Agenda

CONFERENCE DAY ONE
Thursday 23rd February 2012

Day One | Day Two

8:30 Registration and Coffee

9:00 Opening Remarks from the Chair:
John McTaggart, Improvement Specialist, Auckland City Hospital

9:10 A Whole-of-Hospital Approach to Support Removing Access Block
John McTaggart, Improvement Specialist, Auckland City Hospital

9:50 Business Intelligence - Enabling Patient Flow Management

• The project has developed 3 enterprise-wide near real-time patient flow dashboards to give users visibility into the current state of all metropolitan public hospitals (and some country hospitals) within South Australia - emergency department, inpatient activity and elective surgery waiting lists.
• Statewide and Health Network perspective on patient flow versus single hospital only. E.g. Facilitates network wide management of patient flow which enables rationalising services within the network and directing patient flow to appropriate services.
• 3rd party use of the data to assist decision making for services that feed into hospitals - e.g. SAAS & MedStar
• Focus on ensuring changes in process and structure are communicated to ensure dashboards reflect operational activity
• Uptake of the tools by various levels of hospital and SA Health management. E.g. hospital GMs and Network CEs installing additional screens specifically to have dashboards visible at all times
• Success of the project has demonstrated the capability of BI to deliver significant value as an information source for patient flow

Don Stewart, Business Analyst - Corporate Systems Development - Health System Performance, SA Health

10:30 Morning Tea

11:00 Frequent Presenters Program: Southern Health

• Overview of Frequent Presenters to Southern Health network
• Statistical analysis of Frequent Presenters
• What is the Frequent Presenters Program?
• What is an ED care plan?
• What are the outcomes of the program
• Case examples

Donna Markham, General Manager Allied Health, Southern Health

11:40 Managing Demand and Preventing Hospital Admissions:
The Impact of a Mobile Assessment and Treatment Service (MATS) MATS Representative, The Alfred

12:20 Lunch

1:20 Patient Flow Portal - Promoting Patient Flow Behaviour Change with a Health Management Technology

In May 2010 NSW health commenced implementation of a patient flow portal, a health management user interface for their Patient Administration Systems that allows a clinical manager to monitor patient flow performance and flow indicators, and assists them to focus and prioritise their behaviour change efforts.

Clinical Managers in NSW now can see live and at a glance:

• Which patients with a clinician defined Estimated Day of Discharge
• Clinical specialty ward outliers
• Current ward and specialty lists
• A length-of-stay monitor for every specialty group within their hospital and network
• All patients waiting to be transferred into or out of their hospital at the instant the request has been made
• All resource waits that are impacting on individual patients

All hospital managers can analyse the frequency and duration of the patient waits when making strategy or resourcing decisions. With this presentation we would like to show how this management tool works and share early insights into the implementation of our NSW Patient Flow System, and to show the new integrated demand and capacity predictive tool and hospital dashboard.

Paul Preobrajensky, Implementation Manager – Health Service Performance Improvement Branch, NSW Health

2:00 Operationalising the Mathematic Of Patient Flow; Increasing Surgical Activity and Reducing Access Block at the Same Time

Key achievements so far:

• Reduction of access block to 20%
• Improvement in 4 hr emergency waits
• No cancellation of elective surgery
• Increase 15% of surgical activity which has allowed us to achieve Nation Partnership targets
• Establishment of a multidisaplinary Patient Flow Unit with a doctor as director challenging the established nursing lead flow models. This has been achieved over the three hospitals within our district and in the face of challenging financial times

A/Prof James Lind, Emergency Physician – Gold Coast Emergency Dept, Queensland Health

2:40 Afternoon Tea

3:10 Clinical Redesign and Medical Engagement at the Joondalup Health Campus

JHC have recently achieved the required targets under the WA Health Four Hour Rule Program. JHC is one of the busiest single Emergency Departments in Australia with > 80,000 presentations expected this year

This presentation will give an overview of:

• Projects implemented and outcomes to enable improved access for emergency patients – A whole-of-hospital approach
• Challenges for change – What we’ve learned and where we can improve
• Medical Engagement: Actively involving doctors with the reform/redevelopment and redesign agenda
• Junior doctors involved in redesign-RMO Improvement Officer Program

James MacWatt, Clinical Redesign Manager, Joondalup Health Campus

3:50 Panel Discussion: This discussion will look at how different hospitals have tackled the question, "What is the Best Way to Admit Patients from the ED in the Wards?"

• What is the safest way to admit patients to your hospital in a timely manner?
• How can you safely admit patients in a timely manner without reducing continuity of care?
• What is best for your hospital taking into account budgets, staffing, etc?
• What are the challenges?

