1. 1 Patient Management Task Force Presentation to the Designing Care Symposium by Dr Michael Walsh Chair, Patient Management Task Force 2 March 2001

2. Designing Care Symposium2 Terms of Reference & Modus Operandi Terms of Reference –best practice in patient management –quick achievement of change –Key indicators of good practice –Incentives/Strategies to encourage Best practice –Collaborative and consultative Approach –Health Service Visits –Discussions with Peak Bodies –Literature Review –Series of Issues Papers

3. 2 March 2001Designing Care Symposium3 Overview of Opportunities for Improvement Paper 1: Introduction & Background Paper 2: Ambulatory Care Paper 3: Elective Multiday Surg & Med Paper 4: Emergency Care Paper 5: Frail Aged and Chronically Ill Paper 6: The Right Health Care: Social and Ethical Issues Paper 7: Improving the System Paper 8: Summary & Action Plan

4. 2 March 2001Designing Care Symposium4 Ambulatory Care Issue –variation is uptake of ambulatory care Goal –Further Development of Ambulatory Care towards worlds Best practice Opportunities for Improvement –industry benchmarking & incentives for day surgery –Role & operation of ambulatory care units

5. 2 March 2001Designing Care Symposium5 Multiday Electives Issue –Practice variation; good ideas not systematically disseminated Goal –Positive patient experience; optimise Elective throughput without compromising Quality Opportunities for Improvement –Pre-admission process (incl DOSA); Bed Allocation; Op.Theatre Use; Clinical Pathways; Daily/weekly/seasonal activity fluctuation

6. 2 March 2001Designing Care Symposium6 Emergency Care Issue –access for very sick patients Goal –public confidence that when they are critically ill they will get timely, high quality care Opportunities –working with the Ambulance service to coordinate access; bed management; management of patients in the ED; clinical pathways; HITH/PAC

7. 2 March 2001Designing Care Symposium7 Frail Aged & Chronically Ill Issue –Health system frequent flyers often have the worst experiences re: coordination & integration of effort Goal –Well integrated, multi-centred health care team characterised by smooth transition between carers and minimal dislocation for patient Opportunities –Improved interaction between hospitals and Nursing Homes (two way exchange); care coordinators; Integrated health care record

8. 2 March 2001Designing Care Symposium8 The Right Health Care Issue –Doing the right thing: balancing clinical science with individual wishes and responsible resource use Goal –Active participation by patient in health care decisions: nothing about me without me. Opportunities –End of Life decision making; ensuring more active participation

9. 2 March 2001Designing Care Symposium9 Improving the System Issue –Service provision not a system, but a collection of vaguely related, autonomous providers Goal –Well integrated system providing improved community and population health as well as positive patient experiences/outcomes. Victorian Public gets value for money Opportunities –More collaboration; revised targets and incentives; refined funding models, more aggressive use of Performance indicators and Benchmarking

10. 2 March 2001Designing Care Symposium10 Summary & Action Plan (1) Access to Hospital Care 1.Improved Emergency Response 2.Improved Waiting List Management 3.Reduction in substitutable admissions In-Hospital Process Improvements 4.Increased ambulatory care 5. Improved acute hospital capacity 6. Increasing DOSA rates 7.Reducing Acute LOS (towards Best Practice) 8. Process re-engineering and new clinical structures (eg MAPUs/EMUs, care coords)

11. 2 March 2001Designing Care Symposium11 Summary & Action Plan (2) Access to Post-hospital services 9. Links with Residential Aged Care 10.Links with community & home-based care System Management 11. Governance/Leadership/Management 12. Focus on IT to improve Patient Management 13. More Performance Info and Benchmarking (publicly available, hospital identified) 14. Refined Incentives, Health Service Specific 15. Service Planning, esp Role Delineation 16. Patient/Community Participation in care provision

12. 2 March 2001Designing Care Symposium12 Where to from here? Task Force finishes 31 March Paper released serially over March/April Implementation via DHS and 2001/2002 Health Service Agreement

13. 13 Patient Management Task Force The End