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Impact of Dynamic DTC’s

Impact of Dynamic DTC’s. Transformation of Kidderminster Hospital 1st September 2003 David Evans Project Director Worcs Acute Hospitals NHS Trust. Worcestershire. 3 PCTs South Worcestershire pop 280,000 Redditch and Bromsgrove pop 150,000 Wyre Forest pop 110,000 1 Acute Trust

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Impact of Dynamic DTC’s

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  1. Impact of Dynamic DTC’s Transformation of Kidderminster Hospital 1st September 2003 David Evans Project Director Worcs Acute Hospitals NHS Trust

  2. Worcestershire • 3 PCTs • South Worcestershire pop 280,000 • Redditch and Bromsgrove pop 150,000 • Wyre Forest pop 110,000 • 1 Acute Trust • WRH 450 bed PFI • Alexandra 340 bed DGH • Kidderminster DTC and other services

  3. Electives v Emergencies • Which is the priority? • Conflict between medicine and surgery • Cancellations through lack of beds • Patients cared for in inappropriate areas • Waste of time and resources - day to day crisis management • Stressful for patients and staff

  4. Services at Kidderminster • DTC - short stay elective surgery • Diagnostics • Clinics • Midwifery led maternity unit • Minor Injuries Unit/Primary Care Centre • Cancer services • Renal Dialysis Unit • Intermediate care beds • Therapy services • Education Centre

  5. Activity Strands at Kidderminster Local Primary Care IS-DTC Elective Wyre Forest Elective Worcs Kidderminster Hospital Elective Patient Choice

  6. The Design - Ground Floor • Main Entrance • Atrium • Café • MIU/PCC • Oral/Maxillofacial Department

  7. The Design - First Floor Outpatient Functions • Consulting rooms • Radiology • Cancer Services • Ophthalmology • Renal Dialysis • Rehabilitation and therapy services • Clinical Measurement

  8. The Design - Second Floor Treatment and Intervention • Operating Theatres • Intervention Rooms • Short stay elective beds • Other inpatient facilities • Staff rooms and changing facilities

  9. The Design - Third Floor Support Services • Office accommodation • Pathology Laboratories • Education Centre • Midwifery led Maternity Unit

  10. Project Status • Nov 24th - Phase 1 handover • Dec 15th - Outpatients, Radiology and MIU/PCC open • Dec 22nd - 1st operating and endoscopy lists • Jan 5th - Phase 2 starts • Aug 2004 - Phase 2 handover • Oct 2004 - Phase 2 opens

  11. DTC aims • Separation of emergencies and electives • High quality health care facility • Quick access to treatment and diagnostics • Flexible facilities • Patient centred - one stop approach • Patient flows and navigation • ‘Wow’ factor • Wellness model • Focusing on the predictable • Transforming the patient experience

  12. Changing the culture • Patient centred care • Reduced waiting times • Partnership working • Breaking down the barriers • Flexible/multiskilled working • Smarter not harder • Process and systems • Individual responsibility • Healthcare is not rocket science

  13. Changing roles • Scheduler • understands whole journey, books patients, compiles lists, close links with clinical staff, strong customer care aspect • Nursing • Multi-skilled, competency based, nurse discharge • PSP project • case management, assess, diagnose and initiate treatment • Surgeon • customer?, credentials?, audit, little involvement in post op care • Anaesthetist • increased blocks, recovery care, clinical responsibility for DTC? • Radiographer Assistant

  14. Ambulatory - 23 hr investigations & surgery Outpatients - Generalised - Specialised - One Stop Chest Pain Elderly Assessment Medical Surgical areas Acute InpatientCare Community + Primary Care Critical Care Diagnostic Investigation Patient Hotel A&E • Rehabilitation • Low • Dependency • Respite • Shared Care • Home Care • Social Care Intermediate Care Facilities Hospital at Home Peri Acute Care Hospital at Home Secondary Care Primary Care Community Community Primary Care Process not Function

  15. DTC Business • Managed as a business unit of Trust • Activity targets • Income targets and generate surplus • Patient Choice • Order book • High quality care, facility and behaviour • Market services and facilities • Evening and weekend working • Flexible staff

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