The Health Roundtable Productive Mental Health Ward at ORYGEN Youth Health Presenter: Fiona White Health Service: Melbourne Health Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct c_HRT1215-Session_WHITE_Melbhealth_VIC

The Health Roundtable KEY PROBLEM  Significant increase in demand for services over the past 3 years (35% increase in separations across the health service during that period) and higher levels of patient acuity. This increase was not adequately matched with significant changes to ward processes.  Feedback from staff highlighted frustration with inconsistent and inefficient systems.  Consumers and carers reported that breakdown in communication and lack of choice in activities lead to boredom and contributed to a negative experience. 2

The Health Roundtable AIM OF THIS INNOVATION  Increase direct care time with consumers to 50%  Decrease use of seclusion  Improved co-ordination of nursing handover to enhance patient flow and enable earlier discharge of clients  Empower staff to make change through a structure approach to innovation  Create a calmer ward  Increase staff morale 3

The Health Roundtable BASELINE DATA  Direct care time with consumers – 30%  Readmission rate %  Average monthly seclusion rate of 52.30/1000 bed days (2010/11) 4

The Health Roundtable KEY CHANGES IMPLEMENTED 1. Created a Team Vision 2. Streamlined ward processes 3. Created Knowing How We’re Doing & Patient Flow Boards 4. Redesigned handover / medication processes “Responding to the current mental health needs of young people by providing compassionate and specialised professional support, to help them find their path to recovery and their future.” 5

The Health Roundtable OUTCOMES SO FAR  Increased direct consumer care time from 30% to 58%  Decreased interruptions to staff over a 12 hour shift from 109 to 40  Decreased readmission rates from 21.1% to 18.53%  Average Length of Stay decreased from 10.8 to 9.21 days  Decreased average monthly seclusion rate to 27.24/1000 bed days (2011/12) 6

The Health Roundtable LESSONS LEARNT  Ensure that Productive Ward is implemented into wards who feel ready and excited for a change program.  Wards need stable leadership for this kind of project to be successful.  Encourage all staff to be leaders in improvement.  Ensure that the NUM of the ward guides the team but does not make all the decisions. Innovation should be driven by the staff on the floor.  Do not underestimate the power of Executive site visits. 7