Facility: Orthopaedic Department, QEII Hospital
Category: Clinical Pathway Variance Management
District: QEII Health Service District
Reason for Improvement: Current methodology for capturing variance is retrospective and resource intensive
Main Activities:
|
₪ |
Develop a clinician designed list of codes relevant to hip and knee arthroplasty |
|
₪ |
Trial of digital pen and paper technology in 5 phases
|
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Improved clinician compliance with data capture in variance tracking |
|
₪ |
Real-time data input |
|
₪ |
Relevant clinical data to inform clinicians of trends in variance |
|
₪ |
Analysis which could lead to opportunities for service improvement |
|
₪ |
Application of technology not limited to variance management |
| Contact: |
(07) 3636 6363 |
Facility: PAH, Orthopaedic Unit
Category: Queensland Health Clinical Pathway
District: Princess Alexandra Hospital
Reason for Improvement: The #NOF pathway currently being used in the PA hospital needed review as changes in clinical practice had occurred since implementation 12 months previously.
Main Activities:
|
₪ |
Incorporate clinical practice changes into #NOF pathway. |
|
₪ |
Pre and post audit and trial of updated clinical pathway at the PA Hospital. |
|
₪ |
The #NOF pathway will be inclusive of the patient process form the emergency department to discharge or rehabilitation. |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
An improved compliance on the use of the #NOF pathway from the emergency department to the ward and then discharge or rehabilitation. |
|
₪ |
The project officer will prove educate sessions for the PA clinical staff on the updated #NOF clinical pathway. |
| Contact: |
(07) 3636 6363 |
Facility: Bundaberg Hospital
Category: Queensland Health Clinical Pathway
District: Wide Bay
Reason for Improvement: Improve Patient Safety and Quality by standardising the process of care for a range of conditions.
Main Activities:
|
₪ |
Utilise Trendcare as a platform to facilitate the implementation of Queensland Health endorsed Orthopaedic Clinical Pathways into Bundaberg Hospital, in the first instance, then implementation of the Queensland Health suite of Clinical Pathways. |
|
₪ |
Implementing of the Orthopaedic suite of variances into Trendcare. |
|
₪ |
Utilise Trendcare to capture and monitor variation in clinical practice by developing a suite of reports for use within the clinical units and for the provision to the pathways and processes team in CPIC. |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Compliance with contemporary evidence based practice and management |
|
₪ |
Improved analysis of variance |
|
₪ |
Enhanced ability to provide a more efficient, patient focused service |
|
₪ |
Enhanced patient knowledge and expectations of the care process. |
| Contact: |
(07) 3636 6363 |
Facility: RBWH, Stroke Unit
Category: Queensland Health Clinical Pathway
District: Royal Brisbane Women's Hospital
Reason for Improvement: The Care Pathway will assist a tertiary level hospital to comply with the National Stroke Foundation Guidelines, quality and safety and evidence based practice
Main Activities: Produce and evidence based TIA/Stoke care pathway that assists the practitioners and patients decision about appropriate health care for emergency department through the admission and discharge process.
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Achieve 10% reduction/improvement in selected stroke clinical indicators over 6 month period |
|
₪ |
Achieve 100 % of patients presenting to the emergency department with a TIA will be put on the TIA care pathway |
|
₪ |
Increase access to investigation as recommended by the National Stroke Foundation. |
| Contact: |
(07) 3636 6363 |
Facility: Gladstone Hospital
Category: Queensland Health Clinical Pathway
District: Central Queensland Health Service District
Reason for Improvement: Improve Patient Safety and Quality by implementing Queensland Health endorsed clinical pathways into Gladstone Hospital.
Main Activities:
|
₪ |
Utilise Trendcare as a platform to facilitate the implementation of Queensland Health endorsed antenatal, neonate, vaginal birth and LUSCS clinical pathways into Gladstone Hospital in the first instance, then implementation of the Queensland Health suite of Clinical Pathways. |
|
₪ |
Establish a wireless system to support the implementation of Clinical Pathways |
|
₪ |
Utilise Trendcare to capture and monitor variation in clinical practice by developing a suite of reports for use within the clinical units and for the provision to the pathways and processes team in CPIC. |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Standardise the process of care for a range of conditions |
|
₪ |
Compliance with contemporary evidence based practice and management |
|
₪ |
Improved analysis of variance |
|
₪ |
Increased patient and staff satisfaction |
|
₪ |
An analysis of the efficacy of the measurement of variance using wireless technology. |
| Contact: |
(07) 3636 6363 |
Facility: Cairns Hospital
Category: Queensland Health Clinical Pathway
District: Cairns and Hinterland
Reason for Improvement: Improve Patient Safety and Quality by standardising the process of care for a range of conditions.
