Gillian puckeridge and Ailsa Gillett - Management of #NOF patient's time to Theatre

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Gillian Puckeridge, Orthopaedic Clinical Nurse Consultant, Nambour General Hospital
Ailsa Gillett, Nursing Director Perioperative Services, SCHSS delivered this presentation at the 2nd Annual Hip Fracture Management Conference 2013. This conference is the only regional event to discuss practical innovations and improvement processes for the management of Hip Fractures in the hospital setting.

Find out more at http://www.healthcareconferences.com.au/hipfracture2013

Published in: Health & Medicine
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Gillian puckeridge and Ailsa Gillett - Management of #NOF patient's time to Theatre

  1. 1. Management of #NOF patient’s time to Theatre Gillian Puckeridge Ailsa Gillett Nambour General Hospital Sunshine Coast Hospital & Health Service Hip Fracture Management Conference 2 Dec. 2013
  2. 2. #NOF time to Theatre GEOGRAPHY •Population approx. 390,000 •23% population increase expected by 2021 Sourced: www.sunshinecoast.qld.gov.au
  3. 3. #NOF time to Theatre BACKGROUND • Increase in elderly population¹ ² • Evidence shows early intervention lowers mortality rates ³ • Identified this issue whilst addressing another⁴ • Implementation of Incentive funding for HHS’s who achieve Targets⁵
  4. 4. #NOF time to Theatre ACTIVITY 2013 – 379 Procedures 3% 45% 52% Intracapsular Extracapsular Periprosthetic
  5. 5. #NOF time to Theatre ADMISSION SOURCE 1% Own Home 36% 63% Residential Care Facility In Hospital Fall
  6. 6. #NOF time to Theatre ASA Status in % ASA Status 0% 1% 13% ASA 1 13% ASA 2 ASA 3 ASA 4 73% ASA 5
  7. 7. #NOF time to Theatre KEY PROBLEM • Inability to perform surgery on patients with # NOF’s in a timely manner • Unable to provide our patients with optimal care • Not meeting KPI’s In a nutshell we identified that we weren't achieving the KPI of 2 days to theatre for # neck of femur patients.
  8. 8. #NOF time to Theatre AIM OF THIS INNOVATION ‘Design a safe process to expedite the patients journey to surgery’ Optimise our patients recovery, rehabilitation and quality of life outcomes
  9. 9. #NOF time to Theatre What We Know? • There is limited access to elective, trauma and emergency operating sessions • # NOF pt.'s being fasted for too long • Change in emergency categorisation codes disadvantaged #NOF pt.'s • Health Practitioners who are willing to try something new .
  10. 10. #NOF time to Theatre KEY CHANGES IMPLEMENTED • Reviewed and revised process within the emergency department • Redesign of elective theatre lists – • to create all day orthopaedic elective theatre sessions • An allocated space each session for a # NOF patient. • Reviewed and revised processes relating to pre-anesthetic assessment. • Changed the process for booking patients for surgery – • Booked as a category 5 patient (within 24hours), • Upgrade to category 4 occurs if procedure not performed within 24 hours
  11. 11. #NOF time to Theatre Flowchart
  12. 12. #NOF time to Theatre KEY CHANGES IMPLEMENTED
  13. 13. #NOF time to Theatre OUTCOMES SO FAR • Significant improvement for # NOF Patients treated within 48 hours • Meeting National Health reform KPI’s • Obtain incentive funding for meeting targets
  14. 14. #NOF time to Theatre OUTCOMES SO FAR % of pt's in time to Theatre 120% Percentage 100% 80% 60% 40% 20% 0% Month Jul Aug Sept Oct 2010 - 2011 Nov Dec 2011 - 2012 Jan Feb 2012-2013 Mar Apr May 2013 - 2014 Jun
  15. 15. #NOF time to Theatre LESSONS LEARNT IT’S ABOUT OUR PATIENTS & MAXIMISING THEIR QUALITY OF LIFE OUTCOME • Clear processes • The WHOLE team is included • Clear articulation of the goal COMMUNICATION, COMMUNICATION, COMMUICATION & COLABORATION!
  16. 16. #NOF time to Theatre This is what we want to achieve • For our # NOF patients Acknowledgements Gillian and Ailsa would like to acknowledge the hardworking multidisciplinary team made up from • Orthopaedic consultants and nurses • Anaesthetic department • Allied Health • Perioperative Services • Ortho-geriatric Services at Nambour General Hospital, SCHHS.
  17. 17. #NOF time to Theatre References 1. 2. 3. 4. 5. Pasco, J., Brennan, S., Henry, M., Nicholson, G., Sanders, K., Zhang, Y. & Kotowicz, M. 2011, Changes in Hip Fracture Rates in Southeastern Australia Spanning the Period 1994-2007. Journal of Bone and Mineral Research, Vol 26, No. 7, pp. 1648-1654, accessed on 14 Nov. 2013. Chang, K., Center, J., Nguyen, t. & Eisman, J. 2004, Incidence of Hip and other Osteoporotic Fractures in Elderly Men and Women: Dubbo Osteoporosis Epidemiology Study. Journal of Bone and Mineral Research, Vol 19, No. 4, pp. 532-536, accessed on 15 Nov. 2013 Larsson, G. & Holgers, K. 2011, Fast-track care for patients with suspected hip fracture. Cited 16 Nov.2013 www.Elsevier.com/locate/injury Acworth, M & Swierkowski, P. 2013, Theatre Management of non-life threatening emergency cases - #NOF time to Theatre. Innovation Poster Session; HRT1312 – Patient Safety. Uzoigwe, C.E., Burnand, H., Cheesman, C., Aghedo, D., Faizi, M. & Middleton, R. 2012, Early and ultra early surgery in hip Fracture patients improves survival. Cited 16 Nov. 2013 www.Elsevier.com/locate/injury
  18. 18. #NOF time to Theatre QUESTIONS

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