Picking the priorities - Emergency Care Institute

Report
Picking the priorities
Aaron Jones
Whole of Hospital Program Lead
Royal Prince Alfred Hospital
December 2013
NEAT performance
RPA NEAT Clinical Redesign Project
 Undertaken in 2012
 Massive diagnostic phase:
– Patient stories
– Staff interviews
– Focus groups
– Process mapping exercises
– Data analysis
RPA NEAT Clinical Redesign Project
 13 solutions working parties convened in 2012
 7 priorities identified for 2013 based on the further diagnostic
work and a re-focus:
– Patient Journey Boards
– Ward Pull trial
– ED Team Based Care
– Fast Track reconfiguration
– Expand and review EMU – increase utilisation
– NEAT Navigators in the ED
– ED Admission Policy
RPA ED Timeline from Diagnostics
9:30
2014
9:00
8:30
8:38
8:00
7:50
7:30
7:24
7:00
6:58
6:36
6:30
2 Hours
6:00
5:30
5:58
5:14
5:00
4:30
4:00
3:30
4:52
2013
4:00
3:40
3:31
3:00
2:43
2:30
2:01
1:36
1:32
2:00
1:30
4:15
1:54
1:31
2:59
2:30
2:23
3:44
3:20
3:14
4:41
4:26
3:37
2:23
2:09
2 Hours
1:00
0:30
0:33
0:32
0:23
0:00
Average of Average of Average of Average of Average of Average of Average of Average of Average of Average of Average of Average of Average of
Triage to Triage to 1st Triage to
Triage to
Triage to
Triage to
Triage to
Triage to
Triage to
Triage to
Triage to
Triage to
Triage to
enters ED
seen
test request test results referral to review by
admit or
bed
patient
bed
orderlies bed & ward
patient
decision
available
specialist
specialist discharge requested in
ready
allocated
called
ready
discharged
doctor
decision
system
transfer
advised to or admitted
ED
Admit
Discharge
EMU
Setting our 2014 Priorities
 Consolidate on successes/priorities from 2013.
 Remainder of priorities are all “back of house” solutions
 Report developed with 5 key recommendations
 Executive support gained
 January 2014 – commence key stakeholder engagement
and implementation
 Breakdown 5 solutions into staged, workable projects
Lessons Learnt
 Set clear milestones and aim to meet them
 Undertake a thorough diagnostic
 Do not rush implementation
 Meet with key stakeholders regularly (at least weekly)
 Concentrate on the long term – don’t be distracted by
current performance
 External support and designated project leader essential
Acknowledgements
 RPA Emergency Dept Staff
 RPA Executive Team
 RPA WoHP Strategic Committee
 RPA Patient Flow Unit
 RPA Discharge Liaison Service
 RPA Clinicians
 Ministry of Health WoHP team

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