Fiona Butler, Metro South Health: Improving the Entire System

810 views

Published on

Fiona Butler, Nursing Director - Patient Flow, Metro South Health, Queensland delivered this presentation at the 2014 Hospital Bed Management & Patient Flow Conference, Australia's foremost patient flow improvement meeting, showcasing innovative case studies and pioneering best practice in the nation’s hospitals.

Over 150 hospitals and state and federal departments of health throughout Australia and New Zealand have attended this conference over the past years. For more information about the annual event, please visit the conference website: http://www.healthcareconferences.com.au/bedmanagement14

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
810
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
9
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Fiona Butler, Metro South Health: Improving the Entire System

  1. 1. 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
  2. 2. OVERVIEW • Metro South HHS • Patient flow strategy • Logan Hospital • • • • • The drivers Innovation and redesign Long stay and stranded strategy Outcomes Future vision
  3. 3. 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 Metro South at a glance 2011-2012 •279,562 weighted activity units •Emergency and Clinical Support Services •175,886 hospital admissions •Medicine and Chronic Disease Services •242,281 emergency department •Mental Health Services presentations •Patient Flow, Ambulatory Care and Hospital Avoidance •10,980 staff members •Surgical Services •$1.618 billion expenditure •Women’s and Children’s Services
  4. 4. QLD 26 top Hospital ED Presentations ED Presentations 2012/13 80,000 No. of Presentations 60,000 50,000 40,000 30,000 20,000 10,000 0 Metro North HHS 235,839 Metro South HHS 70,000 220,504 Gold Coast HHS 125,731
  5. 5. Jan-14 Dec-13 Nov-13 Oct-13 Sep-13 Aug-13 Jul-13 Jun-13 May-13 Apr-13 Mar-13 Feb-13 Jan-13 Dec-12 Nov-12 Oct-12 Sep-12 7,000 Aug-12 Jul-12 Jun-12 May-12 Apr-12 Mar-12 Feb-12 Jan-12 Dec-11 Nov-11 Oct-11 Sep-11 Aug-11 Jul-11 Emergency Department Presentations by Month 8,000 MEDAI 6,000 5,000 4,000 3,000 2,000 1,000 0
  6. 6. Admissions from the Emergency Department
  7. 7. Key focus areas for Logan Hospital
  8. 8. Logan Patient Flow Redesign and Innovation Program 1 2 3 5 4 6 7 Program Manager Resources Time, Budget, Risks, Communications Program Strategy Governance Organizational Goals 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
  9. 9. 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
  10. 10. Project Vision
  11. 11. 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
  12. 12. 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
  13. 13. Change Process How Did We Do It? • 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
  14. 14. Average Length of Stay - Medicine ALOS - 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%
  15. 15. 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%
  16. 16. 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
  17. 17. Set Realistic Goals Celebrate Success Along The Way
  18. 18. “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 fiona.butler@health.qld.gov.au

×