Prepared by Judy Willis
Principal Policy Advisor – Surgery
Systems Relationships & Frameworks
August 2012
Surgery &Rural F...
NSW Surgery Futures Projects
 The demand for surgery is increasing
 A growing and ageing population
 Our workforce is c...
NSW Surgery Futures Projects
AIM:
To provide a framework for public sector surgery (both
elective and emergency)
in NSW fo...
NSW Surgery Futures Projects
2010 Surgery Futures Project – Sydney, Central
Coast & Illawarra
2011 Rural Surgery Futures –...
Surgery Futures Project (Metropolitan)
 Consulted with around 400 clinicians and speciality
colleges
 Clinician Consulta...
HVSSS Model
– High Volume Short Stay Surgery (HVSSS) is
defined as planned surgery/procedures
requiring admission for up t...
Specialty Centres
Specialist surgery met through development of formal specialist centres
with:
• Clearly delineated refer...
Streaming Emergency Surgery
 Standard-hours scheduling where
clinically appropriate;
 Load balancing of standard-hours
o...
Rural futures -Background
Information
 92 non-metropolitan hospitals provide surgical
services
 80% of surgical activity...
Rural Surgery Futures Project
 Consulted with around 200 clinicians & hospital
managers & Rural Organisations
 200 clini...
Consultation Forums
Findings-
Challenges for Theatre Managers
 Aging Infrastructure
 Frequent turnover of Hospital executives
 Keeping work...
The Rural Surgery Futures Report
33 recommendations
Recommendations
 Networking
 Workforce
 Education & Training
 Infrastructure
 Clinical Service Planning
Networking
 Regional resource centre that networks with
surrounding district hospitals
 Effective sharing & deployment o...
Workforce
 Targeted incentives needed to attract and retain a
high quality of diverse workforce
 Network recruitment not...
Education & Training
 Access to dedicated education for staff seen as
advantageous to improving staff retention and the
q...
Infrastructure
 Ensure clinicians are engaged in the prioritisation of
equipment purchase and replacement
 Maintain & de...
Clinical Services Planning
 Needs to be updated regularly, strengthened and
consultative
 Includes:
– Requirements for n...
Implementation
 Equipment and instrumentation to assist surgery in
the rural hospitals ($375K each rural LHD)
 Surgical ...
Further information
 The RSF Report: http://www.archi.net.au/resources/delivery/rural/rural-futures
 The RSF Survey: htt...
Surgery Futures and Rural Futures – Challenges in Rural OP Theatres
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Surgery Futures and Rural Futures – Challenges in Rural OP Theatres

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Judy Willis, A/Senior Manager (Surgery), Health Services Performance Improvement Branch, NSW Health delivered this presentation at the 2012 Operating Theatre Management conference. For more information about the annual event, please visit:
www.healthcareconferences.com.au

Published in: Health & Medicine, Business
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Surgery Futures and Rural Futures – Challenges in Rural OP Theatres

