Susan Moller, Principal Project Officer, Queensland Health - Electronic Patient Journey Boards -...
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Electronic Patient Journey Boards Where is Queensland up to? July, 2014 Susan Moller - Principal Project Officer, CARU
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Susan Moller, Principal Project Officer, Queensland Health delivered the presentation at the 2014 Discharge Planning Conference. The 2014 Discharge Planning Conference - Assisting health services to adopt an integrated and consumer directed approach to discharge planning. For more information about the event, please visit: http://bit.ly/dischargeplan14
Transcript of Susan Moller, Principal Project Officer, Queensland Health - Electronic Patient Journey Boards -...
Electronic Patient Journey
Boards
Where is Queensland up to?
July, 2014
Susan Moller - Principal Project Officer, CARU
Multi-disciplinary Meeting – Medical ward, Mackay Hospital.
Multidisciplinary Meeting – Neurosurgical ward, RBWH
„Adolescent MH – RBWH Discharge Planning –
Adult & Adolescent Mental Health wards, RBWH
•Designed by clinicians
•Popular, intuitive, well received
•Installed into 2 medical wards
•Reduced data duplication for handovers
•Enhanced communication and discharge planning.
“Ward at a Glance”
2009 - Developed at The Prince Charles
Hospital EMU.
• Medical, Surgical, Maternity, Mental health,
Paediatric & Sub-acute sites included
• Metropolitan, Regional and Rural sites
• Aligned with the „Criteria Led Discharge‟ initiative
• Qualitative and Quantitative outcomes measured
2011 – Statewide trial of EPJB‟s in 50 wards
in 10 hospitals
What was measured?
Quantitative
•Average Length of stay (ALOS)
•Estimated Date of Discharge (EDD) completion rates
Qualitative
•Views on Communication for Handovers, Discharge Planning etc
•Patient Safety factors
•Time saved?
•Level of Passion
Always being aware that EPJB’s not ‘isolated’ change
Quantitative outcomes Using all DRG‟s by ward „TWB MU1‟
LOS comparisons Pre & Post Electronic Patient Journey Board
MU1 TWBA(installed 3/5/11)
1.3
2.5
1.5
3.4
2.5
2.8
1.2
2.1
2.3
2.8
1.2
1.6
1.3
2.8
1.9 1.8
1.1
1.61.5
2.0
-
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
Chest Pain Non-Major
Arrhythmia
Syncope and
Collapse
HFand Shock Oesophagitis &
Gastroent
Unstable
Angina
Coronary
Atherosclerosis
Resp Infections
W/O CC
Seizure Resp Infections
W Severe/ Mod
CC
TOP 10 DRG's
Nu
mb
er
of
da
ys
May-Nov 2010
May-Nov 2011
Quantitative outcomes Using specific DRG by hospital „Resp Infections‟
Comparison of a specific DRG - Pre & Post EPJB
E62B - Respiratory Infections/Inflammations W Severe or Moderate CC
7.2
6.1
11.5
7.06.8
8.0 8.0
4.7
5.65.9
8.4
7.5
4.9
3.7
7.3
5.24.9
5.4
7.6
3.8
5.0 4.9
5.65.9
-
2.0
4.0
6.0
8.0
10.0
12.0
14.0
BUN Med
(6 mnths)
CBH Gen4
(12 mnths)
CBH CCU
(12 mnths)
CBH Med5
(12 mnths)
IPS 7C
(6 mnths)
MBH Med
(12 mnths)
NAM 2B
(6 mnths)
NAM 3FE
(6 mnths)
ROC Med
(5 mnths)
PCH W1C
(12 mnths)
PCH W1D
(12 mnths)
TOO MU2
(6 mnths)
TOO MU4
(6 mnths)
Hospital / Ward / Time period(Data supplied by the Health Statistics Centre, Qhealth, accessed throughout 2011/12)
Nu
mb
er
of
da
ys
Pre EPJB
Post EPJB- same period
Quantitative outcomes Using specific DRG by hospital - „UTI‟
Comparison of a specific DRG - Pre & Post EPJB L63B - Kidney and Urinary Tract Infections Age < 69 or W Severe CC
5.35.5
7.0 7.0
5.8
6.6
8.3
3.5
4.2
5.2
6.1
7.0
4.3 4.3
8.0
7.4
-
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
CBH Gen4
(12 mnths)
IPS 7C
(6 mnths)
MBH Med
(12 mnths)
NAM 2B
(6 mnths)
NAM 3FE
(6 mnths)
ROC Med
(5 mnths)
PCH W1F
(12 mnths)
TOO MU4
(6 mnths)
Hospital / Ward / Time period(Data supplied by the HealthStatistics Centre Qhealth, accessed throughout 2011/12)
Nu
mb
er
of
da
ys
Pre EPJB
Post EPJB Same period
Quantitative outcomes Using specific DRG by hospital „SVD‟
Comparison of a Single DRG Pre & Post EPJBO60B Vaginal Delivery W/O Catastrophic or Severe CC
2.21
2.63
2.44
2.172.172.22
2.44
2.11
0.00
0.50
1.00
1.50
2.00
2.50
3.00
MBH-WHU (6mnths) ROC-MAT (5mnths) TOO-HARBI (6mnths) TSV-TOBS (6mnths)
Hospital / Ward / Time period
(Data supplied by the Health Statistics Centre, Qhealth, access throughout 2011/2012)
Nu
mb
er
of
da
ys
Pre EPJB
Post EPJB same period
�Birth Suite – Royal Brisbane & Women‟s Hospital.
