Susan Moller, Principal Project Officer, Queensland Health - Electronic Patient Journey Boards - Where is Queensland up to?

1,233 views
836 views

Published on

Susan Moller, Principal Project Officer, Queensland Health 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
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,233
On SlideShare
0
From Embeds
0
Number of Embeds
11
Actions
Shares
0
Downloads
27
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Susan Moller, Principal Project Officer, Queensland Health - Electronic Patient Journey Boards - Where is Queensland up to?

  1. 1. Electronic Patient Journey Boards Where is Queensland up to? July, 2014 Susan Moller - Principal Project Officer, CARU
  2. 2. Multi-disciplinary Meeting – Medical ward, Mackay Hospital.
  3. 3. Multidisciplinary Meeting – Neurosurgical ward, RBWH
  4. 4. „Adolescent MH – RBWH Discharge Planning – Adult & Adolescent Mental Health wards, R
  5. 5. •Designed by clinicians •Popular, intuitive, well received •Installed into 2 medical wards •Reduced data duplication for handovers •Enhanced communication and discharge planning. “Ward at a Glance” 2009 - Developed at The Prince Charles Hospital EMU.
  6. 6. • Medical, Surgical, Maternity, Mental health, Paediatric & Sub-acute sites included • Metropolitan, Regional and Rural sites • Aligned with the „Criteria Led Discharge‟ initiative • Qualitative and Quantitative outcomes measured 2011 – Statewide trial of EPJB‟s in 50 wards in 10 hospitals
  7. 7. What was measured? Quantitative •Average Length of stay (ALOS) •Estimated Date of Discharge (EDD) completion rates Qualitative •Views on Communication for Handovers, Discharge Planning etc •Patient Safety factors •Time saved? •Level of Passion Always being aware that EPJB’s not ‘isolated’ change
  8. 8. Quantitative outcomes Using all DRG‟s by ward „TWB MU1‟ LOS comparisons Pre & Post Electronic Patient Journey Board MU1 TWBA (installed 3/5/11) 1.3 2.5 1.5 3.4 2.5 2.8 1.2 2.1 2.3 2.8 1.2 1.6 1.3 2.8 1.9 1.8 1.1 1.6 1.5 2.0 - 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 Chest Pain Non-Major Arrhythmia Syncope and Collapse HFand Shock Oesophagitis & Gastroent Unstable Angina Coronary Atherosclerosis Resp Infections W/O CC Seizure Resp Infections W Severe/ Mod CC TOP 10 DRG's Numberofdays May-Nov 2010 May-Nov 2011
  9. 9. Quantitative outcomes Using specific DRG by hospital „Resp Infections‟ Comparison of a specific DRG - Pre & Post EPJB E62B - Respiratory Infections/Inflammations W Severe or Moderate CC 7.2 6.1 11.5 7.0 6.8 8.0 8.0 4.7 5.6 5.9 8.4 7.5 4.9 3.7 7.3 5.2 4.9 5.4 7.6 3.8 5.0 4.9 5.6 5.9 - 2.0 4.0 6.0 8.0 10.0 12.0 14.0 BUN Med (6 mnths) CBH Gen4 (12 mnths) CBH CCU (12 mnths) CBH Med5 (12 mnths) IPS 7C (6 mnths) MBH Med (12 mnths) NAM 2B (6 mnths) NAM 3FE (6 mnths) ROC Med (5 mnths) PCH W1C (12 mnths) PCH W1D (12 mnths) TOO MU2 (6 mnths) TOO MU4 (6 mnths) Hospital / Ward / Time period (Data supplied by the Health Statistics Centre, Qhealth, accessed throughout 2011/12) Numberofdays Pre EPJB Post EPJB- same period
  10. 10. Quantitative outcomes Using specific DRG by hospital - „UTI‟ Comparison of a specific DRG - Pre & Post EPJB L63B - Kidney and Urinary Tract Infections Age < 69 or W Severe CC 5.3 5.5 7.0 7.0 5.8 6.6 8.3 3.5 4.2 5.2 6.1 7.0 4.3 4.3 8.0 7.4 - 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 CBH Gen4 (12 mnths) IPS 7C (6 mnths) MBH Med (12 mnths) NAM 2B (6 mnths) NAM 3FE (6 mnths) ROC Med (5 mnths) PCH W1F (12 mnths) TOO MU4 (6 mnths) Hospital / Ward / Time period (Data supplied by the HealthStatistics Centre Qhealth, accessed throughout 2011/12) Numberofdays Pre EPJB Post EPJB Same period
