NSW Ministry of Health Patient Flow Portal

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Melinda Pascoe, Principal Policy Analyst - Patient Flow Portal & Damian Miners, Principal Policy Analyst - Patient Flow Portal, NSW Ministry of Health delivered this presentation at the 6th annual Hospital Bed Management & Patient Flow conference 2013 in Melbourne. For more information on the annual event, please visit the conference website: http://bit.ly/1f3Pp03

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NSW Ministry of Health Patient Flow Portal

  1. 1. Prepared by Melinda Pascoe and Damian Miners Principal Policy Analysts System Relationships and Frameworks Branch NSW Ministry of Health February 2013 Patient Flow Systems and the Patient Flow Portal
  2. 2. Agenda Patient Flow Systems Patient Flow Portal Capability Demonstration Patient Flow Portal Testimonial Future Vision Questions
  3. 3. Navigating patients through the health system to prevent delays Care Coordination Navigating patients through the health system to prevent delays Find it, Fix it, Log it, Escalate it Transparent accountable leadership Action Orientated Governance Transparent accountable leadership Action Orientated Demand & Capacity Planning Organising your service to build Reduce the Chaos Variation smoothing the peaks and troughs to distribute the load No Surprises Variation Management Smoothing the peaks and troughs to distribute the load No Surprises Demand Act early to preserve capacity Don’ Demand Escalation Act early to preserve capacity Don’t wait till its too late Practice Promote best practice to lock in expected outcomes Standardised Practice Promote best practice to lock in expected outcomes Express, Model, Reinforce PATIENT FLOW SYSTEMS Quality Structuring systems around an expected outcome Patient Centric Quality Structuring systems around an expected outcome Quality Structuring systems around an expected outcome Patient Centric
  4. 4. Supporting Policies • Care Coordination: Planning from Admission to Transfer of Care in NSW Public Hospitals (PD 2011_015) • Inter-facility Transfer Process for Adults Requiring Specialist Care (PD 2011_ 031) • Emergency Department-Direct Admission to Inpatient Wards (PD2009_055) Approach to Sustainable Change Capability Education and Training Tools Patient Flow Portal
  5. 5. • National Emergency Access Target (NEAT) • National Elective Surgery Target (NEST) • Activity Based Funding (ABF) Current Context
  6. 6. 1700000 1800000 1900000 2000000 2100000 2200000 2300000 2400000 2500000 2600000 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08 2008-09 2010-11 2011-12 Source is NSW Health Annual Report: Total ED Attendances by Year 2002-03 to 2011-12 ED Attendances are increasing in NSW ~ 25% increase in ED Attendances over 7 years
  7. 7. • Navigating the patient through the journey • Identify, avoid and reduce and delays • Involve all relevant staff in planning of care from admission • Commence at entry to the service and progress through to discharge and beyond Care Coordination Key Requirements Transfer of Care Risk Screen Multidisciplinary Team reviews Estimated Date of Discharge Transfer of Care Checklist Referrals, appointments and follow up
  8. 8. • First step to reduce variation is identify sources in existing practices that create unnecessary peaks and troughs:  Variation in patient admission or discharge processes  Variation in clinical management  Variation in booking tests or transport  Variation in pathology processing • Flattening variation within a complex system can lead to smoother outputs and better outcomes Variation Management
  9. 9. • Clinical practice  Align with Evidence Based Practice  Early identification of deterioration • Work process practices  Communication  Referrals  Booking procedures  Escalating delays  Multi disciplinary Team meetings  Utilisation of Transit / Discharge Lounges Standardised Practice in Action
  10. 10. Presentations are predictable Admissions are predictable Demand & Capacity Planning Predictability of Emergency Department Trends
  11. 11. 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 12/31/2007 3/10/2008 5/19/2008 7/28/2008 10/06/2008 12/15/2008 2/23/2009 5/04/2009 7/13/2009 9/21/2009 11/30/2009 2/08/2010 4/19/2010 6/28/2010 Totalseparationsforsurgicalprocedures Emergency vs. non-Emergency Surgical Admissions emergency other Emergency Surgery is predictable Predictability of Emergency Trends Planned Surgery is not
  12. 12. Predictive Tool collates information about • Patients coming into the hospital • Patients exiting • Capacity to fit demand Data is used to inform short and long term capacity planning: • Calculate tipping points • Analyse daily demand for each ward – deliver a plan for required discharges each day • Analyse demand over the long term (e.g. identifying frequent outliers – does this service require extra capacity?) • Manage predicted events – medical term change / public holidays / events Demand & Capacity Planning What is Predictive Tool used for: • Historical data • Current Emergency Department status • Expected overnight Surgical and Medical booked admissions • Direct admissions • Projected discharges / EDD
  13. 13. Tipping Points • Emergency demand • Patient with LOS > 9 days • Staff shortages • Patients waiting RACF • Isolation Patients • Inpatients waiting for surgery Demand Escalation Structure format to escalate response to demand •Capacity Action Plan (CAP) A strategic plan to manage expected demand •Escalate before the problem occurs •Short Term Escalation Plan (STEP) for short term unforseen and immediate mismatches •Unpredicted demand managed through short term solutions
  14. 14. Aim: • PFS approach is to improve quality of service, therefore quality outcomes need to drive the evaluation of the systems performance Quantitative Data • Falls, medication errors, wrong surgical site, deteriorating patients, etc Qualitative Data • Patient Experience, Patient Survey, Co-Design, feedback loop to staff? • Staff Experience Quality – Performance and Quality need to co-exist
  15. 15. • Robust - in structure to lock in process and behavioural change • Defined with accountabilities at all levels • Transparent with processes and accountabilities • Action orientated to make decisions and solve issues • Maintained and committed – throughout the project and beyond • Focussed on the patient and staff experience Governance
  16. 16. Agenda Patient Flow Systems Patient Flow Portal Capability Demonstration Patient Flow Portal Testimonial Future Vision Questions
  17. 17. Agenda Patient Flow Systems Patient Flow Portal Capability Demonstration Patient Flow Portal Testimonial Future Vision Questions
  18. 18. Agenda Patient Flow Systems Patient Flow Portal Capability Demonstration Patient Flow Portal Testimonial Future Vision Questions
  19. 19. 2013 • Increased functionality and Redesign • Working Party of NSW Local Health District Representatives • Releases planned for May and November 2014 • Tablet application Future Vision
  20. 20. Select a Waiting for What Reason
  21. 21. Edit a Waiting for What Reason
  22. 22. Default User Preferences
  23. 23. Colour Coded EDD and Ward Profile
  24. 24. Reports Module – Download Reports
  25. 25. Reports Module – Schedule Emailing Reports
  26. 26. Hospital Dashboard Login
  27. 27. Agenda Patient Flow Systems Patient Flow Portal Capability Demonstration Patient Flow Portal Testimonial Future Vision Questions
  28. 28. NSW Ministry of Health Melinda Pascoe Damian Miners patientflow@moh.health.nsw.gov.au Phone: 02 9391 9368

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