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Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
Emergency Department Models of Care - A State-Wide Perspective
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Emergency Department Models of Care - A State-Wide Perspective

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Sarah Hoy, Principal Policy Advisor Emergency Access, NSW Ministry of Health delivered this presentation at the 6th annual Hospital Bed Management & Patient Flow conference 2013 in Melbourne. For more …

Sarah Hoy, Principal Policy Advisor Emergency Access, 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

Published in: Health & Medicine, Education
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  • 1. Sarah Hoy Principal Policy Advisor, Emergency Access NSW Ministry of Health February 2013 Emergency Department Models of Care A Statewide perspective
  • 2. Why do we need ED Models of Care?  https://www.youtube.com/watch?v=9ll01UNrbR4
  • 3. This presentation will cover….  The review of Emergency Department Models of Care to improve patient flow through NSW EDs  The development of statewide principles of models of care & implementation tools created by NSW clinicians.  The statewide process for reinvigoration of models of care that were no longer working in our EDs and the development of new models of care  Plenty of time for questions
  • 4. The Visionary – Daniel Comerford Patient Flow is everyone’s responsibility
  • 5. ED Models of Care the NSW context 184 Emergency Departments ED Role Delineation 1-6 2.5M patients annually
  • 6. How are we going to get things moving and improve access for patients?  Decision to separate out areas of responsibility – EDs should focus on ED business – Hospital executive and hospital staff should focus on improving access to inpatient beds ED Models of Care Patient Flow SystemsPATIENTS
  • 7. But we’ve already done ED Models of Care haven’t we? 2006 Lots of questions “Is there any more information?” Why is your Fast Track in a cupboard? “Is there anyone whose ED Short Stay Unit works we can talk to?” “What ED models should we have in our new ED?”
  • 8. Review of NSW ED Models of Care needed Project Initiation & Start up Diagnostics Solution Design Implementation Implementation Monitoring Evaluation / Sustainability NEAT is coming! NSW Heath Redesign Methodology used Project Aims  Defining the high level principles for contemporary ED models of care  Explore new innovative models  Provide a basis for capital planning of future EDs
  • 9. Diagnostic Methodology Survey of ED Clinicians ED Performance data NSW Patient Survey Literature review 14 site visits to NSW EDs
  • 10. Key Issues identified in diagnostic Planning The aims, objectives, impacts and outcomes of ED models of care have not been communicated, understood or developed in conjunction with ED staff. Implementation When locally developed business rules are not adhered to for all ED models of care, access to timely, safe and quality emergency care become challenged Variability Standardised key features for ED Models of Care do not exist. ED clinicians have a differing opinion of what they are and hence models look different in hospitals across NSW Sustainability There is loss of confidence in ED models of care because of poor implementation and immense variability, this has resulted in EDs operating without thinking of the principles of models of care i.e. “A bed is a bed”
  • 11. Feedback from EDs
  • 12. Solutions Design Solutions Design workshops held at each of the 14 observation sites We also engaged Local Health District Executive & Operations Managers
  • 13. The High Level Solutions to the Key Issues Documented high level principles for Contemporary Emergency Models of Care in NSW State- Wide Standardised Implementation tools • self assessment toolkit • implementation toolkit System wide implementation strategy • LHD Project Officers • Implementation support provided by NSW Ministry of Health and Emergency Care Institute State-Wide Consultation on revised Models of Care by ED Community and LHD Managers
  • 14. Solution 1 & 2 - NSW ED Models of Care 2012  Available on – NSW Health website http://www0.health.nsw.go v.au/pubs/2012/ed_model_ of_care_2012.html – Emergency Care Institute website www.ecinsw/models_of_ca re
  • 15. Solution 3 - Self assessment checklists are available for each documented model of care
  • 16. Self Assessment Summary Report
  • 17. Solution 4 - Statewide Supported Implementation FUNDING • $1.3M • Project officer each LHD TRAINING • Models of care • Project/change management NETWORKING • Teleconferences • Sharing resources
  • 18. We have since added 2 new Models of Care ED Senior Assessment & Streaming MoC & Implementation Toolkit Aged Care Emergency Model of Care
  • 19. Our Performance remains challenged! Period Target Total NEAT % NEAT (Pts admitted to ward/ICU/OT from ED) NEAT (Patients not admitted to inpatient unit from ED) 1. 1 Jan 2012 – 31 Dec 2012 69% 61.2% 26.5% 71.8% 2. 1 Jan 2013 – 31 Dec 2013 76% 3. 1 Jan 2014 – 31 Dec 2014 83% 4. 1 Jan 2015 – 31 Dec 2015 90%
  • 20. The Emergency Care Institute is here to help you www.ecinsw.com.au
  • 21. ED Models of Care & Patient Flow  Utilisation of functioning models of care in ED provides a planned approach to patient care.  This enables the delivery of better patient outcomes, reduced waste in the system and elimination of unnecessary delays for patients. Thank you Sarah Hoy NSW Ministry of Health sahoy@doh.health.nsw.gov.au

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