Louth Meath Hospital Group Reconfiguration  Programme  2011
Transformation Background 2009 - 2011 <ul><li>HSE NE Transformation is committed to management of quality & risk issues id...
  Directorate of  Clinical Strategy & Programmes 2011 <ul><li>The Directorate of Clinical Strategy & Programmes has been e...
Directorate of  Clinical Strategy & Programmes <ul><li>The work of the Directorate is based on three main objectives; </li...
Proposed Programmes 2011 For the Louth Meath  <ul><li>Heart Failure, OLOL - Commenced </li></ul><ul><li>Acute Medicine, OL...
Acute Medicine Programme <ul><li>A Clinician-Led initiative between, Royal College of Physicians of Ireland (RCPI), the Ir...
Acute Medicine Programme <ul><li>The programme recognises the essential role of large and small Hospitals, General Practit...
<ul><li>Standardised Safe Quality patient care   </li></ul><ul><li>24 hr AMAU </li></ul><ul><li>5 bed CDU  </li></ul><ul><...
Key Operational Objectives   <ul><li>Navigational Hub / Bed Bureau and Case Manager </li></ul><ul><li>Patient Flow / Case ...
Lean Healthcare Review of the Operational Processes in Management of the Medical Patient pathway <ul><li>A multi-disciplin...
Louth Meath Hospital Transformation and Acute Medicine Project Organisational Chart AMP Project Teams Phase I AMAU / AMU &...
<ul><li>OLOL </li></ul><ul><li>MAU </li></ul><ul><li>Acute Stroke Unit / Thrombolysis  </li></ul><ul><li>ICU and CCU </li>...
<ul><li>Capital Refurbishment of old ED facility is complete  </li></ul><ul><li>Permanent MAU opened 25 th  June 2011  </l...
Average Daily Attendances to OLOL MAU 2010/2011 <ul><li>85% of Attendances Discharged Home </li></ul>
<ul><ul><li>Acute Stroke Thrombolysis introduced 23 rd  May 2011 </li></ul></ul><ul><li>New Acute Stroke Unit opened 2 nd ...
<ul><li>New CCU opened Sept 2010, 3rd floor of the new </li></ul><ul><li>ED building </li></ul><ul><ul><ul><li>Incorporati...
<ul><li>PCCC Admission Avoidance/Early discharge Initiative established in February 2011 including Nursing, Home Support, ...
<ul><ul><li>8 stroke rehab beds taking admissions from OLOL ↑ 11 beds </li></ul></ul><ul><ul><li>95% of patients discharge...
<ul><ul><li>Palliative Care Support Beds </li></ul></ul><ul><ul><li>Phased opening of 10 beds – 2 beds operational to date...
<ul><li>Elderly Day Assessment Service  transferred to LCH Sept 2010 </li></ul><ul><li>Integrated Acute / Community ED Avo...
<ul><li>Day  services - Surgical, Gynaecology Day Services </li></ul><ul><li>Elective Endoscopy  </li></ul><ul><li>Inpatie...
Out-patient Services <ul><li>CAWT Projects being progressed  </li></ul><ul><ul><li>Ophthalmology – Provision of Cataract &...
<ul><li>Patient satisfaction questionnaire March 2011  </li></ul><ul><ul><ul><li>Patients seen 0-35 mins = 88 % </li></ul>...
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Presentation to forum delegation to ed 19.10.2011

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Presentation to forum delegation to ed 19.10.2011

  1. 1. Louth Meath Hospital Group Reconfiguration Programme 2011
  2. 2. Transformation Background 2009 - 2011 <ul><li>HSE NE Transformation is committed to management of quality & risk issues identified in the Teamwork report 2006 </li></ul><ul><ul><li>Making the best use of available resources </li></ul></ul><ul><ul><li>Raising services to safe levels of practice and beyond </li></ul></ul><ul><ul><li>Integrating PCCC & Hospital Services </li></ul></ul>
  3. 3. Directorate of Clinical Strategy & Programmes 2011 <ul><li>The Directorate of Clinical Strategy & Programmes has been established to improve and standardise patient care throughout the organisation by bringing together clinical disciplines and enabling them to share innovative solutions to deliver greater benefits to every user of HSE services. </li></ul>
  4. 4. Directorate of Clinical Strategy & Programmes <ul><li>The work of the Directorate is based on three main objectives; </li></ul><ul><li>To improve the quality of care we deliver to all users of HSE services </li></ul><ul><li>To improve access to all services </li></ul><ul><li>To improve cost effectiveness </li></ul>