Main Activities:
|
₪ |
Utilise Trendcare as a platform to facilitate the implementation of Queensland Health endorsed Surgical Clinical Pathways into Cairns Hospital, in the first instance, then implementation of the Queensland Health suite of Clinical Pathways. |
|
₪ |
Utilise Trendcare to capture and monitor variation in clinical practice by developing a suite of reports for use within the clinical units and for the provision to the pathways and processes team in CPIC. |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Compliance with contemporary evidence based practice and management; |
|
₪ |
Improved analysis of variance |
|
₪ |
Enhanced ability to provide a more efficient, patient focused service |
|
₪ |
Increased patient and staff satisfaction. |
| Contact: |
(07) 3636 6363 |
Category: COPD
Facility: The Prince Charles Hospital
District: Northside
Reason for Improvement: Chronic obstructive pulmonary disease (COPD) is a highly prevalent and growing problem that consumes considerable health resources in Australia. Hospital in the Home (HiTH) is a service that provides treatment by health care professionals in the person's home. HiTH has been demonstrated to be a safe and effective alternative for patients with COPD who present without complications. Several studies have shown benefit of HiTH over hospital based acute care, in particular for the outcomes of readmission rates, cost of care, subsequent emergency department presentations, self management skills and patient and carer preference. HITH provides a potentially cost effective and safe strategy for managing up to 25% of patients presenting to emergency departments with exacerbated COPD.
Estimated Completion Date: July 2008
Main Activities:
|
₪ |
Provision of an effective and safe alternative to inpatient care for suitable COPD patients experiencing an exacerbation with improved patient outcomes, and |
|
₪ |
Improving patient and carer skills to manage COPD when stable and during exacerbations through improved care continuity. |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Improved patient self management skills and increased levels of patient and carer Satisfaction |
|
₪ |
Increased support provided without separation from the partner |
|
₪ |
Reduced admissions and Occupied Bed Days for COPD |
|
₪ |
Reduced 28 day readmission rate for COPD |
|
₪ |
If pilot program successful, this model of care could be incorporated into routine service delivery in appropriate locations across Queensland |
| Contact: |
(07) 3636 6363 |
Category: COPD
Facility: The Prince Charles Hospital
District: Northside
Reason for Improvement: There are currently numerous pulmonary rehabilitation booklets available from Queensland Health facilities. These booklets were developed independently of each other and not all of these booklets contain the latest evidence-based information. The review, consolidation and updating of the content of these booklets will prevent duplication of clinician's efforts across the state and ensure alignment with national strategies. The review process will include consultation with relevant multidisciplinary expert groups and consumer advocate groups.
Estimated Completion Date: February 2008
Main Activities:
|
₪ |
Review of existing COPD patient information booklets (Queensland Health and interstate) |
|
₪ |
Alignment of content with National Pulmonary Rehabilitation toolkit modules |
|
₪ |
Review of document to ensure it is "consumer centric" |
|
₪ |
Consultation with key expert stakeholders in each module area |
|
₪ |
Endorsement of booklet by COPD Clinical Network Steering Committee |
|
₪ |
Publication of booklet on QHEPS |
Outputs/Outcomes/Anticipated Impact:
The expected outcome of this project is an improvement in the quality and consistency of pulmonary rehabilitation patient education material distributed to patients across Queensland.
A secondary benefit is that this booklet will help structure and guide regional and remote staff where no local multidisciplinary expertise is available for pulmonary rehabilitation programs.
| Contact: |
(07) 3636 6363 |
Category: Emergency Department
Facility: Nambour, Caloundra, Noosa and Gympie
District: Sunshine Coast and Cooloola Health Service
Estimated Completion Date: April 2008
Reason for Improvement: There are no standardised processes relating to procedural sedation in all emergency departments across the Central Area Health Service. Procedural sedation is associated with risk of adverse outcomes. Adverse events rates relating to procedural sedation are not fully known but the literature suggests rates vary between 0.5 - 4% for hypoxia, and airway complications and 15-20% for emesis, transient rash and recovery agitation. There is no process for assessing the proficiency of clinicians and no standardised routine risk assessment of patients undergoing procedural sedation. Given there are between 1100 - 1500 episodes of procedural sedation per year in SC&CHSD alone, significant risk of adverse events exists.
