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Access Improvement Project Presenter: Dr David Theile Hospital: Eagle Key contact person for this project: Dr David Theile Ph: 07) 3240-7744 [email protected] 30 March 2007 - Auckland. KEY PROBLEMS. ED Access Block approx 50% Bed capacity issues 93% plus occupancy rates

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Access Improvement ProjectPresenter: Dr David TheileHospital: EagleKey contact person for this project: Dr David Theile Ph: 07) [email protected]

30 March 2007 - Auckland


Key problems
KEY PROBLEMS

  • ED Access Block approx 50%

  • Bed capacity issues 93% plus occupancy rates

  • Uncoordinated Discharge planning effort

  • Estimated Discharge Dates determined on day of discharge

  • Top 20 DRG ↑ALOS against benchmarks


Aim of this project
AIM OF THIS PROJECT

  • Develop a KPI Dashboard for ongoing monitoring

  • Improve ED Access Block – target 20%

  • Reduce Top 20 DRG LOS to National benchmarks

  • Decrease wait lists Cat 1 & 2 surgery

  • Improved Theatre access for # NOF cases

  • Increased discharges prior to 10am

  • Improved care planning and coordination

  • Enhanced patient experience

  • External Consultants engaged to undertake a diagnostic & solution design

  • Completion December 2006


Key changes implemented
KEY CHANGES IMPLEMENTED

  • KPI Dashboard

  • ED 3-2-1 Hospital wide clinical system redesign initiative

  • Effective Discharge Planning Project

    • 2 discharges by 10am per unit

    • Estimated Discharge Date (EDD)

    • Daily multi-disciplinary planning meetings

    • Discharge summaries & scripts 24 hours prior to day of discharge

    • Criteria Led Discharge – (in progress)

  • Orthopaedic OT Access - # NOF project

  • Acute Care in the Home project - ACITH

  • Transit Lounge Utilisation improvement

  • Patient Flow Unit established

  • Standardised Medical Officer Induction and education



Outcomes so far1
OUTCOMES SO FAR

  • A reduction in ALOS from 7.95 days when the project commence to 6.77 days in Dec 06. ALOS increased moderately in January but is starting to decrease again in February as we educate new staff in MDT’s and discharge coordination.


Outcomes so far2
OUTCOMES SO FAR

  • ACITH Model of Care implemented

    • Cellulitis

    • Urinary Tract Infection

    • Deep Vein Thrombosis

    • Home IV Antibiotics


Outcomes so far3
OUTCOMES SO FAR

  • #NOF LOS

  • Implemented Monday to Friday knife to skin time of 07.30am

  • Implemented #NOF Liaison Nurse 7 days / week.

  • Waiting times for OT reduced from 5.6 days to 2.0 days.

  • ALOS reduced from 21.4 days to 12.4 days.

  • Decrease in 526 OBD’s over the period of the pilot (3mths).


Outcomes so far4
OUTCOMES SO FAR

  • Access Block reduction


Outcomes so far5
OUTCOMES SO FAR

  • Increased Discharges prior to 10am

  • 50% occur prior to midday

  • Introducing Criteria led discharge as phase 2 of the discharge planning initiative


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