  5. 5. Proposed Programmes 2011 For the Louth Meath <ul><li>Heart Failure, OLOL - Commenced </li></ul><ul><li>Acute Medicine, OLOL </li></ul><ul><li>Stroke, OLH/OLOL </li></ul><ul><li>COPD Outreach, OLOL & Pulmonary Rehab, OLH/LCH </li></ul><ul><li>Diabetic Foot-care, LCH/OLH/OLOL </li></ul><ul><li>MSK Ortho Rheumatology Waiting List Initiative, OLH </li></ul><ul><li>Dermatology Waiting List Initiative, North East </li></ul><ul><li>Regional Rheumatology </li></ul><ul><li>Critical Care, OLOL </li></ul><ul><li>Emergency Care, OLOL </li></ul>
  6. 6. Acute Medicine Programme <ul><li>A Clinician-Led initiative between, Royal College of Physicians of Ireland (RCPI), the Irish Association of Directors of Nursing and Midwifery (IADNAM), the Therapy Professions Committee (TPC), the Irish College of General Practitioners (ICGP) and the Directorate of Clinical Strategy & Programmes, HSE. </li></ul>
  7. 7. Acute Medicine Programme <ul><li>The programme recognises the essential role of large and small Hospitals, General Practitioners (GPs) and Community Services. It provides a framework for the delivery of acute medical services which seeks to substantially improve patient care. </li></ul>
  8. 8. <ul><li>Standardised Safe Quality patient care </li></ul><ul><li>24 hr AMAU </li></ul><ul><li>5 bed CDU </li></ul><ul><li>Specialty Cohort Plan </li></ul><ul><li>Integrated Discharge Planning </li></ul><ul><li>Medical Care pathways & PPG’s </li></ul><ul><li>National Early Warning Score </li></ul><ul><li>Complete </li></ul>Key Operational Objectives 2011 Hospital Models LCH Medical Model agreed Population Health – QCCD Capacity Analysis Louth Meath Hospital Reconfiguration Plan
  9. 9. Key Operational Objectives <ul><li>Navigational Hub / Bed Bureau and Case Manager </li></ul><ul><li>Patient Flow / Case Manager </li></ul><ul><li>pro-active bed management </li></ul><ul><li>OPD </li></ul><ul><li>Lean project to assess OPD Medical Specialty capacity and processes </li></ul><ul><li>Critical Care </li></ul><ul><li>ICU / HDU / CCU Capacity  from 11 to 23 </li></ul><ul><ul><li>Capital project for 5 additional level 3 beds June completion date. </li></ul></ul>
  10. 10. Lean Healthcare Review of the Operational Processes in Management of the Medical Patient pathway <ul><li>A multi-disciplinary group from Our Lady of Lourdes participated in a value stream mapping exercise to identify non-value added activities. Five core projects progressed using a Plan Do Check Act (PDCA) </li></ul><ul><li>EDD </li></ul><ul><li>Visual Whiteboards </li></ul><ul><li>Blood specimen turnaround time </li></ul><ul><li>Cardiology diagnostics scheduling </li></ul><ul><li>Discharge Lounge </li></ul><ul><li>A Review workshop (17 th October 2011) demonstrated improved efficiencies and further opportunities to progress. </li></ul>
  11. 11. Louth Meath Hospital Transformation and Acute Medicine Project Organisational Chart AMP Project Teams Phase I AMAU / AMU & Speciality Cohort CDU / ED Patient Flow Bed Allocation Patient Flow Critical Care OPD Integrated Discharge Planning Phase II Orthopaedic Triage Initiative COPD Cross Site Project Teams Stroke Thrombolysis Acute Stroke Stroke Rehab Cohort Isolation Health Care Records Management PCCC Admission Avoidance Cardiology LCH Project Teams MIU Palliative Care Louth Meath Hospital Group Senior Management Team Louth Meath Acute Medicine Programme Implementation Group Project Sponsors Group GM Clinical Director Transformation Acute Medicine Programme Project Team HSE North East Union Alliance
  12. 12. <ul><li>OLOL </li></ul><ul><li>MAU </li></ul><ul><li>Acute Stroke Unit / Thrombolysis </li></ul><ul><li>ICU and CCU </li></ul><ul><li>Community Response Team ( CRT ) </li></ul><ul><li>LCH </li></ul><ul><li>Stroke Rehab service </li></ul><ul><li>Palliative Care Unit </li></ul><ul><li>Step down beds </li></ul><ul><li>Day Medical Services </li></ul><ul><li>Surgical Services </li></ul><ul><li>Minor Injuries Unit </li></ul><ul><li>Out Patient Initiatives </li></ul>Progress Report on Service Changes -to date
  13. 13. <ul><li>Capital Refurbishment of old ED facility is complete </li></ul><ul><li>Permanent MAU opened 25 th June 2011 </li></ul><ul><li>Referrals from ED and GP’s </li></ul><ul><li>Focus on rapid ambulatory assessment, prompt </li></ul><ul><li>access to diagnostics and treatment initiation </li></ul><ul><li>with expected low rate of inpatient admission </li></ul><ul><li>Transition to an Acute Medical Assessment Unit </li></ul>Medical Assessment Unit (OLOL)
