Diagnostics1. Process Mapping: Findings - Barriers in engaging
new services to BHC – aging infrastructure, waitlistprocess, service governance, staffing profile andadministration across smaller facilities.
2. Data Analysis: Findings - CHHC DOS KPI notmeeting 2% benchmark.
3. Staff Interviews: Findings - 88% perception wasof decreased service confidence in smallerfacilities; inefficient utilisation of resources withwaitlist, management & referral processes.
4. Patient Stories: Findings - 50% patients reportedthey chose not to go to the smaller sites due aginginfrastructure perception of older equipment.
SolutionsCapital works funding has allowed Infrastructuredevelopment and new equipment purchases at BHC.This provides the opportunity for an innovative conceptto establish new services with a centralisedPerioperative governance for co-ordination of surgicalactivity across MHC and BHC.Centralising the waitlist for Macksville & Bellingen willallow movement of activity between sites to maximisetheatre utilisation - effectively regarded as One Entitywith 2 theatres.An associated centralised Preadmission patient triage& screening service complements this, allowingefficiency in managing Requests for Admission (RFA),patient safety, management and appropriate facilityallocation.
AcknowledgementsSteering Committee: Dr Theresa Beswick GM, Kath Boman, Dr Emma Bendall, Andrew Manz, Margaret Laidley, Leonie Sens
Project Team: Janelle Goodall, Lisa Slater, Nicky Aldred, Christine Taylor.aylor
ConclusionThe project outcomes are transforming servicedelivery and patient care in the MNCLHD whileimproving access, safety and consumersatisfaction. The new structure is demonstratingimprovements in process efficiencies andNetworking relationships. The project has requireda broad level of stakeholder engagement, sponsorsupport, and ongoing resources. Commitment isrequired to ensure the effective surgical serviceprovision at BHC and MHC continues to deliverthese efficiencies while supporting CCN SurgicalServices.Lessons Learnt• Strong leadership and effective communication• Clinician and patient engagement • Resource management• The project requires dedicated time as
unexpected roadblocks can threaten outcomes
Contact: [email protected]@ncahs.health.nsw.gov.au
RFA • Received at HCF Booking Office
Triage (HCF
Waitlist)
Pa ent sent LOO
(Generic) Scheduling
Pre‐procedure ‐ PAC / GPA Referral
Admission Surgery Post surgery Discharge
Issue Three: Inappropriate
staffing to efficiently manage the service
Issue Two: Limited PAC processes for Day Only patients
Issue one: Independent waitlists
Results
New Structure
Current Status
Implementation eMR and PAC
screening
Staff at MHC and BHC
supporting service across
both sites
GP Anaesthetist engaged in
supporting new services
Lisa Slater – Perioperative NUM Macksville Health Campus
Janelle Goodall – Deputy Director of Nursing Bellingen Health Campus
Lisa Slater – Perioperative NUM Macksville Health Campus
Janelle Goodall – Deputy Director of Nursing Bellingen Health Campus
Case for changeProcedural allocation across the Coffs Clinical Network ina four-year period showed Coffs Harbour Health Campus(CHHC) to be at capacity - increased activity at MacksvilleHealth Campus (MHC), and decreasing activity atBellingen Health Campus (BHC). This lead to asuccessful application for Rural funding for capital worksat Bellingen to improve the ability to introduce newSurgical services.It was identified that and increase in Day of Surgery(DOS) cancellations at CHHC were a result of increasingEmergency surgeries and this lead to exploration ofsession availability at smaller facilities to support electivesurgery.Process mapping indicated barriers in engaging newservices to BHC, the waitlist process, service governanceand FTE in nursing and administration across smallerfacilities. Root Cause Analysis indicated a decreased ofconsumer confidence at smaller facilities.
CurrentStructure
GoalTo improve patient experience and access to efficientsurgical services and increase theatre capacity atperipheral facilities, improving ability to meet KPIs relatingto Elective Surgical Access Performance (ESAP) targets,Day Of Surgery (DOS) Cancellations & Theatre utilisation.Objectives1. Improve the patient experience – Enable better accessto surgical services by increasing surgical allocation atBHC from 150 to 390 by June 2016.2. Improve the health of populations – Enabling increasedservice capacity with successful commissioning of newservices at BHC by February 2016.
Sustaining changeThe implemented solutions will be sustained by:
Monthly reports to Surgical services meeting Attendance at monthly Network waitlist meeting Quarterly Review of Patient and staff surveys Clinical Indicators (IIMS, Audits, ESAP Targets) Number of Hits from Website (HealtheTube). Ongoing service and staff development Development proposal for Network surgical
service re-branding and promotion to reflectNetwork approach within the community.
Proposal for funding Central managementmodel at BHC & MHC to provide ongoinggovernance and efficiencies in managingresources with service growth.
Project Initiation Diagnostics Solution Design ImplementationPlanningImplementationCheck point Evaluation
Evaluation of service, workflows, Quick Wins, mentoring and coaching
Process Mapping workshops, patient & staff surveys & Tagalongs, audits. Stakeholder interviews
Mock trialing workflow, develop Task list, weekly Project team/Steering Committee meetings
Monthly performance reports, Patient & staff surveys,
Survey Data Analysis, Compilation of issues
Steering committee, Project Team initiation. Communication Plan
Method
Centre of Healthcare Redesign methodology was used for this project
MHC/BHCMHC/BHC
MKS OT
BEL OT
Networking waitlist
Networking waitlist CHHCCHHC
OT 1
OT 2
OT 3
OT 4
OT 5
MHCMHC
OT 1
BHCBHC
OT 1
CHHCCHHC
OT 1
OT 2
OT 3
OT 4
OT 5
First Cataract Patient at BHC – Dawn Lawless with Dr Lim, Dr Radford & NUM Lisa Slater
Coffs Coast Surgical ServicesBellingen - Coffs Harbour - Macksville
Top Related