• Like

Specialist CASE STUDY: Improvements at the Royal Victorian Eye & Ear Hospital

  • 320 views
Uploaded on

Mitchell Wilson, Nurse Unit Manager Short Stay care Centre from the Royal Victorian Eye & Ear Hospital delivered this presentation at the 2012 Elective Surgery Redesign Conference. For more …

Mitchell Wilson, Nurse Unit Manager Short Stay care Centre from the Royal Victorian Eye & Ear Hospital delivered this presentation at the 2012 Elective Surgery Redesign Conference. For more information about our wide range of medical and health events covering a broad range of industry issues, please visit www.healthcareconferences.com.au

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
320
On Slideshare
0
From Embeds
0
Number of Embeds
2

Actions

Shares
Downloads
2
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. Point of Care Admission Royal Victorian Eye & Ear Hospital Elective Surgery Redesign Conference 12-13th Nov 2012 Mitchell Wilson mitchell.wilson@eyeandear.org.au
  • 2. RVEEH Clinical Services • 180,000 occasions of service in outpatient clinics • 46,000 occasions of service in Emergency • 13,000 theatre cases per year • 50% of public eye including most Special Eye and 10% of public ENT services in Victoria • Theatre access: 80% eye & 20% ENT workload
  • 3. RVEEH Surgical Services  Day Surgery Department (DSF)– 3 Theatres (Level 3 Peter Howson Wing)  Operating Theatre Suite (OTS) – 5 Theatres (Basement Peter Howson Wing)  Short Stay Care Centre (SSCC) – 21 recliner bays (Level 4 Peter Howson Wing)  SSCC provides admission and discharge services for patients whose theatre allocation is for the basement OTS
  • 4. Operating Theatre Suite & SPC Day Surgery Short Stay Care Centre Pre-admission Medihotel Ward 8 / Bed Management Admissions GF 3rd 4th 6th 7th 8th Basement Entrance Smorgon Family Wing RVEEH Surgical Service Location Peter Howson Wing
  • 5. • Operates 7am to 7pm Mon – Fri • Two shifts o0700 to 1530 – 4 nursing staff o1030 to 1900 – 3 Nursing Staff • Approx 6000 admissions annually RVEEH Short Stay Care Centre
  • 6. Centralised Admissions • Crowded admission waiting area – DSF & SSCC patients in the one area waiting for admission • There has been both formal and informal patient complaints about the waiting time and environment • Delays in prepping patient for theatre & delays in theatre start time - 6% of incident reports for SSCC • Staff disquiet - rework in data entry in PiMS and clerical work taken on by nursing staff
  • 7. Point of Care Project May - August 2012 Background • Issues – Patient & staff disquiet – Delays in admission and theatre start time – As part of the enabling works for redevelopment • The admission process was reviewed and the Point of Care Project established
  • 8. Methodology and Staging • The methodology adopted for the project was Process Redesign • Phases: – Defining the scope of work – Diagnosing the issues – Developing appropriate interventions – Implementation – Evaluation of outcomes
  • 9. User Group • Project Executive Sponsor • Project Manager: Staff from Planning & Innovation • Project Leads: NUM SSCC & DSF • NUM Inpatient Ward & Preadmission • Perioperative Services Manager • Manager Health Information Services • Admissions Clerk • Accounts Manager
  • 10. Scope • Inclusions are all admission during the hours of 7am to 7pm Monday to Friday – core business hours • Exclusions are admissions that occur out of hours and weekends – these are managed via the Emergency Department
  • 11. Diagnosing the Issues • The User Group mapped the current admission process. • The mapping process provided an: – understanding of patient flow – bottlenecks and – constraints
  • 12. Current State - Admission
  • 13. Developing appropriate interventions • A future state for the admission process was then created which mitigated constraints. • Principles used to guide the development of a future state focused on changing the way patients waited and travelled before their surgery. • The aim was to create a future state which was patient centred and reduced delays.
  • 14. Future State - Admission
  • 15. Prerequisites for Future State • Space available on the SSCC and DSF • Wireless access for data entry and printing of admission registration form • PiMS availability on mobile computer units
  • 16. Trial Period • One month before Go Live implementation a series of trial dates were identified. • Theatre bookings were reviewed to identify lowest activity for alternating morning and afternoon sessions • Staff feed back was recorded immediately after patients had been admitted and debriefing meetings discussed resolution for identified issues • As the trial period progressed and issues were resolved busier and full days were trialled
  • 17. Implementation • Go live was 20th August 2012 • Modifications to the Future State were made for Point of Care due to limitations of PiMs & patient privacy issues o Unable to have 2 patients assigned to the one patient recliner bay o Patient demographics required to be checked on admission, difficult to maintain privacy in a shared room.
  • 18. Implementation Model
  • 19. Evaluation The project realised three key objectives: • Improved patient experience • Reduced delays in prepping patients for theatre • Streamlined patient admission process by removing rework and delays Benefits realised as a result of the project are: • Released space on ground floor for enabling works • Improved communication between admission and inpatient staff
  • 20. Evaluation • No RiskMan entries for delays in patient admission since Go Live 6:54 6:57 7:00 7:03 7:06 7:09 7:12 20/08/2012 21/08/2012 22/08/2012 23/08/2012 24/08/2012 25/08/2012 26/08/2012 27/08/2012 28/08/2012 29/08/2012 30/08/2012 31/08/2012 1/09/2012 2/09/2012 3/09/2012 4/09/2012 5/09/2012 6/09/2012 7/09/2012 8/09/2012 9/09/2012 10/09/2012 11/09/2012 12/09/2012 13/09/2012 14/09/2012 15/09/2012 16/09/2012 17/09/2012 18/09/2012 Time of first Patients presentation at Nurses Station (SSU Specific)
  • 21. User group Review • Composition of the project team • Communication breakdown in private rooms • Resistance to change • Increased patient involvement • Involve IT earlier • Limited baseline data to compare with post go-live data
  • 22. Patient Feedback • It is good to go straight to an area where there are nurses and doctors • I’ve been here before and this time it was much better, I had to stand last time as there were not enough chairs • The new waiting room is very comfortable and warm and it is good to have the big TV to watch • There is plenty of staff around to answer your questions
  • 23. Thank You mitchell.wilson@eyeandear.org.au