Pathways to the future Improving Health System Performance The role of Stochastic simulation in predicting the utility of investments.

Slides:

Advertisements

Similar presentations

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

Advertisements

Paramedic Practitioner Support Scheme for Older People with Minor Injuries or Conditions South Yorkshire Ambulance Service NHS Trust Sheffield.

Hip fracture NICE quality standard March 2012 ABOUT THIS PRESENTATION:

Shorter Stays in the ED forum 26 and 27 March, 2012.

A Systems Dynamics Model for Acute Care Patient Flows In New Zealand A dynamic system model created by Dr Peter Carswell – Investigator Dr Alana Harper.

Paul Walley Associate Professor Warwick Business School Redesigning Emergency Care Lessons from the UK.

Health Innovation Exchange

Midland Region Primary Healthcare Forum 30 May 2014.

Acknowledgements RHH ED staff Safety and Quality Unit RHH for their participation and valuable contribution Next Steps It is envisaged over the next 12.

Irish National Acute Medicine Programme Patient Flow Model O’Reilly O, Courtney G, Casey A* Problem Patients requiring urgent care experienced long delays.

Achieving NEAT Forum 2013 “Transforming NEAT Performance: The Executive Role Dr Richard Ashby AM Chief Executive Metro South Health Brisbane, Australia.

NHS Services, Seven Days a Week Professor Sir Bruce Keogh National Medical Director NHS England.

Local Unscheduled Care Action Plan and Winter Planning Health and Social Care Partnership Meeting 24 Oct 2013.

Ideas from UK modernisation: The Improvement Partnership for Hospitals Penny Pereira Ideas from UK modernisation.

How Clinical Process Simulation Changed Hip Fracture Pathway in Torquay Andrew Fordyce, Rachel Blackshaw, Rob Lofthouse, Mike Swart Torbay Hospital 31st.

The Health Roundtable 3-3b_HRT1215-Session_MILLNER_CARRUCAN_WOOD_ADHB_NZ Orthopaedic Service Excellence – Implementing Management Operating Systems Presenter:

The BHRUT Clinical Strategy Presentation for stakeholders, patients and the public.

LOCAL LHD LOGO Kate Lloyd Manager, Acute Care Agency for Clinical Innovation Tel | Mob Criteria.

Chapter 15 Application of Computer Simulation and Modeling.

Care Continuity and Patient Care Transitions Kari DiCianni, Director of Innovations & Research.

Department of Human Services Dr Paul Scown Chief Executive Melbourne Health 6 th July 2004 Melbourne Health Pilot Case Study.

How did this project come about? The Central Primary Health Organisation (Central PHO) in collaboration with MidCentral District Health Board (MDHB) secondary.

Sasha Karakusevic. We have achieved substantial improvements for our community and receive positive feedback from patients and the public Both the Care.

An Anaesthetist’s perspective on Same Day Surgery

Target Performance: Q1 = 80% Q2 = 85% Q3 = 90% Q4 = 95% We are heading in the right direction 14% Improvement since Sept 2011 Quarter 3 (to date) 87.7.

Department of Human Services Promoting patient care through effective patient flow System wide implementation January – July 2005.

Service 19 TH JUNE 2014 /// SEPTEMBER 4, 2015 ALISON CLEMENTS.

System Dynamics for Strategic Resource Planning at Watford Hospital Esther Moors Goncalo Esteves 13/11/2013.

Management of Adults with Diabetes undergoing Surgery and Elective Procedures UHL Guideline – April 2013 The aim of the guideline is to improve standards.

Everyone Has A Role and Responsibility

Sue Huckson Program Manager National Institute of Clinical Studies Improving care for Mental Health patients in Emergency Departments.

Western NSW Local Health District. 8% Growth to % Growth to % Aboriginal Who we are? Total population 276,000 5,200 Staff.

Council of Governors Meeting Elaine Hobson Chief Operating Officer January 2010, Item 7 Relates to Domain 1 (C4a) and Domain 5 (C18, C19)

Phase Two Learning Session 0 6 May 2013 Diana Dowdle - Campaign Manager David Grayson – Campaign Clinical Leader.

What’s wrong with emergency care in Aneurin Bevan Health Board? Dr Danny Antebi & Dr Julie Vile.

Redesigning Care in the Paediatric Emergency Department CYWHS, SA Presented by Ms Heather Gray Chief Executive : CYWHS 25 th November 2005.

RC (UK) O1 ETHICS AND LEGAL ASPECTS OF RESUSCITATION.

Care in Crisis - the challenge Carol Herity – Head of Partnerships.

BROUGHT TO YOU BY LEADING EDGE GROUP Welcome Using Simulation Modelling to improve the performance of Healthcare Facilities.

Preparing for Winter 2011/12 Guidance Overview Stuart Low Planning Manager Scottish Govt NHSScotland Business & Performance Mgt Team.

General Medicine Improving Quality Care Presenter: Jane Lees Health Service: Auckland District Health Board Innovation Poster Session HRT1215 – Innovation.

ED Capacity Management Admissions Flow through ED Tim Parke ED Consultant through ED.

Using drug use evaluation (DUE) to optimise analgesic prescribing in emergency departments (EDs) Karen Kaye, Susie Welch. NSW Therapeutic Advisory Group*

Quality Education for a Healthier Scotland Pharmacy Pharmaceutical Care Planning Vocational Training Scheme: Level = Stage 2 Arlene Shaw Specialist Clinical.