Main Activities: Development and implemention of clinical processes to standardise assessment and care for patients requiring procedural sedation in the emergency department. This will be undertaken in consultation with the Central Area Health Service Emergency Network, The Patient Safety Centre, Safe Medication Practice Unit, CPIC Measurement & Systems Analysis Team and staff in the districts' four emergency departments.
Outputs/Outcomes/Anticipated Impact:
The project is expected to result in a standardised:
|
₪ |
clinical risk assessment process |
|
₪ |
patient education process |
|
₪ |
patient informed consent process |
|
₪ |
patient monitoring process |
|
₪ |
clinical documentation process |
|
₪ |
patient discharge information process |
|
₪ |
data collection process |
|
₪ |
policy and procedure |
|
₪ |
process for monitoring staff competency in procedural sedation |
Upon completion of the project, the Central Area Emergency Network will consider wider spread of the Procedural Sedation Program (PSP) as a method of standardising clinical practice across the Area, which is expected to contribute to improvements in patient safety. It is anticipated the Program will be made available to the Southern and Northern Area Emergency Networks.
| Contact: |
(07) 3636 6363 |
Category: Emergency Department
Facility: Royal Brisbane & Women's Hospital
District: Royal Brisbane & Women's Hospital HSD
Reason for Improvement: To develop emergency department patient management protocols that will provide effective guidance to staff of varying experience and focus on presenting problems rather than a diagnosis.
The RBWH currently receives numerous enquiries from regional hospitals requesting standardised, evidenced-based management protocols. This project will also enable participation on a statewide emergency department group that will agree on protocols transferable to emergency departments state-wide.
Estimated Completion Date: 31 December 2006
Main Activities:
|
₪ |
Establishment of business rules around "meaningful treatment" |
|
₪ |
Agreement on statewide standardised protocols across for top 20 commonly presenting conditions |
|
₪ |
Development, implementation and evaluation of standardised protocols |
|
₪ |
100% permanent staff to receive education regarding use of protocols |
|
₪ |
Link to ED nurse transition program |
|
₪ |
Participation on statewide group standardising ED protocols |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Decrease in time to meaningful treatment |
|
₪ |
Decrease in time of arrival for specimens to pathology |
|
₪ |
Decreased percentage of patients who "Did not wait" |
|
₪ |
Decrease in ED waiting times |
|
₪ |
Decrease in aggression incidents |
|
₪ |
Decrease in patient complaints |
|
₪ |
Increase in staff satisfaction |
|
₪ |
Reduced time to decision endpoint (eg bed booking, discharge etc) |
| Contact: |
(07) 3636 6363 |
Category: Paediatrics and Neonatal
Facility: Logan Hospital
District: Logan Beaudesert
Reason for Improvement: Logan Special Care Nursery (SCN) is currently running at 109.5% to 125% occupancy. Overcrowding and access block for tertiary referrals is commonplace. The aim of this project is to implement a program of early discharge from SCN with a model where expert neonatal nurses working within a neonatal unit provide community follow up.
Estimated Completion Date: 30 September 2007
Main Activities:
|
₪ |
Early discharge program developed including discharge criteria for neonates suitable for the program and minimum qualification/skill requirements for neonatal nursing staff involved in home visits |
|
₪ |
Baseline audit data collected |
|
₪ |
Early discharge program implemented |
|
₪ |
Early discharge program evaluated |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Reduced length of stay, access block & overcrowding to Special Care Nursery |
|
₪ |
Reduced readmission rate to Special Care Nursery |
|
₪ |
Increased breast feeding rates and consistent weight gain |
|
₪ |
Parent/Carer satisfaction |
| Contact: |
(07) 3636 6363 |
Category: Maternity
Facility/Service/Unit: Goondiwindi Health Service Catchment Area
District: Toowoomba and Darling Downs Health Service District
Estimated Completion Date: 31 January 2008
Reason for Improvement: The increasing numbers of births at Goondiwindi are creating demands on the service that cannot be met by practising in the current model. A change in service delivery leading to service and practice improvement whilst practising in an evidence-based and wellness model of care will address this gap. Following an extensive consultation process in Phase One of this project, commitment has been drawn from midwives, GP's, local and district management, indigenous and non-indigenous communities to implement the midwifery-led model of service delivery.
