western nsw lhd · • ^golden handshake presentations via preadmission and short stay surgical...
TRANSCRIPT
![Page 1: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/1.jpg)
Western NSW LHD
in Partnership with
CareWest Ltd Collaboration in Action
ComPacks
![Page 2: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/2.jpg)
Demographics
• Western NSW LHD covers around 250,000 square kilometres. The LHD is diverse encompassing cities, inner regional, outer regional and remote communities, with a population of 270,775.
• There are 40 referring facilities ranging from Base Hospitals to Multi Purpose Services.
![Page 3: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/3.jpg)
ComPacks Management
Pre 2014
![Page 4: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/4.jpg)
• LHD had four service outlets managing the ComPacks program.
• “Demand” was not managed at an LHD level.
• Inconsistent referral processes and acceptance criterion.
• A significant number of incidents were raised at operational meetings.
![Page 5: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/5.jpg)
Referrals
• Referrers were “unruly” creating uncertainty for ComPacks providers and referring facilities.
• Not gaining consent before referring = AO.
• “Golden Handshake” presentations via preadmission and short stay surgical units.
![Page 6: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/6.jpg)
![Page 7: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/7.jpg)
Referrals (2) • Poor quality referrals
• Poor information to assist Service Providers to decide whether to accept or reject referral.
• High care need clients were referred and accepted by some providers.
• Inconsistent management of quarterly target and service bands across providers.
• Lack of clear direction around prioritisation of available ComPacks
![Page 8: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/8.jpg)
• Result – the LHD manager and staff consumed on a daily basis with micro-managing the ComPacks program
• The flexibility to reallocate packages to areas of demand due to provider boundaries and funding agreements was a significant problem
• SO……………………………………………
![Page 9: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/9.jpg)
Moving Forward
• Strategic decisions were made to enable efficiencies for the program at LHD level.
• Key enablers:
–Single Provider; and
–Centralised access.
![Page 10: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/10.jpg)
Single Provider
• The LHD opted for a single provider who could service the whole District and who was prepared to partner with the LHD in meeting patient flow demands.
• This allowed for the flexibility to provide packages to meet demand; AND
• Reduced confusion for the referrers as to who the provider was for their “patch”.
![Page 11: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/11.jpg)
Operation – “Give me a stiff drink!!”
![Page 12: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/12.jpg)
Centralised Referrals
• To manage inappropriate referrals the LHD decided to manage all referrals centrally through the LHD Aged Care Access Centre.
• The intake officers began screening and accepting referrals before submitting to the ComPacks provider.
• Allocations were also managed by the LHD and not providers.
![Page 13: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/13.jpg)
Post 2014
• A single provider, CareWest, was appointed following a contract review process.
• CareWest recruited Case Managers in Bathurst and Dubbo to complement the existing staff based in Orange and Parkes.
• This recruitment was done strategically based on:
– projected referral data; and
– the need to respond and support the Base Hospitals in their bed management strategies.
![Page 14: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/14.jpg)
• A Case Management team of 6 FTE was put in place to manage approximately 1200 packages.
• CareWest undertook an extensive educational and promotional roadshow across all facilities in the Western LHD including the Aged Care Access Centre.
![Page 15: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/15.jpg)
Referral Process • The Intake Officers are on duty daily in the
Aged Care Access Centre to manage and screen referrals.
• A revised referral process was put in place to:
– ensure timely discharge;
– gain Consent;
– arrange Assessment (FTF / Telehealth /phone);
– facilitate after hours and weekend referrals; and
– prioritise allocation of packages across the LHD.
![Page 16: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/16.jpg)
Client allocation process
• Referral received by Team Leader Case Management services from the Aged Care Access Centre.
• Referral reviewed and allocated to a Case Manager based on date of discharge, location and caseload.
![Page 17: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/17.jpg)
Assessment • Face to Face / Video Conference / Phone
• 92% of assessments were completed within 24 hours of receipt of referral
• 86% of clients received services within 2 working days of discharge
• 20% of assessments completed using video conference or phone
• 30% reduction in Assessment Only YTD – projected full year reduction of 35%
![Page 18: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/18.jpg)
Service delivery
• Currently 70% of services are provided by CareWest Home Care Workers.
• The balance of service delivery is brokered to a network of skilled and professional providers across the District.
![Page 19: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/19.jpg)
Reporting
• A report indicating number of referrals, predicted band, AO (and reasons for), referring hospital and Case Manager allocation is provided weekly by CareWest.
• Regular Operational meetings.
• Regular Steering Group meetings.
• Issues Log.
![Page 20: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/20.jpg)
Where are we now?
• Minimal number of issues or concerns raised with the quality of the service.
• Minimal issues raised regarding allocation of packages.
• Referrals between ComPacks and TACP are sorted out through appropriate screening at the Aged Care Access Centre.
• Flexible utilisation of packages allocated across the year for the LHD.
![Page 21: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/21.jpg)
Where are we now? cont…
• Hospital staff have an improved awareness of the ComPacks program and consider other community supports to enable safe discharge.
• Healthy at Home being considered.
• LHD and Provider have been collaboratively identifying areas of continuous improvement.
![Page 22: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/22.jpg)
Integrated Care
• Achieving Integrated Care!
• There is a sense that we are in this together and we do have the same program outcomes.
![Page 23: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/23.jpg)
Client Satisfaction All clients are sent a satisfaction survey on exit from program
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
OK / Good/ Very Good Poor / Very Poor
Overall Support Received from CareWest ComPacks
January 2015 to present
![Page 24: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/24.jpg)
Client satisfaction
0
10
20
30
40
50
60
Yes No
60
2
Did Compacks make going home easier
January 2015 to present
![Page 25: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/25.jpg)
![Page 26: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/26.jpg)
![Page 27: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/27.jpg)
![Page 28: Western NSW LHD · • ^Golden Handshake presentations via preadmission and short stay surgical units. Referrals (2) •Poor quality referrals •Poor information to assist Service](https://reader034.vdocument.in/reader034/viewer/2022042103/5e815d850a571a61d67077a7/html5/thumbnails/28.jpg)