Fiona Butler, Metro South Health: Improving the Entire System
-
Upload
informa-australia -
Category
Health & Medicine
-
view
328 -
download
2
description
Transcript of Fiona Butler, Metro South Health: Improving the Entire System
![Page 1: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/1.jpg)
ADDRESSING LONG STAY PATIENTS
IMPROVE ENTIRE SYSTEM Ms Fiona Butler
Nursing Director Patient Flow
Logan Beaudesert Hospital
Sub-Stream Leader, Patient Flow
Ambulatory Care & Hospital Avoidance Stream
Metro South Health Services
![Page 2: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/2.jpg)
OVERVIEW
• Metro South HHS
• Patient flow strategy
• Logan Hospital
• The drivers
• Innovation and redesign
• Long stay and stranded strategy
• Outcomes
• Future vision
![Page 3: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/3.jpg)
![Page 4: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/4.jpg)
Metro South HHS Metro South is the most populated Hospital and Health Service in Queensland. In 2011, there are 991,961 residents in Metro South, equal to 23 per cent of Queensland’s population. By 2016, this is expected to grow to 1,126,304 residents.
Metro South Health covers 3,856 square kilometres from the Brisbane River south to the Redland City Council in the east, and to the Scenic Rim Shire down to the border of New South Wales in the south-west.
Through these facilities we deliver a full suite of specialties from eight clinical streams including:
•Aged Care and Rehabilitation Services
•Cancer Services
•Emergency and Clinical Support Services
•Medicine and Chronic Disease Services
•Mental Health Services
•Patient Flow, Ambulatory Care and Hospital Avoidance
•Surgical Services
•Women’s and Children’s Services
Metro South at a glance 2011-2012 •279,562 weighted activity units •175,886 hospital admissions •242,281 emergency department presentations •10,980 staff members •$1.618 billion expenditure
![Page 5: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/5.jpg)
![Page 6: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/6.jpg)
![Page 7: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/7.jpg)
![Page 8: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/8.jpg)
![Page 9: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/9.jpg)
![Page 10: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/10.jpg)
![Page 11: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/11.jpg)
![Page 12: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/12.jpg)
![Page 13: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/13.jpg)
![Page 14: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/14.jpg)
![Page 15: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/15.jpg)
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
No
. of P
rese
nta
tio
ns
ED Presentations 2012/13
Metro North HHS 235,839
Metro South HHS 220,504
Gold Coast HHS 125,731
QLD 26 top Hospital ED Presentations
![Page 16: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/16.jpg)
Emergency Department Presentations by Month
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
Jul-1
1
Aug-
11
Sep-
11
Oct
-11
Nov
-11
Dec-
11
Jan-
12
Feb-
12
Mar
-12
Apr-
12
May
-12
Jun-
12
Jul-1
2
Aug-
12
Sep-
12
Oct
-12
Nov
-12
Dec-
12
Jan-
13
Feb-
13
Mar
-13
Apr-
13
May
-13
Jun-
13
Jul-1
3
Aug-
13
Sep-
13
Oct
-13
Nov
-13
Dec-
13
Jan-
14
MEDAI
![Page 17: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/17.jpg)
Admissions from the Emergency Department
![Page 18: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/18.jpg)
![Page 19: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/19.jpg)
Key focus areas for Logan Hospital
![Page 20: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/20.jpg)
Logan Patient Flow Redesign and
Innovation Program
Org
an
iza
tio
na
l G
oa
ls
Go
ve
rna
nce
Pro
gra
m S
tra
teg
y
Pro
gra
m M
an
ag
er
Re
so
urc
es
Tim
e,
Bu
dg
et,
Ris
ks,
Co
mm
un
ica
tio
ns
1 2 3 5 4 6 7
Project 1
Output
(e.g. New
Building)
Governance
Project
Manager /
Resources
Time Frame
Budget
Risks
Communications
Project 2
Output
(e.g. New
Software )
Governance
Project
Manager /
Resources
Time Frame
Budget
Risks
Communications
Project 1
Output
(e.g. New
Building)
Governance
Project
Manager /
Resources
Time Frame
Budget
Risks
Communications
Project 2
Output
(e.g. New
Software )
Governance
Project
Manager /
Resources
Time Frame
Budget
Risks
Communications
Project 1
Output
(e.g. New
Building)
Governance
Project
Manager /
Resources
Time Frame
Budget
Risks
Communications
Project 2
Output
(e.g. New
Software )
Governance
Project
Manager /
Resources
Time Frame
Budget
Risks
Communications
![Page 21: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/21.jpg)
Highlighted Projects to date
• Full bed platform redesign
• New models of care
• Standardisation
• Visual management tools (PFM)
• DRG LOS
• OBD specifically business areas utilising excusive OBD
• Medical bed management
• Medical LOS changing the utilisation
• Embedding acute bed management
![Page 22: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/22.jpg)
Project Vision
![Page 23: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/23.jpg)
Change Process Bed platform management
• How did we do it?