Main activities:
|
₪ |
Refine project plan including continuous community and stakeholder communication |
|
₪ |
Up skilling of midwives and health care team |
|
₪ |
Review and update policies and procedures |
|
₪ |
Implement model of care |
|
₪ |
Evaluate model. |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Strengthened partnerships between GP OBS, tertiary sites and midwives for medium/high risk women |
|
₪ |
Increased midwife retention |
|
₪ |
Increased professional profile for midwives |
|
₪ |
Increased clinical skills for midwives |
|
₪ |
Increased use of evidence based practice |
|
₪ |
Service delivery improvement |
|
₪ |
Increased birthing rate for Goondiwindi catchment area |
|
₪ |
Reduction in the numbers of high risk presentation without adequate antenatal care |
|
₪ |
A more collaborative service delivery between GHS, tertiary referral centre and NSW Health services |
|
₪ |
Improvement of overall data collection to facilitate evaluation of the service delivery model |
|
₪ |
A sustainable model of care |
|
₪ |
Transferability of the model of care. |
| Contact: |
(07) 3636 6363 |
Category: Maternity
Facility: Sunshine Coast Health Service District
District: Sunshine Coast Health Service District
Reason for Improvement: The problem is maintaining services at best practice level and addressing the increasing community demands of a growing population. Birthing women live in coastal, hinterland and rural communities. The opportunity exists to develop a model following the hub and spoke model for the majority of women in these areas.
Estimated Completion Date: April 2007
Main Activities:
|
₪ |
Identify an appropriate model through consultation and gap analysis |
|
₪ |
Determine the viability of a service within the geographical constraints |
|
₪ |
Propose a model that fits the philosophy of Maternity Services |
|
₪ |
Develop an options plan for this type of care |
|
₪ |
Develop a proposed implementation plan. |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Recommendations for flow of maternity patients across the continuum of care |
|
₪ |
Identified model to improve breast feeding rates at 6 months |
|
₪ |
Recommendations to reduce average length of stay |
|
₪ |
Improved access for high risk patients to receive in-home antenatal services |
|
₪ |
Improved options for accessing postnatal care in-home after early discharge |
|
₪ |
Identified strategies to improve client satisfaction, parent education and support. |
| Contact: | (07) 3636 6363 cpic@health.qld.gov.au |
Category: Maternity and Child and Family Health
Facility/Service/Unit: Capricorn Coast Health Service, Yeppoon
District: Central Queensland Health Service
Estimated Completion Date: July 2008
Reason for Improvement:
The area has experienced a significant increase in births over the last two years complicated by increase in nursing and medical staffing shortages. This has contributed the staffing & care issues at the Rockhampton Hospital, where women from the Capricorn Coast birth, as birthing in Yeppoon was discontinued 10 years ago. Capricorn Coast experiences the same range of problems that exist throughout rural Queensland that increase the risk to both mother and baby. These specifically relate to:
|
₪ |
Lack of early postnatal support- very limited post natal home visiting available to coast residents |
|
₪ |
Fragmentation of care |
|
₪ |
Lack of communication between local care providers |
|
₪ |
Ineffective referral system between services |
|
₪ |
Lack of local counselling and case management services for families with complex needs |
|
₪ |
Significant drop in breastfeeding from birth to six weeks postnatal |
|
₪ |
Limited scope of practice to maintain midwives' skills, despite healthy numbers of midwives on staff |
|
₪ |
Complex paediatric clients living in rural areas |
Main activities:
The main activities of the Integrated Maternity and Child Health Model of Care include:
|
₪ |
Expansion & evaluation of antenatal care (clinics & classes); early transfer back to Yeppoon post birth |
|
₪ |
Development & evaluation of an extended midwifery service |
|
₪ |
Development and evaluation of local case management of complex paediatric cases |
|
₪ |
Development and evaluation of referral systems and communication between general practitioners and public health services |
|
₪ |
Development, support and supervision for staff working with complex families |
|
₪ |
Development of processes to ensure the sustainability of the service changes |
|
₪ |
Evaluation of the model of care |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Increased breast feeding rates and postnatal visiting rates |
|
₪ |
Increased psychosocial skills and supports |
|
₪ |
Integration of Maternity and Family and Child Health Services |
|
₪ |
