Department of Human Services

Promoting patient care through effective patient flowSystem wide implementation January – July 2005

Promoting patient care through effective patient flowSystem wide implementation January – July 2005

This guide is for Health Services to assist with key innovations which will make organisational wide improvements for patient access. It has been designed to highlight the key innovations which will promote and improve patient access.

The toolkit has been formatted as a check list, to enable a planned, system-wide implementation of improvements between January and June 2005.

Additional resources to support the innovations are available in the Patient Flow Change Package.

For further information on the Patient Flow Collaborative, please visit www.health.vic.gov.au/patientflow

Introduction

Promoting patient care through effective patient flowSystem wide implementation January – July 2005

Hospital executive and leadership staff working with common vision and purpose to achieve improved patient flow

Agree on governance and vision to improve patient flow

Systems that focus on the patient and their journey through service facilities

Patient flows that are free of unnecessary delays

Patient flow that meets or exceeds user expectation in quality, safety and access.

Clear responsibility and accountability within hospitals for efficient patient flow management systems

Governance and vision

Promoting patient care through effective patient flowSystem wide implementation January – July 2005

Flow management system and demand indicators Implemented

Plan completed to implement by July 05

Tracking systems will measure demand load and reasons for patient flow delays (eg via the PFC web tracker). Demand load and system delays will be communicated in real time within hospitals to executives, bed management and clinical staff

Hospitals will implement policy endorsed action plans for demand overload situations, or for unacceptable delays

Emergency department

Emergency departments will implement patient streaming strategies to improve all patients’ throughput times and to decrease emergency department congestion and waits

Implemented Plan completed to implement by July 05

Discharged patients will be managed through fast-track and specific care streams

Admitted patients will have appropriate and timely decision-to-admit facilitated by Emergency Physician oversight and receiving unit engagement

Promoting patient care through effective patient flowSystem wide implementation January – July 2005

Length of stay management is the key to effective and efficient patient access Implemented

Plan completed to implement by July 05

Simple delay tracking systems on each unit/ ward to allow delay free patient care will be implemented

Standard care bundles for admission & discharge planning will promote proactive length of stay management

Executive grand rounds will occur as needed and will identify possible constraints to inpatient flow, and emphasise efficient systems and processes for delay reduction

Length of stay

Promoting patient care through effective patient flowSystem wide implementation January – July 2005

Effective whole system inpatient management Implemented

Plan completed to implement by July 05

Bed management systems that have an overview of admissions, length of stay and discharge will be promoted

Executive support for bed managers will be clearly defined

Predicted bed requirements for daily emergency access will be an integral part of daily bed management meetings and access planning

Elective patient access will balance known and predictable emergency patient needs

Bed management

Promoting patient care through effective patient flowSystem wide implementation January – July 2005

Promoting best use of surgical capacity Implemented

Plan completed to implement by July 05

Day case surgery will become the default preference for elective throughput. Hospitals will review same day surgery practices and agree progressively increasing targets with each clinical service. Targets for increased same day surgery will be monitored weekly

Day of Surgery admission will become the norm. Variance will be tracked and audited

Same day surgery

Promoting patient care through effective patient flowSystem wide implementation January – July 2005

Managing patients elective surgical waits Implemented

Plan completed to implement by July 05

Audit and validation should be completed via telephone every two months to maintain a live elective surgical waiting list and promote care of the patients waiting

Systems and policy for waiting list removals due to patient choice should be followed

Clinical validation of available surgical procedure should be made. Any patient who is waiting for an unavailable clinical procedure should be identified and an action plan made after advice and discussion with the Hospital Demand Management team, Department of Human Services

Waiting list management

Promoting patient care through effective patient flowSystem wide implementation January – July 2005

AcknowledgementsJenny Bartlett Chief Clinical Advisor, Office of the Chief Clinical Advisor

Lee MartinManager, Clinical Innovation AgencyDirector, Patient Flow Collaborative

Marcus KennedyClinical Lead, Patient Flow Collaborative

Patient Flow Collaborative TeamRochelle Condon, Improvement LeadRuth Smith, Improvement LeadFiona Dickson, Improvement LeadJohn Walker, Communications and Logistics Lead Prue Beams, Data Analyst

Promoting patient care through effective patient flowSystem wide implementation January – July 2005

ContactsSupport to implement these system wide initiatives is available via the Patient Flow Collaborative team who can be contact via:

Clinical Innovation AgencyEmail: cia@dhs.vic.gov.auPhone: 9616 7022

Patient Flow Collaborative TeamLee Martin 9616 7859 Manager, Clinical Innovation

Patient Flow Collaborative Director Rochelle Condon 9616 9026 Improvement LeadRuth Smith 9616 9025 Improvement LeadFiona Dickson 9616 9030 Improvement LeadPrue Beams 9616 7742 Data Consultant John Walker 9616 9037 Communications and Logistics Lead