Verity Luckey

2013

MODEL OF CARE

REVIEW

Short Stay Surgical Unit

Sydney Children’s Hospitals Network

Sydney Children’s Hospital Randwick

Children’s Hospital Westmead

Related child health services

SCHR co – located

– POWH

– RHW

– POWP

Sydney Children’s Hospital Randwick

Co-located with 3 other hospitals has many benefits

– Operating Theatre

– CSSD

– Anaesthetics

– Pathology*

– Medical Imaging

– Security

The Project

New Clinical Services Building

A new building announced to open in 2013

4 Floors which include 2 wards

– Surgery

– Acute Adolescent Mental Health

New Clinical Services Building

Where to Start ?

Information Gathering

Research

Data

Communication – asking key stake holders

Agended at meetings

Corridor conversations

Workshops

Examples of Workshop Mapping

Mapping from the Brown Paper Workshop

If ICU take 2 copies

> one for Tony Yee

> one for Ortho reg

to book ICU bed

Put on IPM / PAS

Date Stamp

Check if completePut IPC code and

CMBS ON RFA

Put on Wait List

on IPM / PAS

Send out Waiting

List letter

(copy in file)

Send out Waiting

List letters to

parent/carers and

file copy with RFA

Put in Anaesthetic

tray to be checked

if questionnaire

filled in

Send out letter of

offer with letter

packs if required

File RFA

Received RFA

WITH DATE(for RFA’s that can

be booked into

ORMIS as sessions

available at time of

receipt of RFA.)

Date Stamp

Check if complete

Put IPC code and

CMBS on RFAWrite in diary and

book HDU (phone

C1S) Book

interpreter if needed

Put on ORMIS

Put in Anaesthetic

tray to be checked

if questionnaire

filled in

File RFA

Received RFA

WITH DATE(for RFA’s which

don’t have to go

into ORMIS ie;

Radiology

procedures or

ORMIS sessions

not available.)

Date Stamp

Check if complete

Put IPC code and

CMBS on RFA

Write in diary and

book HDU (phone

C1S) Book int if

needed

If ICU take 2 copies

> one for Tony Yee

> one for Ortho reg

to book ICU bed

Put on IPM / PAS

Send out letter. If

RFA doesn’t need

to go on ORMIS

with letter pack

Or

Send out WL letter

as sessions on

ORMIS not

available to book

into yet.

Put in Anaesthetic

tray to be checked

if questionnaire

filled in

Order old notes if

requested

Order old notes if

requested

File RFA

Received RFA

WITH

NO DATE

Order old notes if

requested

If not page team

If not page team

If not page team

MAP 1: ADMISSION PROCESS – CLERICAL AMBULATORY CARE

Research - Adelaide

Adelaide Women’s and Children’s Hospital

Tour of their unit

Geographical space was hugely different

Brought back information to all clinicians

Committee formed included surgeons, anaesthetists,

nursing and allied health to work with architects and designers

Current Ward – Waiting Area for DO and

DOSA

Current Ward – Day Only Ward and preop

DOSA

Proposed changes in MOC

Patients admitted clerically to the unit and allowed to play

whilst waiting for surgery.

Medical staff consulted with children and families in

consultation rooms

2 trolleys for children who required premedications although

rarely used as most children did not have premedications

Children walked to theatre

Return postoperatively to day only chairs or beds for up to 2

hours after recovery

If requiring overnight stay – up to 72 hours – to be

transferred to SSS beds.

Allow flexibility with SSS beds and DO beds to flex up or

down.

Nursing staff specialised in surgical nursing

Monday to Saturday 24 hour roster

New Waiting Area for DO and DOSA

New Waiting Area for DO and DOSA

Plan for SSSU

New Ward Area for DO and SSS patients

Implementing

MOC Changes

SSSU MOC committee 12 months ago

Membership includes

Nursing Unit Managers from surgical wards

CNEs

Head of Anaesthetics

Head of Surgery

General Surgeon

Clinical Directors

Patient Flow

Waitlist Manager

Clerical Manager

Recovery

Operating Theatre

Implementing

MOC Changes

Key stake holders sent to tour Women’s and Childrens

Hospital in Adelaide – medical and nursing

Communicate with staff

Nursing Unit Manager from Women’s and Children’s

presented to all staff at SCH.

Included presentation forum to all staff

One on one discussions with key stake holders

including NUMs, surgeons, anaesthetists,

educators, patient flow, OT and management

Meeting with nursing, medical and allied health

staff for Q & A

Implementing

MOC Changes

Hospital Staff Forums

Staff surveys

Tours of the new unit

Important to

Note

Project Runway

B-Free

Emergency Surgery

MoH – HVSSSU, KPIs including NEST and NEAT

Where are we

now?

Where are we

now?

Where are we

now?

Where are we

now?

Where are we

now?

Where to from

here?

The building is planned to be completed by end of March

Plan to move Ambulatory Care and surgical beds into unit

in May 2013

Continue to communicate, communicate, communicate

All staff and consumers

Continue to develop education programs for nursing and

medical staff

Increase SSSU MOC committee and working parties in

preparation for commissioning.

The New

Building

Thank you