  14. 14. Average Daily Attendances to OLOL MAU 2010/2011 <ul><li>85% of Attendances Discharged Home </li></ul>
  15. 15. <ul><ul><li>Acute Stroke Thrombolysis introduced 23 rd May 2011 </li></ul></ul><ul><li>New Acute Stroke Unit opened 2 nd Floor of new build on the 14 th March 2011 </li></ul><ul><li>Accommodation includes single and double room accommodation – all rooms are en-suite </li></ul><ul><li>Multi-disciplinary Stroke Team in Place </li></ul>Acute Stroke Services (OLOL)
  16. 16. <ul><li>New CCU opened Sept 2010, 3rd floor of the new </li></ul><ul><li>ED building </li></ul><ul><ul><ul><li>Incorporating facility for 8 CCU beds </li></ul></ul></ul><ul><ul><ul><li>5 Step down Cardiology beds </li></ul></ul></ul><ul><ul><ul><li>5 Beds are Operational </li></ul></ul></ul><ul><li>Capital project for 5 additional level 3 ICU beds </li></ul><ul><li>complete </li></ul><ul><ul><ul><li>5 level 3 Beds & 3 Level 2 Beds - Operational </li></ul></ul></ul><ul><ul><ul><li>Physical Bed Capacity of 15 in place </li></ul></ul></ul>ICU and CCU (OLOL)
  17. 17. <ul><li>PCCC Admission Avoidance/Early discharge Initiative established in February 2011 including Nursing, Home Support, Physiotherapy & OT </li></ul><ul><li>An average of 3 referrals daily from the ward areas </li></ul>Community Response Team – Louth
  18. 18. <ul><ul><li>8 stroke rehab beds taking admissions from OLOL ↑ 11 beds </li></ul></ul><ul><ul><li>95% of patients discharged home to date </li></ul></ul><ul><ul><li>€ 300,000 refurbishment project complete </li></ul></ul><ul><ul><ul><ul><li>Facilities include a dedicated AHP rehab facilities & an independent living area </li></ul></ul></ul></ul>Stroke Rehab Service (LCH)
  19. 19. <ul><ul><li>Palliative Care Support Beds </li></ul></ul><ul><ul><li>Phased opening of 10 beds – 2 beds operational to date </li></ul></ul><ul><ul><li>Admission Criteria </li></ul></ul><ul><ul><ul><li>End of life care </li></ul></ul></ul><ul><ul><ul><li>planned respite care </li></ul></ul></ul><ul><ul><ul><li>convalescence </li></ul></ul></ul><ul><ul><ul><li>rehab continuous Nursing Care </li></ul></ul></ul><ul><ul><li>Further expansion of rehab services is planned. </li></ul></ul><ul><ul><li>In the interim step down beds are available for Step down patients who are unable to go directly home from OLOL requiring further care for 1-6 weeks </li></ul></ul>Palliative Care Support Beds & Stepdown (LCH)
  20. 20. <ul><li>Elderly Day Assessment Service transferred to LCH Sept 2010 </li></ul><ul><li>Integrated Acute / Community ED Avoidance initiative </li></ul><ul><li>Consultant provided </li></ul><ul><li>One stop assessment service incl; Diagnostics & AHP </li></ul><ul><li>Ring-fenced appointments for urgent GP / Community Response Team referrals </li></ul><ul><li>9 x New referrals weekly </li></ul><ul><li>Nurse Led Venesection service for Louth Hospitals – Total 550 Patients attending the service </li></ul>Day Medical Services (LCH)
  21. 21. <ul><li>Day services - Surgical, Gynaecology Day Services </li></ul><ul><li>Elective Endoscopy </li></ul><ul><li>Inpatient Services – 8 intermediate surgical beds </li></ul><ul><li>Colposcopy service </li></ul><ul><li>Selected as candidate hospital for national </li></ul><ul><li>Colo-rectal screening service </li></ul>Surgical Services (LCH)
  22. 22. Out-patient Services <ul><li>CAWT Projects being progressed </li></ul><ul><ul><li>Ophthalmology – Provision of Cataract & Intra-macular injections </li></ul></ul><ul><ul><li>ENT – Waiting List Initiative </li></ul></ul><ul><ul><li>GUM – Out Patient Clinic </li></ul></ul>
  23. 23. <ul><li>Patient satisfaction questionnaire March 2011 </li></ul><ul><ul><ul><li>Patients seen 0-35 mins = 88 % </li></ul></ul></ul><ul><ul><ul><li>Care carried out by professional, skilful & competent staff = 98% </li></ul></ul></ul><ul><ul><ul><li>Did you receive adequate information on your treatment = 98% </li></ul></ul></ul><ul><li>Average LOS in Dept < 1 hour </li></ul><ul><li>Average daily attendance 25-30 patients </li></ul>Minor Injury Unit (LCH)
  24. 24. Questions

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