

Hospital Mortality Outcome 5.55% 5.72% 4.88% ↓

Ward Mortality Outcome 4.33% 4.37% 3.68% ↓(n = deaths) (n = 31) (n = 40) (n = 34)

Mean ward length of stay (hours) 103.68 105.36 101.28 ↓

Readmissions back to Orange Health Service within 147 183 148 ↓28 days of discharge (20.5%) (20%) (16%)

* For Medical Ward B, Orange Health Service, excluding patients flagged as Palliative Care. Selecting patients with ward date of discharge within applicable period.


Outcomes

Outcome KPI Feb/ March 2012 Feb/ March 2013

Length of stay 5.6 days 5.1 days

Length of time IDC insitu 5.66 days 3.25 days

VTE prophylaxis 50 % of patients 77 % of patients


Towards the Triple AimIntegration withEnhanced PrimaryCare & Aged Care

96% Patients Med. Rec. Early ACD discussion& hospital avoidance


Future Scope

In Safe Hands Residential School June 2013, March 2014

Adaptability of the model

CEC Deputy Chair Peter Kennedy

“the initiative that you took with the (In Safe Hands) ward in Orange has led the whole process in NSW and will continue to lead it in NSW. “

“if it hadn't been for the enthusiasm of the Orange team, we wouldn't have had a residential school “

Documents

Prepared by Susan Patterson & Darryl Mackender G Shannon, R. Devlin Orange Health Service In Safe Hands Patient as Partners