Bedside Patient Interviews: A Tool to Reduce Unplanned Re-admissions
Upcoming SlideShare
Loading in...5
×
 

Bedside Patient Interviews: A Tool to Reduce Unplanned Re-admissions

on

  • 150 views

This presentation was delivered in session C2 of Quality Forum 2014 by:

This presentation was delivered in session C2 of Quality Forum 2014 by:

Penny Anguish
Chief Operating Officer, Northwest Health Service Delivery Area
Northern Health

Statistics

Views

Total Views
150
Views on SlideShare
127
Embed Views
23

Actions

Likes
0
Downloads
0
Comments
0

1 Embed 23

http://qualityforum.ca 23

Accessibility

Categories

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Bedside Patient Interviews: A Tool to Reduce Unplanned Re-admissions Bedside Patient Interviews: A Tool to Reduce Unplanned Re-admissions Presentation Transcript

  • IMPROVING FLOW IN the NW HSDA TO PROVIDE “CARE IN THE RIGHT PLACE” Penny Anguish, NW COO On behalf of the NW CitRP Steering Group Quality Forum – Vancouver February 26, 2014
  • Northwest Health Service Delivery Area
  • Participating Communities… Hazelton Prince Rupert Kitimat Terrace Smithers
  • The (Burning) Quality Issue      Admitted patients in the Emergency Department…. Inpatient congestion the norm in our rural community hospitals…. Many patients waiting for an alternate level of care (ALC)…. ~20 - 25% of the acute beds had people waiting for residential care, usually for > 9 months…. Far too many “awful shifts”…..
  • The Quality Initiative: “Care in the Right Place”   Overarching Goal o Smooth and timely transitions of patients to the right level of care to optimize use of acute care and community resources Planned Outcomes o Reduced acute care occupancy rates o Reduced ALC and ALC to residential care placement in particular
  • Key Interventions   Typical “FLOW” strategies o Unit white boards o Daily FLOW huddles o Interprofessional care planning o Optimizing use of community resources o Daily management with a focus on timely results for the people that need to act But change leadership at all levels mattered most…..
  • Steering Group and Local Team Accountability NH Executive NW Senior Leadership Team NW CitRP Steering Group NW QI Lead Prince Rupert Improvement Team Kitimat Improvement Team Terrace Improvement Team Hazleton Improvement Team Smithers Improvement Team
  • Execution Strategies    Project charter (2 page summary) o Developed collaboratively o Provided clear goals for teams Steering Group Action plan o Pulled goals from charter o Basis for development of local plans Reporting results o Daily and monthly reporting o Increased accountability o Communicated success
  • What Worked / What Changed  One team’s story: Prince Rupert <Insert video link>
  • Results
  • Results NW Acute Facilities ALC Patient Days (QC & Haida Gwaii Excluded) Variance from Prior Year Period Pd 9 Care in the Right Place Starts 450 350 250 ALC Patient Days 150 50 (50) (150) (250) (350) (450) P1 P2 P3 P4 P5 P6 P7 P8 P9 P10 P11 P12 P13 P1 P2 P3 FY2012/13 ALC Days Variance P4 P5 P6 P7 FY2013/14 Prior Year Baseline P8 P9 P10 P11
  • Results
  • Results NW HSDA - ALC Placement Patient Days Special Cause Flag Last Center Value 273.5 Last Data Value 204 Sigma for Limits 49.01 700 Base for LimitsAverage MR Care in Right Place Starts 600 Individual Value 500 400 300 200 100 Nov 2012 Dec 2012 Jan 2013 Feb 2013 Mar 2013 Apr 2013 May 2013 Jun 2013 Jul 2013 Aug 2013 Sep 2013 Oct 2013 Nov 2013 Dec 2013 Jan 2014 628.88 628.88 628.88 628.88 628.88 628.88 420.54 420.54 420.54 420.54 420.54 420.54 420.54 420.54 420.54 420.54 334.79 334.79 334.79 334.79 334.79 334.79 126.46 126.46 126.46 126.46 126.46 126.46 126.46 126.46 126.46 126.46 481.83 481.83 481.83 481.83 481.83 481.83 273.50 273.50 273.50 273.50 273.50 273.50 273.50 273.50 273.50 273.50 571.00 505.00 486.00 531.00 423.00 375.00 338.00 387.00 321.00 291.00 213.00 254.00 283.00 229.00 215.00 204.00 0.00 A. 1 Beyond Control Limit B. 9 On One Side of Average Oct 2012 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 D. 14 Alternating Up & Down E. 2 of 3 Beyond 2 Sigma G. 15 Within 1 Sigma H. 8 Outside 1 Sigma X. Excluded or Missing Data Calendar Month
  • Residential Care Waitlists: New Referrals ???
  • Key Learnings      There is untapped capacity in the system if you are looking for it Initial assistance (FLOW Coordinators and QI Lead) key in LITs getting started Rich communication to physicians mitigated early resistance from this group, sharing results fosters physician engagement Engaging staff through LITs using QI process/strategies is a must Daily management is key to sustainability
  • Next Steps  Solidifying daily management accountability to point of care managers (acute and community)    Acting on data analysis of Emergency Department activity (high user care coordination and CTAS 3 admission avoidance) Shifting acute care to a rehabilitative approach (our care of the frail elderly) Further optimization of community resources/residential care avoidance strategies