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Cardiology Facilitated Discharge Program. Dr. Paramjit Singh Panesar. Executive Director. Nottingham North and East Clinical Commissioning Group. Background. CCG level financial productivity targets QIPP. Cardiology Spend. Right Care Analysis. Spend vs. Outcome

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cardiology facilitated discharge program

Cardiology Facilitated Discharge Program

Dr. Paramjit Singh Panesar.

Executive Director.

Nottingham North and East Clinical Commissioning Group.

background
Background
  • CCG level financial productivity targets
    • QIPP.
  • Cardiology Spend.
  • Right Care Analysis.
    • Spend vs. Outcome
  • Clinical Contracting Board.
    • Identification of higher numbers of follow-up patients vs. new referrals.
the problem
The Problem…..
  • “The problem is…”
  • “…. The number of stable follow-up patients in cardiology outpatients is too high”
the objective
The Objective
  • “To reduce the number of stable follow-up patients in cardiology outpatients by discharging at least twenty percent of dischargeable audited patients within 6 months”
the selected strategy
The selected strategy
  • Facilitated Discharge Program for stable cardiology patients.
    • High benefit, low cost and timely strategy.
  • Stakeholders:
    • Primary care, Secondary care and Patients.
  • Overview of strategy.
    • Using eHealthscope, categorisation of patients into:
      • A – Active long term follow-up.
      • B – Being investigated.
      • C1 – Combined follow up (by GP and Pacemaker clinic).
      • C2 – Combined follow up (by GP and ECHO clinic).
      • D – Discharged.
    • Verification by Secondary Care and Discharge Process.
implementation plan
Implementation plan
  • Include a list of actions and sequencing.
  • Be clear on who (group/person) will be accountable for task and overall governance of the plan.
  • Describe how you will manage resistance.
evaluation plan
Evaluation plan
  • 4 month evaluation point.
  • Process indicator.
    • At least 12 out of 21 practices (50%) take part in the discharge program
  • Outcome indicator.
    • At least 20% of audited stable cardiology patients are discharged to the community.
  • So how did we do?
conclusions
Conclusions
  • Leadership:
    • Importance of creating a share vision.
    • Engagement of a variety of stakeholders.
    • Responsive leadership to change and challenge.
  • Problem solving:
    • Define a problem that achieves stakeholder engagement.
    • Strategy implementation needs to be dynamic and responsive with timely evaluation.
    • Stakeholder engagement is key to implementing the strategy.
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Working in groups:

    • Need for clear leadership and common goal.
    • Clearly defined roles within the team.
      • Champion the strategy
      • Implementation team
      • Stakeholder engagement
    • Responsive to change and challenge.
  • Impact on organisation?
    • Better alignment with longer term strategy having worked on a shared goal.
    • Proven model for change to be implemented again in the future.
    • Increased patient access for new referrals and greater financial stability for the CCG.
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