• Know the strategic direction
• Metric Total Admitted Volume: Day, Week, Month
Bed Platform
Acute/SNAP
All Patients LOS <10 days (Now 7 days)
LOS Stranded above <21 days (Now 15 days)
Frequent attenders
*HBCIS drops off the initial LOS when a patient SNAP’d
To get Truth of Total LOS for an admission we had to develop Krystal report
![Page 24: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/24.jpg)
Change Process How Did We Do It
• Bed Platform
• Know Your Cohort Acute
Non Acute
SNAP
Daily Admitted
• Visual Tools - standardisation Electronic Journey Boards
Patient Flow Manager (PFM)
EDD
![Page 25: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/25.jpg)
• Team Senior Clinicians Medical & Nursing
Senior Allied & Senior Community Interface
• Communication Plan Daily Morning Meeting 0800 advise our position
Daily Multidisciplinary Meeting at the Journey Board 0915
Weekly Complex Multidisciplinary LOS & Stranded Complex Senior Ex Team/Family Meetings
Individual Doctors: Discuss their Cohort, Complex Issues & LOS
Winter strategy
Change Process How Did We Do It?
![Page 26: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/26.jpg)
![Page 27: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/27.jpg)
![Page 28: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/28.jpg)
![Page 29: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/29.jpg)
Average Length of Stay - Medicine
Result
Actual / prior
year Change Change %
Average Length of Stay (ALOS) - Month 3.53 4.20 -0.67 -16.1%
Average Length of Stay (ALOS) - YTD 3.72 4.53 -0.81 -17.8%
ALOS - Medicine
![Page 30: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/30.jpg)
OBD - Medicine Occupied Bed Days - Medicine, excluding Nephrology
Result
Actual/ prior
year Change Change %
Occupied Bed Days (OBD) - Month 2,518 2,987 -469 -15.7%
Occupied Bed Days (OBD) - YTD 18,344 22,491 -4147 -18.4%
Average Daily Occupied Beds - Month 81.2 96.4 -15 -15.7%
Average Daily Occupied Beds - YTD 85.3 104.6 -19 -18.4%
![Page 31: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/31.jpg)
![Page 32: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/32.jpg)
![Page 33: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/33.jpg)
![Page 34: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/34.jpg)
NEAT into the future
• Target 90% NEAT discharge home
• Target 90% NEAT short stay
• Target 50% NEAT inpatient admission
• Interim Care Direct Admit
• CDU/APU
![Page 35: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/35.jpg)
Set Realistic Goals Celebrate Success
Along The Way
![Page 36: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/36.jpg)
![Page 37: Fiona Butler, Metro South Health: Improving the Entire System](https://reader036.fdocuments.in/reader036/viewer/2022082309/558b982ed8b42acc378b47b9/html5/thumbnails/37.jpg)
“Excellence is never an accident. It is always the result of high intention,
sincere effort, and intelligent execution; it represents the wise choice of
many alternatives - and its choice, not chance, that determines your future”.
Aristotle
Ms Fiona Butler
Nursing Director Patient Flow
Logan Beaudesert Hospital
Sub-Stream Leader, Patient Flow
Ambulatory Care & Hospital Avoidance Stream
Metro South Health Services
Ph: 3299 8065