Improved follow up and coordination of consumers who are identified as moderate to high risk |
|
₪ |
Increased culturally appropriate services for Indigenous and South Sea Islander women and families |
|
₪ |
Transfer of maternity services to community health site |
|
₪ |
Introduction of an Extended Midwifery Service |
|
₪ |
Introduction of a Case Management model |
|
₪ |
Established referral pathways between care providers |
|
₪ |
Improved clinical practice of midwives working across the continuum |
|
₪ |
Consumer participation in service planning |
|
₪ |
Improved and coordinated liaison with general practitioners |
| Contact: | (07) 3636 6363 cpic@health.qld.gov.au |
Category: Mental Health
Facility: Royal Children's Hospital Child and Youth Mental Health Service
District: Royal Childen's Hospital Health Service District
Reason for Improvement: The reason for undertaking this project is to:
|
₪ |
Improve service access and enhance consistency of processes to enable greater output from the resources available |
|
₪ |
Improve capacity with increasing demand and population growth through process re-engineering and specialisation |
|
₪ |
Meet both consumer and stakeholder expectations of service responsiveness and refine pathways to care. |
Estimated Completion Date: July 2008
Main Activities:
|
₪ |
Pilot a new model of mental health intake that is multidisciplinary and customer focussed |
|
₪ |
Development of processes around referral, crisis management, follow-up |
|
₪ |
Collaboration with staff, internal and external stakeholders, and the Area Health Service |
|
₪ |
Evaluation will be undertaken over 6 months |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
A best practice after hours crisis and assessment service |
|
₪ |
Reduction in patient waiting times for assessment |
|
₪ |
Reduced patient risk |
|
₪ |
Improved relapse prevention |
|
₪ |
Increased system and staff capacity to manage crisis assessments |
|
₪ |
Improved cost and system efficiency |
|
₪ |
A network of community clinics with dedicated intake officers |
|
₪ |
Increased stakeholder and staff satisfaction |
|
₪ |
Strengthened community collaboration |
| Contact: |
(07) 3636 6363 |
Category: Adult Mental Health
Facility/Service/Unit: The Prince Charles Hospital
District: Northside Health Service District
Estimated Completion Date November 2008
Reason for Improvement:
The central issue relates to the appropriateness of seclusion which remains contentious amongst health care administrators, consumers, consumer groups, human rights workers, doctors and nurses. Evidence from outside Australia indicates that:
Northside District experiences a higher rate of seclusion periods exceeding 4 hours compared to its peers. This service is unique in that there is no access to an emergency department whereby clients are assessed before being admitted. On average the percentage of patients secluded per month is 8.8%, of which 79.6% are secluded for more than a 4 hour period (data from 2006-2007 seclusion statistics). The peer average is 31%.
Main activities:
The main activities of the include:
Outputs/Outcomes/Anticipated Impact:
The project is expected to result in the following:
|
Category: Palliative Care |
Facility/Service/Unit: Ipswich Hospital
District: West Moreton
Estimated Completion Date: May 2007
Reason for Improvement: In January 2006 a baseline documentation audit was conducted at Ipswich Hospital, community and hospice, providing data on current quality of end of life care. Significant gaps between recognised best practice and current practice were identified across all performance indicators. This project aims to improve care to dying patients and support their relatives.
Main activities: To implement the Liverpool Care Pathway (LCP), an integrated Care Pathway.
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Improved comfort measures and symptom control |
|
₪ |
Psychological/insight measures documented and integrated into care plan |
|
₪ |
Religious/spiritual support needs assessed, documented and initiated as required |
|
₪ |
Improved communication with patient/family including support and information provision |
|
₪ |
Communication within the Primary Health Care Team mapped and documented |
|
₪ |
Improved assessment and control of symptoms |
|
₪ |
Increased number of patients dying in preferred place of choice - better patient-centred care |
|
₪ |
Improved staff communication, confidence and co-working with hospital and specialists |
| Contact: |
(07) 3636 6363 |
Facility: Emergency Department and medical in-patient areas
Category: Patient Flow
District: Bayside Health Service District
Reason for Improvement: Identify constraints within the system that lead to "access block" which impact on both the emergency department and in-patient areas.