Qualitative outcomes:
• Improved efficiencies in Discharge planning
• Improved communication between all staff
• Improved handover processes
• Intuitive & user friendly, minimal training needed
• Improved patient safety & quality of care
• Level of Passion was high, ensuring liklihood of
sustainability
University of Southern Queensland (USQ)
How is Discharge Planning enhanced?
• Mandatory Estimated Discharge Date
• Mandatory Discharge Destination
• Discharge script status – Traffic Lights
• Transport bookings
• Allied Health referral status
• Collective discharge details for multiple patients
• Inter-hospital transfers
• Current demographic details ie addresses, postcodes
• Can effectively plan in advance
The notion that whiteboards facilitated patient flow and discharge planning was
a consistent finding and has been widely recognised……Chaboyer 2009
The EPJB journey -
2012 – Contracts with External provider commenced
- Mandatory fields
• Estimated Discharge Date (EDD)
• Discharge Destination
- “Ward at a Glance” to be a priority
- Traffic Light formatting
- Interfacing with HBCIS, EDIS & „The Viewer‟ now possible
- Whole of Hospital /Health Service now visible
- Remote access by all team members enhanced
Cairns & Hinterland HHS 22
Townsville HHS 22
Mackay HHS 4*
Central HHS 19
Wide Bay HHS 17
Darling Downs HHS 17
South West HHS 6
Electronic Patient Journey Boards in QLD
Sunshine Coast HHS 3
Metro North HHS 93
Royal Children‟s Hosp 8
West Moreton HHS 21
Metro South HHS 61
Gold Coast HHS 16*
Total = 309 EPJB‟s
Original MS „ACCESS‟ software
Patient Flow Manager
C
„WardView‟ at TPCH
Irrespective of Software used,
the underlying principle of
‘visual de-cluttering’ should apply
if use is to be maximised……
Less is more:
Ability to customise:
When staff perceive they are part of
the design and implementation, they
develop ownership……
Lessons learned re installs….
• Privacy concerns
• Geographical space
• Staff traffic
• Ward size
• Screen size
• 24/7, 16/7 or less….
• Ceiling, wall or desk mount
• „Touch‟ versus „non-touch‟
• Viewing comfort
• Landscape or Portrait
• Screen versus Handover
sheets for information transfer
• Workstation access
• Existing processes
• Cost
Key elements for Discharge Planning….
1.People
2.Processes
3.Tools
Is this the demise of the Manual Whiteboard?.........
MU4 ward – Toowoomba Hospital
7C ward – Ipswich Hospital
7B ward – Ipswich Hospital
1F ward – The Prince Charles Hospital
Medical ward – Mackay Hospital
Paterson ward – The Royal Children‟s Hospital
Neurosurgical ward – Townsville Hospital
Oncology ward – Royal Brisbane & Women‟s Hospital
GEM ward – The Prince Charles Hospital
And next….?
•Transit Lounges
•Pharmacies
•DEM‟s
•Operating Theatres
•Bed Management units &
•Residential Facilities
are being included.
Since 2014, not confined to
only „Inpatient areas‟
6AS –
RBWH
Susan Moller & Brent McMillin
Clinical Access & Redesign Unit,
Department of Health
Enquiries:
6AS - RBWH
