Heather Banham, Central Adelaide Local Health Network - Discharge Planning: “It’s more than a last minute thing”

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Heather Banham, Nursing Co-Director Medical Specialties, Central Adelaide Local Health Network 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

Published in: Health & Medicine
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Heather Banham, Central Adelaide Local Health Network - Discharge Planning: “It’s more than a last minute thing”

  1. 1. Discharge Planning It’s more than a last minute thing…
  2. 2. Central Adelaide Local Health Network Patient Centred SA Health Patient Centred Team Work Respect Professionalism
  3. 3. > Diverse People groups: England, Italy, Vietnam, India, Greece, Sudan, Afghanistan > 1.5% Aboriginal and Torres Strait Islander > Slightly higher percentage of females: males > Ageing population: > 65 Central Adelaide Local Health Network SA Health > Ageing population: > 65 years 17.5%, > 75 years 9.4% > Western Adelaide has a 5.9% unemployment rate > 31.6% Single person households in the west
  4. 4. Drivers for Change: Discharge Blockages • Extended length of stay: patients decondition • Bed block: decreased access to hospital services • Patients not admitted to home wards • Emergency Department over capacity • Unnecessary re-admissions SA Health • Unnecessary re-admissions • Delayed planning: who to call? • Lack of accommodation options • Lack of discharge champions • Lack of consensus between acute, sub-acute and community sectors • Poor communication • Ownership: who’s responsibility is it?
  5. 5. Discharge Planning Goals Patient Centred approach Dignity in Care principles Best Practice Improved Outcomes for patientsImproved Outcomes for patients Improved service access i.e. the right patient, in the right place, at the right time. SA Health
  6. 6. 10 Dignity in Care Principles > Zero tolerance of all forms of abuse > Support people with the same respect you would want for yourself or a member of your family > Treat each person as an individual by offering a personalised service > Enable people to maintain the maximum possibly level of independence, choice, and control > Listen and support people to express their needs and SA Health > Listen and support people to express their needs and wants > Respect people’s privacy > Ensure people feel able to complain without fear of retribution > Engage with family members and carers as care partners > Assist people to maintain confidence and a positive self esteem > Act to alleviate people's loneliness and isolation.
  7. 7. In the beginning... Local TQEH/Community SA Health Regional CALHN/CAHML Community SA Health
  8. 8. A Strategic and Operational Approach > Outcomes shared with CALHN Executive > Support to expand the Collaborative Membership > Terms Of Reference Endorsed > Reporting line established SA Health > Reporting line established > Escalation pathways established > Operationally Collaborative Action Group: shared goals and achievable outcomes > Established key workgroups with Measurable Outcomes
  9. 9. Family Allied Health Team Approach: Who do We Call? Medical Team Acute SA Health Health Pharmacist Nursing Acute and Community Community Health Providers PATIENT Acute and Primary
  10. 10. Working Collaboratively: Changing Perspective? > Developing the network & sharing with other services and providers > Communicating across all sectors and services > Conducting a gap analysis: what do we have, what do we need? > Defining shared goals SA Health > Defining shared goals > Breaking down the barriers and pre-conceived ideas > Encouraging conversations, fresh ideas and initiatives
  11. 11. Ways of Working > Patient centred: Consumer Engagement > Terms of Reference > Executive support > Escalation pathway: Feedback mechanism > Shared outcomes and goals SA Health > Shared outcomes and goals > Equal partnerships > Open communication
  12. 12. Outcomes Workgroups: Aged Care, Disability, Hospital Avoidance, Length of Stay, ED Frequent Presenters Improved communication at all levels Improved Education opportunities Increased knowledge, confidence and communication Improved pathways and networks SA Health Improved pathways and networks Service agreements under development Patient and Consumer engagement resources
  13. 13. Development of patient information sheets, posters and brochures to encourage active SA Health active participation in care.
  14. 14. SA Health
  15. 15. What have learnt? •Discharge Planning commences at the first patient encounter: Acute/Sub Acute/Primary Care •Staff need to be supported to commence the planning and networking •Staff should be resourced and have confidence to SA Health develop and communicate the plan: verbal and written •Good and comprehensive clinical handover supports discharge planning and avoids unnecessary readmission. •Discharge planning is everyone's responsibility
  16. 16. SA Health

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