Main Activities:
|
₪ |
Identify process issues within the ED through process mapping, patient tracking and staff involvement. |
|
₪ |
Identifying process issues within the in-patient areas preventing timely discharges |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Decrease in time spent in ED for medical patients |
|
₪ |
More efficient patient focused service |
|
₪ |
Decreased length of stay through implementing improved discharge process |
|
₪ |
Reduction in waste in areas of waiting, over-processing, and over-utilisation. |
| Contact: |
(07) 3636 6363 |
Facility: Surgical Process
Category: Patient Flow
District: Northern Downs Health Service District
Reason for Improvement: Facilitate standardisation of the surgical care process utilising process redesign methodologies.
Main Activities:
|
₪ |
Build capacity to understand, implement and redesign processes that impact on organisational effectiveness |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
More efficient, patient focused service |
|
₪ |
Reduced waste through standardisation of the process of care for a range of surgical conditions. |
|
₪ |
Increased patient and staff satisfaction. |
| Contact: |
(07) 3636 6363 |
|
Category: Patient Flow |
|
Facility: Medical Ward and Pharmacy Department
District: Rockhampton Health Service District
Reason for Improvement: Bed block in the medical unit is negatively impacting on service provision in many areas within the Rockhampton Hospital.
Estimated Completion Date: n/a
Main Activities:
|
₪ |
Develop a multidisciplinary team approach to managing patient flow. |
|
₪ |
Improve knowledge and links with key stakeholders. |
|
₪ |
Implement an individualised system for inpatient medication supply on the medical unit. |
|
₪ |
Develop policy and procedures to improve patient flow as well as an individualised system for inpatient medication supply. |
|
₪ |
Review data and develop systems to regularly analyse, report and monitor improvements in processes / work practices. |
|
₪ |
Evaluate the effectiveness of implemented changes. |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Improved patient flow and patients' hospital experiences from admission through to discharge. |
|
₪ |
Improved quality and effectiveness of discharge planning processes. |
|
₪ |
Improved communication between medical unit clinical staff, community agencies / General Practitioners. |
|
₪ |
Improved quality and rate of production of patient discharge medication summaries. |
| Contact: |
(07) 3636 6363 |
Facility/Service/Unit: The Prince Charles Hospital and Royal Brisbane & Women's Hospital
Category: Patient Flow
District: The Prince Charles Hospital and Royal Brisbane & Women's Hospital
Estimated Completion Date: July 2007
Reason for Improvement: Rehabilitation and sub acute patients currently block acute beds in tertiary centres leading to an inappropriate allocation of resources and a subsequent decrease in efficiency and effectiveness of acute services. Bed capacity across both sites is built to service acute episodes of care with limited ability to provide extended care. This care is provided to a proficient level within this built environment although within the Area Health Service there is capacity to treat these patients under a more appropriate model.
Main Activities: This project will develop a referral and bed utilisation process for sub and non-acute patients between the RBWH and TPCH. The project will target patients who fall into the following SNAP categories:
|
₪ |
Respite |
|
₪ |
Sub Acute - Geriatric evaluation and management |
|
₪ |
Rehabilitation - in acute rehabilitation |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Mapping current referral processes |
|
₪ |
Development of cross district referral pathways that are endorsed by key stakeholders and are:
|
|
₪ |
100% utilisation of transitional care beds across both Districts |
|
₪ |
100% utilisation of Interim care and palliative beds that are corporately funded |
|
₪ |
Decrease in acute bed block created by SNAP patients |
|
₪ |
Provide increase in efficiency, effectiveness and equity of care for the targeted patient group |
| Contact: |
(07) 3636 6363 |
Facility/Service Unit: Multiple Units including Emergency Department and Cardiology
Category: Patient Flow
District: Townsville Health Service District
Reason for improvement: Improve the patient experience through all aspects of the health service, significantly reduce access block to acute beds, and identify and decrease the number of blockages within the service that contribute to excess waiting times for clinical and clinical support services.
