Riding The Waves Of
Change –
The Queensland Update

Queensland Health
Laureen Hines
Clinical Access and Redesign Unit
The View From Above Overview
Turbulent Waters
 Increased

service demand
 Growth outstripping supply
 Shortfall of 3036 public beds for 2026
 Incre...
Streamlining Health Care
 National

Quality and Safety performance

targets
 National and State funding reforms
 Indepe...
The Perfect Wave
The Blueprint for better healthcare in Queensland
Four principal themes:
• Health services focused on pat...
Past View

Transfer location

Wards
9

ED
9

OPD
6

Admitting Doctor

Inpatient team
8

ED SMO
1

HITH Doctor
0

Triage

I...
Supporting The Tide
Hospital In The Home (HITH)
•provides care in a community setting
(permanent or temporary residence)
•...
Encouraging The Flow
 Setting

clear targets for activity levels
 Supporting projects to maximise
efficiencies
 Forums ...
A Drop In The Ocean
HITH Utilisation (as % of total seps by
HHS)
HITH Utilisation - Year to date December 2012
1.0%
0.9%
0...
Increasing The Volume
• HITH is in the Blueprint
• Executive support HITH as a safe
and important model
• Statewide adviso...
Supporting Safe
Practice


Implement guidelines



Early detection and direct referral strategies



Common processes

...
Changing Tide of
HITH in Queensland
 New patient cohorts
 Engagement with general practice
 Review possible public/priv...
To all those who have
contributed to reshaping and
expanding HITH in
Queensland
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Laureen Hines, Queensland Health: Queensland State HITH Services Update

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Laureen Hines, Project Manager - Clinical Access & Redesign Unit, Queensland Health delivered this presentation at the 2013 Hospital in the Home conference. This 2-day event is a nurse oriented program to improve HITH services and maximise hospital efficiency. For more information about the annual event, please visit the conference website: http://www.communitycareconferences.com.au/hospitalinthehome

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Laureen Hines, Queensland Health: Queensland State HITH Services Update

  1. 1. Riding The Waves Of Change – The Queensland Update Queensland Health Laureen Hines Clinical Access and Redesign Unit
  2. 2. The View From Above Overview
  3. 3. Turbulent Waters  Increased service demand  Growth outstripping supply  Shortfall of 3036 public beds for 2026  Increased cost  11% less efficient  A need to reduce staff  3 P’s Prince, Patel and Payroll
  4. 4. Streamlining Health Care  National Quality and Safety performance targets  National and State funding reforms  Independent Pricing Authority has set purchasing targets and prices for service delivery  Creation of Health and Hospital Services
  5. 5. The Perfect Wave The Blueprint for better healthcare in Queensland Four principal themes: • Health services focused on patients and people. • Empowering the community and our health workforce. • Providing Queenslanders with value in health services. • Investing, innovating and planning for the future.
  6. 6. Past View Transfer location Wards 9 ED 9 OPD 6 Admitting Doctor Inpatient team 8 ED SMO 1 HITH Doctor 0 Triage In person 7 Phone 2 Inclusion exclusion criteria similar Multidisciplinary care Available 5 Not Available 4 Limited allied health on weekends Medical Home Visits Available 3 Not available 6 Readmission process inconsistant 7 day Nursing All 24 hour on call Available 6 Not Available 3 Length of stay set on admission Yes 7 No 2 Funding Source Hospital 5 Community 3 Clinics Available 7 Occasional used 2 KPI inconsistent –incidents monitored All require growth to meet 1.5% target Pharmacy not able to be tracked
  7. 7. Supporting The Tide Hospital In The Home (HITH) •provides care in a community setting (permanent or temporary residence) •acute conditions requiring clinical governance, monitoring and/or input •that would otherwise require treatment in the traditional inpatient hospital bed. •Queensland Health Admission Policy •focuses exclusively on acute admitted care substitution.
  8. 8. Encouraging The Flow  Setting clear targets for activity levels  Supporting projects to maximise efficiencies  Forums bringing clinical leaders together
  9. 9. A Drop In The Ocean HITH Utilisation (as % of total seps by HHS) HITH Utilisation - Year to date December 2012 1.0% 0.9% 0.7% 0.6% 0.5% 0.4% 0.3% 0.2% 0.1% sla nd Percentage of HITH Utilisation 0.60 0.50 0.40 Percentage e Ba y Qu ee n on or et W id oa st tM W es h So SC ut h o et r M M et r o d Co No rt as t ns Go l s Do w ng ild re n' Da r li Ch s Ca irn ra lQ ld 0.0% Ce nt % HITH Utilisation 0.8% 2010-11 0.30 2011-12 2012-13 0.20 0.10 0.00 July Aug Sept Oct Nov Dec jan Month Feb Mar Apr May June
  10. 10. Increasing The Volume • HITH is in the Blueprint • Executive support HITH as a safe and important model • Statewide advisory and working groups • HITH funding model improvements • Innovation fund • PPP Funding
  11. 11. Supporting Safe Practice  Implement guidelines  Early detection and direct referral strategies  Common processes  Develop state-wide tools  Increase ability to benchmark
  12. 12. Changing Tide of HITH in Queensland  New patient cohorts  Engagement with general practice  Review possible public/private partnerships  Conversion of activity to HITH models  Support culture change due to increased accountability  Embed governance requirements  Support developing services  Standardise care where possible and initiate statewide tool development  Support existing services to grow
  13. 13. To all those who have contributed to reshaping and expanding HITH in Queensland

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