If you must go to hospital, most of us would want the journey from being admitted to being discharged to be as short and smooth as possible.
The Odyssey Program at the Royal Brisbane and Women's Hospital (RBWH) is using process and cultural reform to improve the experience of patients and staff, with the intended effects of more efficiency and better patient flow.
The program shares a name with one of the world's oldest still-read stories about the long and difficult journey home of the Greek hero Odysseus, following the fall of Troy.
With 6500-plus staff, a hospital the size of RBWH is a huge, highly complex entity with many interdependencies, both internal and external. But the patient's journey through it needs not be an odyssey.
"There is no linear relationship between a bed being free on the ward and improved flow in the emergency department. That is why we are working on as many projects as possible to provide better care, where efficiency is a by-product of providing better for our patients," head of the Odyssey Program, and Director Patient Flow Services at RBWH, Gareth Davies said.
"Odyssey is taking a whole of hospital approach to patient care where everyone has a role to play, working towards a focus of continual change to better meet the needs of those who require RBWH services.
"We see our 6500 staff as experts, and we are engaging with them, to find out what their experiences are, where the problems are, and what they think the solutions could be."
Odyssey has four main streams:
- Emergency and Trauma Centre
- Whole of hospital
- Mental health
- Governance and operations.
For example, in the RBWH's Emergency and Trauma Centre (ETC), which is one of the busiest adult EDs in Queensland, clinicians and administrators are looking hard at their processes and individual performance, always seeking ways to become more efficient.
"With regard to Odyssey, the emergency department is trying to influence what we can with the patients when they are in our department," ETC Clinical Director Dr Sean Rothwell said.
"Some of the things we have done is firstly to really reinvigorate our THERMoSTAT model (an evaluation and referral model that has been in use in the hospital for more than a decade).
"And some of the keys to that are: early senior review, early referral, and early decision making. Other things we've focussed on, is we're looking at individual performance using THERMoSTAT, and we report that to each consultant in their performance appraisals.”
Acting Assistant Director of Nursing in the ETC, Ali Bell, added that nursing staff were also highly involved in improving patient flow through the Odyssey initiative.
"Some of the things we've looked at (with Odyssey) are criteria-led discharge from short-stay, which enables the nursing staff to effectively discharge staff without being seen by a medical doctor, therefore we can try and facilitate some early discharges from short-stay,” Ali said.
Odyssey is working with a host of other internal and external RBWH stakeholders, such as the Queensland Ambulance Service (QAS), the virtual ward and Hospital in the Home team, which provides in-home hospital care to patients, and the discharge transit centre, which provides co-ordination and final care requirements to patients being discharged.
All the work under the Odyssey banner is focused on continual improvement to make the hospital experience better for patients and staff.
“It’s all of our responsibility, not just the clinical team, not just the administrative team, not food services, not protective services, and all the other support services at RBWH, it’s everybody’s responsibility to improve the care for our patients,” Gareth said.