Main activities:
|
₪ |
Identify gaps within the system through process mapping and tracking across the continuum of care |
|
₪ |
Identify causes of access block and develop processes to eliminate these causes |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Improve access to diagnostic testing |
|
₪ |
Eliminate access block greater than 12 hours by July 2007 |
|
₪ |
Improved patient and staff satisfaction |
| Contact: |
(07) 3636 6363 |
Facility/Service Unit: Royal Children's Hospital & Health Service District
District: Royal Children's Hospital & Health Service District
Reason for improvement:
The reason for undertaking this project is to:
|
₪ |
Improve service access and enhance consistency of processes to enable greater output from the resources available |
|
₪ |
Improve capacity with increasing demand and population growth through process re-engineering and specialisation |
|
₪ |
Meet both consumer and stakeholder expectations of service responsiveness and refine pathways to care. |
Estimated Completion Date: March 2008
Main activities:
The scope of this project is to:
|
₪ |
Support the redesign of clinical systems and processes |
|
₪ |
Include the establishment of a Patient Flow Program |
|
₪ |
Review and redesign clinical systems |
|
₪ |
Reduce access block |
|
₪ |
Ensure an efficient and effective patient journey. |
This project will address the following priority areas:
|
₪ |
Oncology Outpatients Day Service |
|
₪ |
Child Development Client Flow |
|
₪ |
Patient Flow Operating Room Suite |
|
₪ |
Gastroenterology |
|
₪ |
Primary Care / Hospital Interface |
Outputs/Outcomes/Anticipated Impact:
|
₪ |
Diagnosis of patient journeys in identified priority areas |
|
₪ |
Implementation of Identified service improvement interventions |
|
₪ |
Increased service redesign capability within staff of RCH district |
|
₪ |
Standardised pathways and protocols for identified service areas within RCH District |
|
₪ |
Evaluation and analysis of results |
|
₪ |
Improved patient-focused service model of care |
| Contact: |
(07) 3636 6363 |
Facility/Service Unit: Mackay Hospital
District: Mackay Health Service District
Reason for improvement: The reason for undertaking this project is to identify the processes that impact on access to beds including a review of the interface between Whitsunday Health Service, Bowen Hospital and the rural sector Mackay District.
Estimated Completion Date: July 2007
Main activities:
Phase 1
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Mapping of patient flow through emergency department and specialty areas to identify current processes |
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Identification of service gaps in emergency department and specialty areas |
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Identification of priority areas for improvement |
Phase 2
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Development and implementation of improvement strategies based on priority areas |
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Evaluation of improvement strategies |
Outputs/Outcomes/Anticipated Impact:
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decreased levels of access block |
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improved efficiencies in discharge from medical units |
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improved efficiency of patient journeys through targeted areas |
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appropriate referral pathways |
| Contact: | (07) 3636 6363 cpic@health.qld.gov.au |
Facility/Service Unit: Ipswich Hospital
District: West Moreton South Burnett Health Service District
Reason for improvement: To identify and improve the work processes and subsequent patient flows and outcomes within the Emergency Department at the Ipswich Hospital to reduce time to admission and improve access block.
Estimated Completion Date: January 2008
Main activities:
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track and measure (process map) key processes within the Emergency Department and the quality of their outcomes |
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identify opportunities to simplify processes through reduction in steps, "hand-offs", and other means |
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pilot operational changes utilising rapid tests of change |
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target processes for classification and management of high risk re-presentations |
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attempt to reduce system stress and improve flow and efficiency (and thereby improve safety) |
Outputs/Outcomes/Anticipated Impact:
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building a multidisciplinary patient flow team |
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undertaking an aggressive research exploration of the Ipswich Hospital Emergency Department, applying complex systems theory to understand the functioning and subsequent flow elements at work |
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identifying all forms of artificial (potentially controllable) variation in the demand and supply of service flow |
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using metrics and benchmarking data to evaluate the Emergency Department and set improvement goals |
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creating and implementing a reward system to initiate and sustain good patient flow behaviours |
| Contact: |
(07) 3636 6363 |
Facility/Service Unit: Toowoomba Hospital
District: Toowoomba & Darling Downs Health Service District
Reason for improvement: To continue to establish processes within the Emergency Department and acute Medical Units which promote improved timeliness of patient flow.
Estimated Completion Date: September 2007
Main activities:
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'Streaming' patients in the Emergency Department (ED) (i.e., managing groups of patients who undergo similar processes) |
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Introduction of the '3-2-1' process in ED ('3-2-1' breaks the patient journey down into three discrete time targets for patient care, namely: patient ED assessment within three hours of presentation, medical review within a further two hours, and transfer to a ward within a further one hour) |
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Reframing the role of the existing Central Bed Manager, to become Central Flow Coordinator |
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Aiming to promote equity in workload among medical units |
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Conducting a feasibility study of a Medical Assessment and Planning Unit |
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Standardising the process for ward rounds |
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Developing a medical patient admission protocol for ED |
Outputs/Outcomes/Anticipated Impact:
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Improved patient flow within the ED |
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Decreased time in ED |
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Implementation of a medical model of service delivery which will facilitate timely discharge |
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Timely access to medical beds and therefore reduce outliers |
| Contacts: |
(07) 3636 6363 |
Facility/Service Unit: Bundaberg Hospital
District: Wide Bay Health Service District
Reason for Improvement: The reason for undertaking this project is to facilitate improvements to patient care services within the Wide Bay Health Service District. This project will lead the pursuit of patient flow improvement efforts within Bundaberg Hospital.
