1. Unscheduled care - The Challenges and Opportunities in Radiology CUH Trish Murphy Acting RSM1

2. What is Unscheduled Care
Unscheduled care can be defined as health and/or social care which cannot reasonably be foreseen or planned in advance of contact with the relevant professional. It follows that such demand can occur any time and that services to meet this demand must be available 24 hours a day seven days a week. Improving the patient pathway through the Emergency Department for either subsequent admission or discharge is the most important challenge for the Hospital and requires collective commitment from all medical, surgical and diagnostic services.

3. Challenges Capacity issues in the Radiology Department
Combining Scheduled & Unscheduled patients
Overreliance on diagnostic tests by Clinicians
Patient expectations to obtain diagnostics & TAT
24/7 service demands
Changing demographics /patient profile ( Bed patients & co morbidities )
Recruitment & Retention of staff
Resources from Management
Justification , Triage & Prioritising of patients ( Transposition of the BSS September 2018 )
Support for Role advancement from Clinicians & Management
Technological advances & CPD support
Work life balance for overburdened staff

4. Capacity & Process

5. CUH CAMPUS

6. The hospital Campus

7. Floor Plan of CUH X-ray Main Block

8. Campus Diagnostic Activity 2017

9. Modality Activity 2017

11. Challenges Capacity issues in the Radiology Department
Overreliance on diagnostic tests by Clinicians
Patient expectations to obtain diagnostics & TAT
24/7 service demands
Changing demographics /patient profile ( Bed patients & co morbidities )
Recruitment & Retention of staff
Resources from Management
Justification , Triage & Prioritising of patients ( Transposition of the BSS September 2018 )
Support for Role advancement from Clinicians & Management
Technological advances & CPD support
Work life balance for overburdened staff

12. Opportunities Project Flow Diagnostic Dependant Discharge (DDD)
GP Liaison Nurse
Dedicated CT & Ultrasound slots (AMAU & MSSU)
Lean Management Culture
Policy Procedure & Guideline (PPG)
Teaching Hospital and student placement structure
MSC Graduate Radiography Programme in UCC
Audit & Review Process

13. What is Project Flow ?
Project Flow aims to clearly identify the processes and systems that are required for safe, timely and effective delivery of care to the people that enter the hospital site. It includes looking more in depth at :
Each patient’s required length of stay,
Planning for each patient’s individual discharge,
looking at weekday and weekend demand,
linking with integrated care programmes in primary and community care services,
A visual display of data in the hospital

14. Priorities Ward whiteboards Communication
Patients in the hospital >14 days
Non admitted patient experience time (PET)
Weekend discharges
Integrated care projects
Cit opat etc dc handout

15. PF 18 Objectives Patient Safety Admission avoidance D2A Over 75
pathway
Stranded Patient
Weekend
discharges
System
Re-design
Data
Acute Floor
True
Community
Integration
Navigational
Hub

16. Project Flow 18 CUH

17. Team Based Approach

18. Opportunities Project Flow Diagnostic Dependant Discharge (DDD)
GP Liaison Nurse
Dedicated CT & Ultrasound slots (AMAU & MSSU)
Lean Management Culture
Policy Procedure & Guideline (PPG)
Teaching Hospital and student placement structure
MSC Graduate Radiography Programme in UCC
Audit & Review Process

20. Cultural Change