  1. 1. Prepared by Judy Willis Principal Policy Advisor – Surgery Systems Relationships & Frameworks August 2012 Surgery &Rural Futures- Challenges in Rural Operating Theatre Management
  2. 2. NSW Surgery Futures Projects  The demand for surgery is increasing  A growing and ageing population  Our workforce is changing  Economic and health technology impacts  Wide dispersion of surgical services across NSW  Significant demographic changes
  3. 3. NSW Surgery Futures Projects AIM: To provide a framework for public sector surgery (both elective and emergency) in NSW for the next 5 -10 years.
  4. 4. NSW Surgery Futures Projects 2010 Surgery Futures Project – Sydney, Central Coast & Illawarra 2011 Rural Surgery Futures – Non-metro NSW 2011 Newcastle Surgery Futures – Greater Newcastle
  5. 5. Surgery Futures Project (Metropolitan)  Consulted with around 400 clinicians and speciality colleges  Clinician Consultation recommended three models of care: – High Volume Short Stay Surgical – Specialist Centres – Streaming of Elective and Emergency Surgery
  6. 6. HVSSS Model – High Volume Short Stay Surgery (HVSSS) is defined as planned surgery/procedures requiring admission for up to 72 hours. It includes both Day only and Extended Day Only Surgery – Builds on the established Extended Day Only Model
  7. 7. Specialty Centres Specialist surgery met through development of formal specialist centres with: • Clearly delineated referral roles within a geographic region; • Clinical and research leadership provided throughout the catchment; • Operates within a network of services; • Provides access to a high level of expertise; and • Concentrating high cost resources such as highly complex interventional radiology and other medical imaging and surgical support services Potential Benefits: •Better patient quality outcomes through better access to subspecialty care and state of the art clinical practice and technology; and •Capacity to support registrar training as per speciality accreditation as well as post fellowship training
  8. 8. Streaming Emergency Surgery  Standard-hours scheduling where clinically appropriate;  Load balancing of standard-hours operating theatre sessions with emergency surgery demand;  Streaming of elective and emergency surgery in hospitals;  Reallocation of surgery resources appropriate to roles of the designated hospitals;  Safe interhospital transfer processes; and  Specific emergency surgery KPIs
  9. 9. Rural futures -Background Information  92 non-metropolitan hospitals provide surgical services  80% of surgical activity is provided by 20 of these hospitals  There are 33 hospitals in rural NSW that provide less than 100 procedures per year Broken Hill Hospital
  10. 10. Rural Surgery Futures Project  Consulted with around 200 clinicians & hospital managers & Rural Organisations  200 clinician responses from an online survey  Visited 26 non metropolitan hospitals  Steering Committee – chaired by Dr Austin Curtin
  11. 11. Consultation Forums
  12. 12. Findings- Challenges for Theatre Managers  Aging Infrastructure  Frequent turnover of Hospital executives  Keeping workforce skilled and resources for training new staff  Aging Equipment – gifted to smaller hospitals  Networking across the LHD  Locum medical staff
  13. 13. The Rural Surgery Futures Report 33 recommendations
  14. 14. Recommendations  Networking  Workforce  Education & Training  Infrastructure  Clinical Service Planning
  15. 15. Networking  Regional resource centre that networks with surrounding district hospitals  Effective sharing & deployment of resources – Technological – Physical – Financial – Human – for Periop Nurses?
  16. 16. Workforce  Targeted incentives needed to attract and retain a high quality of diverse workforce  Network recruitment not site appointment  LHD Perioperative CNCs supported by CNEs Goulburn Base Hospital
  17. 17. Education & Training  Access to dedicated education for staff seen as advantageous to improving staff retention and the quality of patient care  That LHDs ensure that perioperative staff have internet access for educational purposes  Network model – experience in range of specialities across LHD The Tweed Hospital
  18. 18. Infrastructure  Ensure clinicians are engaged in the prioritisation of equipment purchase and replacement  Maintain & determine the useful life of and replace key surgical assets  Adoption and dissemination of new clinical practices and surgical technologies within the regional surgical network
  19. 19. Clinical Services Planning  Needs to be updated regularly, strengthened and consultative  Includes: – Requirements for new technology – Future workforce – Community expectations
  20. 20. Implementation  Equipment and instrumentation to assist surgery in the rural hospitals ($375K each rural LHD)  Surgical Fellowship positions in each rural LHD  Emergency Surgery Redesign (Wagga & Orange)  Additional nursing fte positions for Theatres Wagga Wagga Base Hospital
  21. 21. Further information  The RSF Report: http://www.archi.net.au/resources/delivery/rural/rural-futures  The RSF Survey: http://www.archi.net.au/documents/resources/hsd/rural/rural- futures/rural-surgery-survey.pdf  The RSF Insights Paper: http:www.archi.net.au/documents/resources/hsd/rural- futures/rural-insights.pdf  The Surgery Futures Report: http://www.archi.net.au/documents/resources/hsd/surgery/futures/surgery-plan.pdf Ministry Contacts Judy Willis juwil@doh.health.nsw.gov.au

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