James MacWatt, Clinical Redesign Manager, Joondalup Health Campus
John McTaggart, Improvement Specialist, Auckland City Hospital
A/Prof James Lind, Emergency Physician – Gold Coast Emergency Dept, Queensland Health

4:30 Close of the Day from the Chair

4:40 Networking Drinks Reception

CONFERENCE DAY TWO
Friday 24th February 2012

Day One | Day Two

8:30 Morning Coffee

9:00 Opening remarks from the chair:
John Merchant, Emergency Physician and Clinical Project Manager, Calvary Health Care ACT

9:10 Implementing a Redesigned Clinical Operations Framework

Calvary Health Care ACT is a regional generalist hospital of approximately 200 beds, with a busy emergency department seeing 50,000 presentations per annum. To adjust to the new operational paradigm, driven by the recent healthcare reform agenda, the organisation responded with a whole-of-system review of the supporting clinical operations framework. The overarching aim of this review was to improve capacity by increasing patient flow, with particular focus on standardising operations around bed management.

This presentation provides:

• An overview of this approach
• The solution components
• Implementation strategies
• Results and challenges of the project, in the context of the national healthcare reform agenda, through the perspective of a mid-sized public hospital.
• Overview of sustained improvement in organisational capacity through improved patient flow, as evidenced by both qualitative and quantitative measures

John Merchant, Emergency Physician and Clinical Project Manager, Calvary Health Care ACT

9:50 International Session: Patient Flow - Everybody’s Responsibility

• Success of our rapid improvement event (based on the lean six sigma) - structured 5-day event where we were given an objective to move our patients out of the emergency department within nine minutes of booking a bed
• Bed management – Bed request to acknowledgement time, new ways of working
• Looking at the inpatient services – Success of rapid rounds, nurse facilitated discharge, discharge tickets, weekend discharges
• Timely transfers – Handover hotline, transfer of care forms standardising handovers

Jane Lees, Nurse Advisor – GINOA portfolio, Auckland City Hospital
Joyce Forsyth, Team Leader Daily Operations, Auckland City Hospital

10:30 Morning Tea

11:00 Redesigning the Surgical Journey - Creating Improvements in Patient Flow

• Date for decision making
• Engagement of stakeholders
• Agreeing on improvement plans
• Measuring the outcomes

Denis O’Leary, Project Manager Surgical Services Redesign, Barwon Health

11:40 Recent Initiatives at the Peter MacCallum Cancer Centre to Improve Access for Oncology Patients

• Improving access and reducing waiting times for patients in the Chemotherapy Day Unit
• Implementation of telephone triage tools to improve the management of patients in the community

Rebecca Paterson, Nurse Director Patient Services, Peter MacCallum Cancer Centre

12:20 Lunch

1:30 Redesign Streamlines Flow at Logan Hospital

• Clinical service redesign project with a whole-of-organisation focus to improve access block in the Emergency Department
• Patient Flow – change to meetings, Direct admission to ward for Palliative care patients, Increased Utilisation Transit Lounge, RMO support – 10:00am discharge
• Discharge planning – move to daily ward discharge planning meetings NUM driven
• EDD recorded
• Journey boards
• 10.00am discharge
• Surgical flow – conversion of elective patients to day cases
• Surgical patients pulled from ED to theatre without ward bed available-bed allocated post theatre, staggered admissions patients go directly to LPOS (used to all come in at same time and sit in front foyer)
• Emergency Department processes - 4hr rule from Triage to admission, white boards at each bedside in ED time displayed
• Paediatric Surgical flow
• Demand management plan-escalation of capacity situations - (tool and check list)

Sandy Lenerhan, Acting Nursing Director for Medical Services, Logan Hospital
Helena Moore, Nurse Unit Manager, Logan Hospital

2:10 Developing an Inpatient Board that Allows Inpatient Staff at the New RCH to have an Efficient, Reliable and Accurate System to Capture the Latest Status of Inpatient Beds and Enhance Staff Coordination and Performance

The Royal Children’s Hospital is currently upgrading much of its IT infrastructure with the move to the new hospital. This is an opportune moment to review the current processes and systems relating to patient flow to increase efficiency and enhance patient safety within the hospital whilst improving transparency of areas of difficulty across the entire hospital.

The new RCH is expansive compared to the current RCH and the electronic patient management system will assist in managing patient flow between areas and movement of patients to theatre from Emergency Department to inpatient wards and other clinical services. This new technology will be the first of its type in a Victorian hospital.

This presentation will include:

• Project overview
• Goals and objectives
• Implementation
• How the new tool aids bed management and patient flow
• Review and Lessons learned
• Plan for future and Stage 2

Emma Jones, Access & BARO Manager - Operations & Nursing Services, The Royal Children's Hospital Melbourne

2:50 Close of Conference from the Chair

3:00 Afternoon Tea

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