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Patient Management Task Force. Presentation to the Designing Care Symposium by Dr Michael Walsh Chair, Patient Management Task Force 2 March 2001. Terms of Reference & Modus Operandi. Terms of Reference best practice in patient management quick achievement of change
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Patient Management Task Force Presentation to the Designing Care Symposium by Dr Michael Walsh Chair, Patient Management Task Force 2 March 2001
Terms of Reference & Modus Operandi • Terms of Reference • best practice in patient management • quick achievement of change • Key indicators of good practice • Incentives/Strategies to encourage Best practice • Collaborative and consultative • Approach • Health Service Visits • Discussions with Peak Bodies • Literature Review • Series of Issues Papers Designing Care Symposium
Overview of Opportunities for Improvement • Paper 1: Introduction & Background • Paper 2: Ambulatory Care • Paper 3: Elective Multiday Surg & Med • Paper 4: Emergency Care • Paper 5: Frail Aged and Chronically Ill • Paper 6: The Right Health Care: Social and Ethical Issues • Paper 7: Improving the System • Paper 8: Summary & Action Plan Designing Care Symposium
Ambulatory Care • Issue • variation is uptake of ambulatory care • Goal • Further Development of Ambulatory Care towards “worlds Best practice” • Opportunities for Improvement • industry benchmarking & incentives for day surgery • Role & operation of ambulatory care units Designing Care Symposium
Multiday Electives • Issue • Practice variation; good ideas not systematically disseminated • Goal • Positive patient experience; optimise Elective throughput without compromising Quality • Opportunities for Improvement • Pre-admission process (incl DOSA); Bed Allocation; Op.Theatre Use; Clinical Pathways; Daily/weekly/seasonal activity fluctuation Designing Care Symposium
Emergency Care • Issue • access for very sick patients • Goal • public confidence that when they are critically ill they will get timely, high quality care • Opportunities • working with the Ambulance service to coordinate access; bed management; management of patients in the ED; clinical pathways; HITH/PAC Designing Care Symposium
Frail Aged & Chronically Ill • Issue • Health system “frequent flyers” often have the worst experiences re: coordination & integration of effort • Goal • Well integrated, multi-centred health care team characterised by smooth transition between carers and minimal dislocation for patient • Opportunities • Improved interaction between hospitals and Nursing Homes (two way exchange); care coordinators; Integrated health care record Designing Care Symposium
The Right Health Care • Issue • Doing the right thing: balancing clinical science with individual wishes and responsible resource use • Goal • Active participation by patient in health care decisions: “nothing about me without me”. • Opportunities • End of Life decision making; ensuring more active participation Designing Care Symposium
Improving the System • Issue • Service provision not a system, but a collection of vaguely related, autonomous providers • Goal • Well integrated system providing improved community and population health as well as positive patient experiences/outcomes. Victorian Public gets “value for money” • Opportunities • More collaboration; revised targets and incentives; refined funding models, more aggressive use of Performance indicators and Benchmarking Designing Care Symposium
Summary & Action Plan (1) • Access to Hospital Care 1. Improved Emergency Response 2. Improved Waiting List Management 3. Reduction in “substitutable” admissions • In-Hospital Process Improvements 4. Increased ambulatory care 5. Improved acute hospital capacity 6. Increasing DOSA rates 7. Reducing Acute LOS (towards Best Practice) 8. Process re-engineering and new clinical structures (eg MAPUs/EMUs, care coord’s) Designing Care Symposium
Summary & Action Plan (2) • Access to Post-hospital services 9. Links with Residential Aged Care 10. Links with community & home-based care • System Management 11. Governance/Leadership/Management 12. Focus on IT to improve Patient Management 13. More Performance Info and Benchmarking (publicly available, hospital identified) 14. Refined Incentives, Health Service Specific 15. Service Planning, esp Role Delineation 16. Patient/Community Participation in care provision Designing Care Symposium
Where to from here? • Task Force finishes 31 March • Paper released serially over March/April • Implementation via DHS and 2001/2002 Health Service Agreement Designing Care Symposium
Patient Management Task Force The End