1. Shorter Stays NMDHB Data Analysis

2. NMDHB Nelson ED 25,500 334 breaches = 98% Wairau ED 21,000 752 breaches = 96%

4. NMDHB – no EDIS – no whiteboard – outdated PMS

5. Hospital's cat missing BY CLAIRE CONNELL Wairau Hospital has lost its much-loved pet, Norman, and wants people to help with any sightings of the ginger cat

6. ED Process Triage time recorded directly on PMS Clerical staff transcribe hand written time seen, discharge time, diagnosis and disposition into PMS Business support team collate this data into monthly reports Two hospitals – multiple separate reports and some combined Electronic data available: No further electronic detail available or searchable So…. Triage timeNumber of patients ATSTriage benchmarks Time seenEDLOS Time dischargedAdmission rates ED handwritten diagnosis - not coded Disposition

7. Photo of big pile of notes

8. The Spreadsheet NHINameAgeTriageTriage dateVisit TimeEDLOS DoctorDispositionComplaint/Diagnosis FDF6796 434 08/10/201017:308.2 PR BLEED CZC9233 643 09/10/201010:187.5 AdmittedBACK PAIN AKN0299 293 09/10/201013:506.3 AdmittedPUJ OBSTRUCTION BQM1407 413 13/10/201001:006.0 ABDO PAIN ? CAUSE MGX4583 182 14/10/201000:158.1 PNEUMONIA CFM7017 502 14/10/201012:5210.0 Transfer#C5/6 RRA8628 522 15/10/201014:107.5 CHEST PAIN LNQ8487 482 16/10/201003:327.5 AdmittedPANCREATITIS CDA8286 383 16/10/201010:588.2 POLYPHARMACY OD AJB1690 302 17/10/201002:2512.0 AdmittedOVERDOSE DTJ9674 764 17/10/201013:357.7 CELLULITIS (L) LEG BYE1944 293 18/10/201000:407.8 SEIZURES BRB6026 723 18/10/201002:427.5 UTI BRM1207 773 18/10/201003:308.4 RENAL COLIC ATH1375 685 20/10/201010:456.4 AdmittedWOUND INFECTION LAB6373 212 20/10/201011:547.0 AdmittedABDO PAIN? CAUSE FZF9290 542 21/10/201002:448.8 CHEST PAIN TROP NEGATIVE

9. Making sense of it all Not a perfect science – Appropriate – Clinical Decision Making (the doctor, patient complexity, time of day) – Test Delay – Delay in RV – Access Block Which Doctor? Which team? When? Admitted or Not?

19. How was the data used? Informing ED team – more watchful attitude (both nurses and doctors) Added EDLOS to the SBAR handover tool Bed managers more aware Target the surgeons Improved lab TAT’s Medical Triage for patients referred to inpatient teams New admission policy Wairau ED