Tools developed to help match capacity and demand for patient care. Presented by Julie Robinson, Bay of Plenty DHB and Angela Neil, NZ Nurses Organisation, at HINZ 2014, 12 November 2014, 12pm, Marlborough Room 3

1. From Toys to Tools
Presenters:
Julie Robinson - Director of Nursing, Bay of Plenty DHB
Angela Neil - Organiser, New Zealand Nurses Organisation
Co-author: Catherine Ross - Information Services Manager, Bay of
Plenty DHB

2. 2005-2006
Committee of Inquiry
2007- mid 2009
Establishment of SSHW
unit by Minister of
Health
2010-2015 Ongoing
commitment from
DHBs & Health
Unions

3. BOPDHB Issue
“Quality patient care and a
healthy workplace is
routinely compromised and
too frequently made unsafe”.

4. Why we need the CCDM approach
Variance creates a productivity ‘black hole’
-risky! increases patient risk and decreases
Accurate Base Planning & Resourcing
(care capacity = demand)
Effective Service Delivery
variance
quality of care
-unsatisfactory stressful and unsatisfactory for staff
-unproductive! diverts significant resource away
from frontline care
Original slide SSHW unit

6. What does care capacity variance look like?
Surplus capacity in the system.
Capacity is about right to efficiently provide quality care
with reasonable work effort.
Safe effective care provided with extra work effort.
Ability to provide safe care is at risk. Care is prioritised.
Resources diverted away from direct care into service
rearrangement.
Care and safety compromised. The system is gridlocked. Resource
attention is being directed at the system rather than care.

7. What does Hospital at a Glance look like?
• Re-uses data that is already collected – refreshed every 12minutes.
• Forecast volumes of ED attendances shown against actual with hourly
peak flow indicators
Palliative
Medical
Orthopaedic
Each cell in the bar is coloured according to health specialty
Each vertical bar shows a ward with the number of beds = height
Various icons indicate things about the patient event that may
impact on demand or capacity – long stayer, readmissions,
adults in children’s ward
Indicates expected admissions or expected discharge
Cardiology

11. What did we learn?
• Resource it better, more developer and systems analyst time
upfront
• Install Hospital at a Glance screens across all departments
earlier
• Communicate, communicate, communicate – we can always do
more
• Boys like the toys - but you will not get the real gains without
the culture change which includes executive leadership and
union partners
• Whole of system change is slow

12. Results
5.00
4.80
4.60
4.40
4.20
4.00
3.80
3.60
3.40
3.20
3.00
Average Length of Stay (Acute)
Actual 12 Mth Rolling Avg

13. 4.5%
4.0%
3.5%
3.0%
2.5%
2.0%
1.5%
1.0%
0.5%
0.0%
%age
Results
Trended RN Bureau Hours as a %age of Total Nursing Hours

14. What have we achieved
• Timely, robust, cheap and effective way to see at a glance the demand in
our hospitals, theatres and radiology
• Increased awareness of demand by all services throughout the hospital
• Increased awareness of capacity at many levels - variance response
agreement and expectations.
• Better data quality and timeliness – reliable forecasts that are used for
planning
• Better understanding and relationship between IT and the service areas
– teamwork
• Improved use of resources - staff and equipment
• Culture change – trusting the data and planning and acting upon it with
confidence