Alison Read, Cancer Systems Innovation Manager CCLHD Carla ...€¦ · Active bright blood bleeding...
Transcript of Alison Read, Cancer Systems Innovation Manager CCLHD Carla ...€¦ · Active bright blood bleeding...
Alison Read, Cancer Systems Innovation Manager CCLHD Carla Kelly, (previous) Project Officer Cancer Services CCLHD
Case for change
Letter receiv (S ed from GP, 6th Ma y 2015
ourced from patient emergency
department eMR) Dear Sir/Madam
Thanks you for seeing this young man. Mr X. age 59yrs for urgent colonoscopy.
Presenting Problem Active bright blood bleeding since yesterday.
Positive occults in June 2014 – but for various reasons colonoscopy could not be
arranged. I’ve had no success trying to get someone to do a colonoscopy.
They are all away or have not got lists in GDH anymore.
In view of his current ongoing bleeding, he needs a colonoscopy on an emergency
basis. He does not have insurance. Yours Sincerely, Patient’s GP
Goal The Central Coast Local Health District (CCLHD) will work collaboratively with the Hunter New England Central Coast Primary Health Network (HNECCPHN) to ensure consistent and equitable access to public colonoscopy services for the people of the Central Coast.
Objectives 1. Reduce the colonoscopy wait times by 20% for positive faecal occult blood test (FOBT+) or high risk/symptomatic (Category A) patients by January 2016 including: • Time from GP Referral to date added to the Colonoscopy wait
list • Time from added to colonoscopy wait list to colonoscopy
procedure date (category A waitlist) 2. A 20% decrease in complaints related to colonoscopy services by April 2016.
Method Tagalongs Integrated Booking Unit –May and June 2015 Process mapping of current process – June 2015 Solutions workshop – 26th July 2015 Process mapping of new process – 20th August 2015 Steering committee meetings (n = 6) Executive Sponsor Meetings (n = 4) Project Team Meetings (n=3) Patient interviews (n=8) Patient Experience Tracking (n= 241) Procedure and wait list audits - ongoing
Diagnostics
Clinical Priority Category 1 (or A) within 30 days
High likelihood of significant organic pathology, e.g. Clinically significant overt lower gastrointestinal bleeding; active inflammatory bowel disease or diarrhoea, clinically significant iron deficiency anaemia, FOBT +ve.
*based on proportional increase
We chose A
our solutions simplified patient
to achieve: journey
Consistent and equitable access to public colonoscopy in CCLHD
Reduction in incidence & mortality from bowel cancer in CCLHD
Procedures being completed within the recommended timeframes
Planning and Implementing Solutions Currently the implementation of solutions has not occurred although the following solutions and implementation planning has been completed.
Development of a Colorectal suite of CCLHD localised pathways including: • Colorectal Cancer Symptoms • Positive Faecal Occult Blood Test (FOBT) • Screening and Surveillance Colonoscopy Top 10 Most Viewed Central Coast Pathways Feb 2016 1. Screening and Surveillance Colonoscopy 9. Colorectal Cancer Symptoms
Sustaining change
• Business case increasing capacity will support the district to manage the increased demand, which complements the direct access pathway.
• The ITC solution will allow for continual reporting and evaluation of direct access FOBT model by measuring time points such as:
• GP referral to registration
• Registration to appointment or procedure
• Procedure to discharge • GP education/consultation and localised HealthPathways
Conclusion
This project has identified the data and process changes to support the proposed increase in capacity to perform colonoscopies in CCLHD. The implementation of direct access is ongoing, however, changes in process are based on evidence (literature review), predicted increase in demand via the diagnostics phase and robust solutions identified by the project team.
Acknowledgements Executive Sponsor: Mr Matt Hanrahan (Chief Executive CCLHD)
Funding Body: Cancer Institute NSW
Steering Committee:
Andrew Roberts, Manager Division of Medicine
Debra McGillicuddy Project Officer , Cancer Services (incoming)
Glenn Hawken Gastroenterologist and Head of Department Gastroenterology
John Haydon Consumer Representative CCLHD
Karen Schofield A/Manager Division Surgery, Anaesthetics & ICU
Phil Godden General Practitioner Clinical Lead HealthPathways
Working Party:
Jenny Eisner, NUM Endoscopy Gosford
Beth Burgin, NUM IBU Gosford
Terri Pavlovich, IBU Gosford
Anna Pantoulas, Waitlist Management Clerk
Jennifer Drennan, Theatre & Waitlist Management Clerk
Lynette King, Theatre Bookings & Waitlist Management Clerk
Elizabeth Eyres, CNS Endoscopy Wyong
Lyn Frew, Waitlist Clerk
Oliver Higgins, Acting Clinical Redesign Manager
Contact
Alison Read (02) 4320 9804 [email protected]
Carla Kelly [email protected]
Debbie McGillicuddy [email protected]