1. Department of Human Services in collaboration with Peninsula Health Patient Flow Collaborative Eddie Dunn Operations Director, Rosebud Hospital Facilitator – Peninsula Health PFC

2. Presentation A WHOLE SYSTEM APPROACH TO PATIENT FLOW MANAGEMENT

3. Aims How we got started Challenges to date and in the future Key strategies Early achievements & activities to date Lessons learned Next steps

4. How we got started The first six months Key stakeholders chosen from the quality area Multiple collaboratives underway at same time Facilitator could not provide a focussed effort due to workload commitments Minimal communication about the PFC Brainstorming sessions across Peninsula Health Small project focussed

5. How we got started - The first six months Who was involved? −Peninsula Health wide brainstorming Patients Frontline staff Departmental Managers Reactions? –Have done it before –Good, let’s get this right

6. How we got started The second six months Change in key stakeholders Executive Sponsor Vision – Major Change Initiative A facilitator that could provide a focussed effort Increased co-ordination & communication Regular meetings with new PFC Executive Team Multiple project teams built Gained increased PH Executive support

7. How we got started - The second six months Collation of Brainstorming results into Priority Areas Identifying Priority Area Leaders Refining Priority Areas Re-aligning Priority Area Leaders to Priority Areas Turning major trends into projects Linking into work already done for quick wins Submerge PFC into Day to Day Business

8. Key Strategies Have a vision Build an Executive Team from multiple disciplines Agree on a direction and Priority Areas Meet regularly and empower PALs Encourage accountability through regular reporting

9. Guiding Statement “ A delay in the discharge of one patient means a delayed admission for another.”

10. Guiding Principles Patient focussed Improved patient outcomes Right patient, place, resource, time and clinician Prompt access Optimal flow Enhance professional networks and relationships Efficiency

11. Peninsula Health PFC Executive Team Executive Sponsor - Siva Sivarajah Facilitator - Eddie Dunn Priority Area Leader’s (PALs) Priority Area 1 - Dr Susan Sdrinis & Shamala Jones Priority Area 2 - Jane Poxon & Robert Barker Priority Area 3 - Di Jamieson & Kate MacRae Priority Area 4 - Jan Child & Lyn Jamieson

12. Priority Areas Optimise patient flow from the Emergency Department Eliminate delays for patients awaiting surgery Optimise bed utilisation across all sites Facilitate consistent systems and processes across Peninsula Health

13. Whole System Approach

15. Challenges – Co-ordination Needed to bring all PFC info to date together Needed to provide up to date information Needed to develop consistent tools for all to use Needed to “Pinch with Pride” and share

16. Key Strategies – Co-ordination Have a central point for all information and make available all information from all projects Disseminate information Format tools that could be used across multiple projects Communicate, communicate, communicate

17. Challenges - Communication Needed a co-ordinated approach Needed to use the same language Needed a signature / design Needed to be simple, understandable & effective Needed to be targeted Needed to be planned

18. Key Strategies - Communication Develop a Public Folder for all PFC Teams/participants Executive Sponsor – “Paving the way for success” Standing Item on Operational Executives meeting Fortnightly PAL meetings Engaged Peninsula Health’s Public Relations Unit Quarterly four page newsletter and monthly update

19. Next steps - Communication Develop a PFC Intranet site with a “Score Chart” Update Internet site Road show Maintain the central point of documented evidence Orientation programme presentation

20. Communication “This is bureaucratic gobbledegook to clinicians. I have NO IDEA what a patient flow collaborative is, something to do with Urology perhaps?” (Peninsula Health Medical Officer December 2004)

21. Early Achievements Focus on quick wins Identified established work that could link with PFC Targeted projects from Brainstorming Analysis High Level Executive Support Team approach

22. Activities to date ED / Radiology Emergency Streaming Direct RAPCS admissions from ED Allied Health Pre-discharge Home Visits Patient Transfers and Transport

23. Activities to date LOS and Early Discharge Volunteers Incident Management Theatre Utilisation Project

24. Future Activities Communication and referral processes between ED and Inpatient Units Orthopaedic Streaming Neuro Streaming Weekend Discharges

25. Future Activities Multiple patient assessments High Risk follow up Transfer of Medical Records across sites Ward Clerk and PSA roles

26. Lessons learned Quick wins are important! Processes and decisions to be patient focussed Strategies to support accountability to be put in place early Communication and co-ordination required for success NHS Sustainability Tool is effective

27. Lessons learned Quick wins are important! Independent project facilitators support success Involve frontline staff at beginning of process Pressure test regularly with front end users Provide increased education An analysis of one problem often identifies other issues, which will need to be addressed.

28. Future Challenges Gaining participation of medical officers How to involve more frontline staff in the process Keeping staff motivated Managing the growth of activity

29. Critical to Success High level management support Clinicians fully engaged Clinical Leadership Team work Communication & mass involvement of staff and healthcare partner organisations Improvements must involve structures, processes & patterns/systems

30. Questions ?