Estimated Completion Date: March 2008
Main activities:
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Mapping the patient journey through the hospital of a representative group of patients |
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Diagnosing issues that contribute to delays to wards, bed block and delays to discharge |
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Undertaking a review of the flow of patients through the system to identify factors contributing to: - Avoidable admissions - Review times and processes by specialties, eg medical admissions - Delays to decanting from ED to wards as identified by the most recent ACHS survey |
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Identifying the inter-hospital transfer process from when a patient arrives at Bundaberg Base Hospital |
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Undertaking a trial of 5 'S' |
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Determine indicators and targets that reflect the outcomes of the project in conjunction with the Measurement, Systems and Analysis Team (CPIC) |
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Implementing service improvement initiatives to address patient flow issues identified |
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Measuring the interventions implemented and evaluating the outcomes of the project. |
Outputs/Outcomes/Anticipated Impact:
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A reduction in waiting times in Emergency Department, |
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Reduced lengths of stay, |
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Increased bed access, |
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Improved customer service, |
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An increase in consumer and staff satisfaction, |
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Improved efficiency indicators, and |
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Results of a Snapshot survey of DEM ward clerk / Triage Nurse staff - Verbal abuse occurrence regarding waiting times. |
| Contact: |
(07) 3636 6363 |
Facility/Service Unit: Hervey Bay and Maryborough Hospitals
District: Fraser Coast
Reason for Improvement: The reason for undertaking this project is to improve patient flow for all patients through the emergency department and across the Fraser Coast Health Service District. A high volume, high need, acute Respiratory DRG patient group that relies on key aspects of the hospitals system will be mapped.
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Chronic Obstructive Airways Disease W Catastrophic or Severe CC |
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Chronic Obstructive Airways Disease W/O Catastrophic or Severe CC |
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Respiratory Infections/Inflammations W Severe or Moderate CC |
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Respiratory Infections/Inflammations W/O CC |
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Respiratory Infections/Inflammations W Catastrophic CC |
Estimated Completion Date: 12 months - probably start in June / July 2007
Main activities: The project objectives include diagnosis, improving processes related to increased Emergency Departing waiting times, bed block and delays to discharge.
Outputs/Outcomes/Anticipated Impact:
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Reduction in waiting times in Emergency Department, |
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Reduced lengths of stay (mapping DRG's), |
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Identify duplication and inefficiency, |
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Increased bed access, |
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Improved patient discharge times, |
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An increase in consumer and staff satisfaction, |
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Improved efficiency indicators, and |
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Improved support services access (Radiology / Pathology / Pharmacy). |
| Contact: |
(07) 3636 6363 |
Facility/Service Unit: Cairns Hospital
District: Cairns and Hinterland Health Service District
Reason for Improvement: The reason for undertaking this project is to identify potential areas for improving patient flow throughout Cairns District and subsequently implement service improvement initiatives to improve patient access to crucial healthcare services
Estimated Completion Date: June 2008
Main activities: This project will occur in two phases:
Phase 1 will involve the education of staff in, and use of various diagnostic tools including mapping and tracking to describe the patient journey from service entry to discharge. A series of metrics will also be established to determine progress. Common causes of ramping, increased ED waiting times, bed block and delays to discharge will also be investigated.
Service improvement initiatives identified during phase 1 will be prioritized according to impact and ease in phase 2. Those that gain precedence will be undertaken during this phase to gain some "quick wins". Evaluation of these improvement strategies will also occur in phase 2.
Outputs/Outcomes/Anticipated Impact:
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a reduction in waiting times in Emergency Department, |
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reduced lengths of stay, |
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improved Hospital / Community interface, |
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increased bed access, |
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improved customer service, |
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an increase in consumer and staff satisfaction, and |
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improved efficiency indicators. |
| Contact: |
(07) 3636 6363 |
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