  11. 11. Quantitative outcomes Using specific DRG by hospital „SVD‟ Comparison of a Single DRG Pre & Post EPJB O60B Vaginal Delivery W/O Catastrophic or Severe CC 2.21 2.63 2.44 2.172.17 2.22 2.44 2.11 0.00 0.50 1.00 1.50 2.00 2.50 3.00 MBH-WHU (6mnths) ROC-MAT (5mnths) TOO-HARBI (6mnths) TSV-TOBS (6mnths) Hospital / Ward / Time period (Data supplied by the Health Statistics Centre, Qhealth, access throughout 2011/2012) Numberofdays Pre EPJB Post EPJB same period
  12. 12. Birth Suite – Royal Brisbane & Women‟s Hospital.
  13. 13. Qualitative outcomes: • Improved efficiencies in Discharge planning • Improved communication between all staff • Improved handover processes • Intuitive & user friendly, minimal training needed • Improved patient safety & quality of care • Level of Passion was high, ensuring liklihood of sustainability University of Southern Queensland (USQ)
  14. 14. How is Discharge Planning enhanced? • Mandatory Estimated Discharge Date • Mandatory Discharge Destination • Discharge script status – Traffic Lights • Transport bookings • Allied Health referral status • Collective discharge details for multiple patients • Inter-hospital transfers • Current demographic details ie addresses, postcodes • Can effectively plan in advance The notion that whiteboards facilitated patient flow and discharge planning was a consistent finding and has been widely recognised……Chaboyer 2009
  15. 15. The EPJB journey - 2012 – Contracts with External provider commenced - Mandatory fields • Estimated Discharge Date (EDD) • Discharge Destination - “Ward at a Glance” to be a priority - Traffic Light formatting - Interfacing with HBCIS, EDIS & „The Viewer‟ now possible - Whole of Hospital /Health Service now visible - Remote access by all team members enhanced
  16. 16. Cairns & Hinterland HHS 22 Townsville HHS 22 Mackay HHS 4* Central HHS 19 Wide Bay HHS 17 Darling Downs HHS 17 South West HHS 6 Electronic Patient Journey Boards in QLD
  17. 17. Sunshine Coast HHS 3 Metro North HHS 93 Royal Children‟s Hosp 8 West Moreton HHS 21 Metro South HHS 61 Gold Coast HHS 16* Total = 309 EPJB‟s
  18. 18. Original MS „ACCESS‟ software
  19. 19. Patient Flow Manager C
  20. 20. „WardView‟ at TPCH
  21. 21. Irrespective of Software used, the underlying principle of ‘visual de-cluttering’ should apply if use is to be maximised…… Less is more:
  22. 22. Ability to customise: When staff perceive they are part of the design and implementation, they develop ownership……
  23. 23. Lessons learned re installs…. • Privacy concerns • Geographical space • Staff traffic • Ward size • Screen size • 24/7, 16/7 or less…. • Ceiling, wall or desk mount • „Touch‟ versus „non-touch‟ • Viewing comfort • Landscape or Portrait • Screen versus Handover sheets for information transfer • Workstation access • Existing processes • Cost
  24. 24. Key elements for Discharge Planning…. 1.People 2.Processes 3.Tools Is this the demise of the Manual Whiteboard?.........
  25. 25. MU4 ward – Toowoomba Hospital
  26. 26. 7C ward – Ipswich Hospital
  27. 27. 7B ward – Ipswich Hospital
  28. 28. 1F ward – The Prince Charles Hospital
  29. 29. Medical ward – Mackay Hospital
  30. 30. Paterson ward – The Royal Children‟s Hospital
  31. 31. Neurosurgical ward – Townsville Hospital
  32. 32. Oncology ward – Royal Brisbane & Women‟s Hospital
  33. 33. GEM ward – The Prince Charles Hospital
  34. 34. And next….? •Transit Lounges •Pharmacies •DEM‟s •Operating Theatres •Bed Management units & •Residential Facilities are being included. Since 2014, not confined to only „Inpatient areas‟
  35. 35. 6AS – RBWH Susan Moller & Brent McMillin Clinical Access & Redesign Unit, Department of Health Enquiries: Susan.Moller@health.qld.gov.au Brent.McMillin@health.qld.gov.au 6AS - RBWH

×