HaDSCO Collaborate & Learn Platform Professor Frank Daly Chief Executive South Metropolitan Health Service

The future What are we trying to achieve?  Best possible outcomes for patients  Improved patient experience  Committed workforce  Financial sustainability

Evidence and outcome  High quality care is effective, safe, personal, timely and efficient  It is self-evident that we should provide evidence- based clinical care wherever possible

Evidence and outcome  There exists a robust evidence-base regarding how organisational culture, teamwork and clinical engagement effect patient outcomes, organisational performance and financial outcomes

Patient satisfaction and experience  Clear relationships between staff satisfaction and patient satisfaction  Patient satisfaction highest where staff have clear goals  Good HR processes associated with lower mortality in acute hospitals

Teams  Compassion is often cited as the key ingredient required to provide high quality care  Notice others  with an empathetic response  that leads to intelligent action  Staff do not come to work thinking they will not be compassionate that day. A lack of compassion comes from being ill-equipped to cope with day-to-day challenges  Working in teams* provides the capacity to manage challenges and improve

Indicators  Process indicators  Outcome indicators  Lead indicators

Indicators  Lead indicators might assist an understanding of hospital capability and culture  Patient experience  Staff satisfaction  “Would you want a loved one to be treated here?”  The percentage of staff working in true teams  Process measures to show the way to improvement

Consumer Complaints for SMHS 2012/13  During the 2012/2013 Financial Year the South Metropolitan Health Service (SMHS) received a total 1,662 complaints from which 2,253 issues were identified.  The top three (3) issues identified in complaints received by SMHS were:  32% Quality of Clinical Care  19% Communication  17% Access

Case Study: Spinal Surgery and Bracing Wait Times  Several complaints were received at Royal Perth Hospital with regard to the wait times for spinal surgery and spinal bracing for scoliosis patients.  Complaints highlighted that some patients were resorting to eastern states travel for surgery and bracing.

Case Study: Spinal Surgery and Bracing Wait Times Investigation findings:  Imbalance between theatre activity and referrals for the spinal service causing an ever increasing wait list.  The amount of theatre time scheduled for spinal surgery was insufficient.  Complexity of the surgery for scoliosis required additional surgical expertise.

Case Study: Spinal Surgery and Bracing Wait Times  Many patients waiting an excessive amount of time between assessment and fitting of the prescribed spinal bracing.  Identification of “single points of failure”.

Case Study: Spinal Surgery and Bracing Wait Times Actions:  Negotiations to employ additional FTE to significantly reduce the waitlist for spinal surgery.  Creation of an official State Spinal Service at Royal Perth Hospital (RPH).  Outsourcing some spinal bracing to the private sector.