ED Stream Workshop Acute MOC

ED Stream Workshop TMH ED MOC August 2013 ED Stream Workshop 1.

Critical Appraisal (CA) I Prepared by Dr. Hoda Abd El Azim.

The Health Roundtable Improving the patient journey through ED Presenter: Kate Jurd Health Service: Toowoomba Hospital Innovation Poster Session HRT1215.

ED Stream Workshop Acute MOC August 2013 ED Stream Workshop 1.

Grantham Children’s Services A Problem or an Opportunity?

Reviewing Vascular Services Tuesday 4 th June 2013.

One Episode of Care ……. National Demonstration Hospitals Program Sharon Donovan, Executive Director - Nursing Services Wendy Hubbard, Director - Allied.

Yorkshire and the Humber Emergency Surgery Survey Jon Ausobsky RCS Director for Professional Affairs Yorkshire and the Humber & Alison Young Regional Coordinator.

Mel Pickup, Chief Executive Warrington & Halton Hospitals NHS FT Andy Davies, Accountable Officer Warrington Clinical Commissioning Group Achieving the.

Working for healthier lungs The Whys and Whats of Care Bundles 23 November 2012.

Yorkshire and the Humber Emergency Surgery Survey Jon Ausobsky RCS Director for Professional Affairs Yorkshire and the Humber & Alison Young Regional Coordinator.

2 November John Childs and Deborah Woodley

Preparation for Practice Learning

Operational & Process Improvement using Simulation

Accessing health information in the UK

Aotearoa: New Zealand Michael Tetwiler.

Title of the Change Project

Geriatrics Curriculum to Model Characteristics of the

Emergency Department Waits and Patient Flow April 12, 2016

NRS 410 Topic 1 Mandatory Discussion Question FOR MORE CLASSES VISIT Max Points: 20.0 The case scenario provided will be used to answer.

Delivery System Reform Incentive Payment (DSRIP) Collaboration

Wednesday 7 June – Tuesday 13 June

Objectives of patients flow map

Operational site management principles

Operational site management principles

Presentation transcript:

Pathways to the future Improving Health System Performance The role of Stochastic simulation in predicting the utility of investments

Pathways to the future Amid the entangled complexities of health services all aspects of performance are inter-dependent

Pathways to the future Mike Ardagh, National Clinical Director of Emergency Department Services Stuart Powell and Emmanuel Jo, Service Analysis, National Health Board Business Unit, Ministry of Health ; Joy Farley and Warwick Gilchrist, Taranaki District Health Board

Pathways to the future Shorter stays in the Emergency Department 95% will be admitted, discharged or transferred within 6 hours

Improving health system performance Shorter stays in the ED About the whole of system Overlaps with; Elective aspirations Primary care considerations Cost containment endeavors Quality concerns

Improving health system performance 1 2 3

Patients 1.43 year old man with pneumonia, waiting for the medical registrar to assess year old lady with a compound ankle fracture awaiting surgery. 3.A 73 year old woman with chest pain, waiting for a free ED cubicle

Improving health system performance Patients 1.43 year old man with pneumonia, waiting for the medical registrar to assess. What if we had a separate medical assessment unit? Or a second medical registrar? Or IV antibiotics in primary care?

Improving health system performance Patients 2.60 year old lady with a compound ankle fracture awaiting surgery. What if we had a dedicated acute theatre? Or another orthopaedic registrar? Or if elective orthopaedic activity was at another site?

Improving health system performance Patients 3.A 73 year old woman with chest pain, waiting for a free ED cubicle. Should we have more monitored cubicles? Or a bigger Coronary Care Unit? Or a low risk chest pain pathway run through the ED observation unit?

Improving health system performance

Seeking answers Value stream mapping and other lean thinking techniques Breach analysis and other measures of variance Street wisdom Turning data until it catches the light Modelling of present state compared to present state plus an intervention

Improving health system performance Advantages of using simulation Real life experiments without implementing in the real world Identify how changes to variables within the system can impact other parts of the system Easy identification of bottle necks

Improving health system performance Disadvantages of using simulation If the data doesn’t reflect reality, the results won’t be real There may be unknown/unpredicted confounders the data has not taken into account

Improving health system performance The Simulation Tool Witness Simulation Software Used with success in a variety of industries 3 examples of use in Health Care and Hospitals on website (2 UK, 1 USA) Trialled with ADHB data*, and TDHB underway.

Improving health system performance Patient flow simulation for Taranaki DHB Aim: To investigate the influence on patient flow, of a short stay unit next to ED.

Improving health system performance Model structure

Improving health system performance Timeline for a process optimisation using simulation for a DHB StepTaskTime Required 1Plan and identify what to optimise1 day 2Draw up a model structure and flow diagrams1 week 3Check the structure by the MOH team1 day 4Data gathering for the model2-3 weeks 5Building the model using special simulation software 2-4 weeks 6Validate and calibrate the model for Business as Usual Scenario 1 week 7Test different policy options in the complex virtual life environment to identify better outcome 1 week Approximately 10 weeks !!!!

Improving health system performance Summary Achieving the Shorter Stays in the Emergency Department Target requires whole of system reforms Health systems are complex and interactive Interventions will influence many parts of the system Simulation has the potential to predict the influence of interventions The Shorter Stays Target is not competing with other priorities.