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Manly Hospital the Fairy Tale…..
“NEAT and Tidy on the Northern
Beaches”

Deb Stewart

Sue Hair

Clinical Redesign Manager...
Manly, NSW
Setting the Scene
Once upon a time in a land far, far away there was a
majestical place called the Ministry of Health
In the Ministry there was a fiefdom known as
Northern Sydney Local Health District

Ruling over 800,000 loyal subjects and...
Five “castles” in the Local Health District
Royal North Shore Hospital
Ryde Hospital
Hornsby Hospital
Mona Vale Hospital
Manly Hospital
Manly Hospital
Manly Hospital
Manly Hospital
Manly Hospital
The interior was sadly as tired and worn
out as the exterior …..
Setting the scene……
Manly Hospital and its community health services have served
the loyal subjects of Manly and Warringah...
The journey from frog to handsome prince
Galvanising our troops
Transforming Manly into the Jewel in the
Crown
Strategy
We had a strategy to move us from a poor performing hospital to
one of the best that we and our community could b...
Whole of Hospital Strategy
to implement and embed new models of care and improve
our care processes

ED
Access

Inpatient
...
We couldn’t implement our strategy
without our “3C”s
Leadership
and
followership

Culture

Strategy

“Can do”
attitude

Co...
Strategy: ED and Access Projects
ED Models
ED SASS
Triage and registration
Fast Track

Voice recognition

ED and
Access
In 4 hours you can………
Fly from Sydney
to Fiji

Cook a 13kg Turkey
Travel from London
to Paris on the
Chunnel

Cook 120 pac...
Voice Recognition Project
Voice Recognition Project
Voice Recognition Project
Length of Stay in the Emergency Department-hours
Service Access and Patient Flow – NEAT by
Facility for Peer Group B (report Dec 2013)
Transfer of care 2013-14
Arrival to Clinician Seen Time in Emergency- minutes
Strategy: Patient

Transit Unit

Flow
Patient
Flow

ED Direct to Ward Admission Project
Fractured NOF Project
Interhospita...
Transit Unit
Short Stay Unit Admissions
Transit Unit Utilisation
Comments from our Transit Unit
patients
“Overall I feel it was a very well run little unit”
“Manly Hospital is great & we ...
Strategy: Capacity

Management

Discharge Program (Inc. Patient Journey
Boards)
Telemetry Project
Pharmacy Project
Patient...
Patient Journey Boards and rapid
rounding
Rapid Rounding at the Boards
Patients discharged within 24 hours of EDD
Inpatient Length of Stay
Challenges-% of discharges by time of day
Themes from open ended question
Overall positive response across all staff groups
“great for staff and patients as a quick...
The happy ending …
Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity...
Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity...
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Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and Hospital Performance

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Susan Hair, Director of Nursing and Midwifery, Manly Hospital, NSW and Deb Stewart, Manager of Clinical Redesign, Northern Beaches and Hornsby Ku-ring-gai Health Services, NSW
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
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Transcript of "Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and Hospital Performance "

  1. 1. Manly Hospital the Fairy Tale….. “NEAT and Tidy on the Northern Beaches” Deb Stewart Sue Hair Clinical Redesign Manager Director of Nursing NBHS & HKHS Manly Hospital
  2. 2. Manly, NSW
  3. 3. Setting the Scene Once upon a time in a land far, far away there was a majestical place called the Ministry of Health
  4. 4. In the Ministry there was a fiefdom known as Northern Sydney Local Health District Ruling over 800,000 loyal subjects and covering some 900 square kilometres, the LHD was rightly proud of its premier place in the Ministry
  5. 5. Five “castles” in the Local Health District
  6. 6. Royal North Shore Hospital
  7. 7. Ryde Hospital
  8. 8. Hornsby Hospital
  9. 9. Mona Vale Hospital
  10. 10. Manly Hospital
  11. 11. Manly Hospital
  12. 12. Manly Hospital
  13. 13. Manly Hospital
  14. 14. Manly Hospital
  15. 15. The interior was sadly as tired and worn out as the exterior …..
  16. 16. Setting the scene…… Manly Hospital and its community health services have served the loyal subjects of Manly and Warringah since 1896.  Treats over 25,000 wounded warriors through our ED and almost one third go on to require a stay at the inn  Within the castle we provide acute care services -including critical care, emergency medicine, obstetric, medical, psychiatric, surgical and orthopaedic services.  Non-acute services- include oncology, rehabilitation, drug and alcohol services, stroke management, cardiac rehabilitation and  A range of Community Health services.
  17. 17. The journey from frog to handsome prince
  18. 18. Galvanising our troops
  19. 19. Transforming Manly into the Jewel in the Crown
  20. 20. Strategy We had a strategy to move us from a poor performing hospital to one of the best that we and our community could be proud of. Our goal was and is to improve the quality of care our patients can expect and the way our hospitals function. Our strategy did not have a fairy godmother or a magic wand but involved taking a whole of hospital approach to redesign our processes and care systems.
  21. 21. Whole of Hospital Strategy to implement and embed new models of care and improve our care processes ED Access Inpatient Flow Capacity Management
  22. 22. We couldn’t implement our strategy without our “3C”s Leadership and followership Culture Strategy “Can do” attitude Commitment
  23. 23. Strategy: ED and Access Projects ED Models ED SASS Triage and registration Fast Track Voice recognition ED and Access
  24. 24. In 4 hours you can……… Fly from Sydney to Fiji Cook a 13kg Turkey Travel from London to Paris on the Chunnel Cook 120 packets of 2 minute noodles Watch Gone with the Wind Have a Kate Middleton Hairdo Listen to the Beethoven’s 5th eight times Run 5 City to Surfs
  25. 25. Voice Recognition Project
  26. 26. Voice Recognition Project
  27. 27. Voice Recognition Project
  28. 28. Length of Stay in the Emergency Department-hours
  29. 29. Service Access and Patient Flow – NEAT by Facility for Peer Group B (report Dec 2013)
  30. 30. Transfer of care 2013-14
  31. 31. Arrival to Clinician Seen Time in Emergency- minutes
  32. 32. Strategy: Patient Transit Unit Flow Patient Flow ED Direct to Ward Admission Project Fractured NOF Project Interhospital Transfer
  33. 33. Transit Unit
  34. 34. Short Stay Unit Admissions
  35. 35. Transit Unit Utilisation
  36. 36. Comments from our Transit Unit patients “Overall I feel it was a very well run little unit” “Manly Hospital is great & we have nothing to complain about…our healthcare system could not be better” “No complaints from me, everything was so well explained and I was very comfortable while I waited to go home” “Felt for staff here…what a run down hospital, but the staff could not have been better!” “Noted D/C letter did not include important bloods but TU nurse was able to retrieve”
  37. 37. Strategy: Capacity Management Discharge Program (Inc. Patient Journey Boards) Telemetry Project Pharmacy Project Patient Flow Unit Restructure Capacity Management
  38. 38. Patient Journey Boards and rapid rounding
  39. 39. Rapid Rounding at the Boards
  40. 40. Patients discharged within 24 hours of EDD
  41. 41. Inpatient Length of Stay
  42. 42. Challenges-% of discharges by time of day
  43. 43. Themes from open ended question Overall positive response across all staff groups “great for staff and patients as a quick reference” “the boards have significantly improved communication” “has been positively accepted by all staff on my ward” “the PJBs are one of the tools that make a real difference to care” “great to have all allied health staff in one place at one time”
  44. 44. The happy ending …
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