1. The Health Roundtable Presenter: Margaret Harley Health Service: (Melbourne Health) Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012 1 1-1b_HRT1215-Session_HARLEY_MELB_VIC

2. The Health Roundtable KEY PROBLEMS  Patients were waiting for excessive periods prior to their appointment (in the waiting room), and again in the Day Centre itself during their treatment.  Inefficient processes (e.g. duplication, delays, lack of standardisation).  Staff dissatisfaction with the Day Centre physical environment (e.g. lack of privacy, insufficient space) 2

3. The Health Roundtable AIMS OF THIS INNOVATION  Reduce waiting between appointment time and treatment at Day Centre  Reduce % of ‘non-value add’ activity during treatment episode  Improve patient and staff satisfaction with physical environment 3

4. The Health Roundtable BASELINE DATA  Wait time  % of ‘non-value add’ activity  Staff satisfaction with physical environment 21.88% patients waiting over 60 minutes Median = 30 minutes Target Median = 25 min Average of 26% ‘non value add’ activity across 27 patients tracked Target Mean = 15% Mean staff score 1.8 (n= 27) Target Mean > 2 4

5. The Health Roundtable KEY CHANGES IMPLEMENTED  1. Transfer of pathology tests from the ward to outpatient pathology services  Saving of 660 mins of chair time per day  Pathology is now completed by Melbourne Health Pathology Services (including Hickmans, PICCs and port access)  2. Development of triage guidelines  Medical staff (Haematology & Med Oncology) worked collaboratively to develop a set of triage criteria  This allows for even distribution of appointments based upon clinical need  3. Environmental modifications  5S, painting, re-arrangement of furniture, standardisation, visual management Before After 5

6. The Health Roundtable KEY CHANGES IMPLEMENTED  4. Implementation of a new booking system (BookWise Oncology)  Provides data for several key performance indicators allowing benchmarking between services and improved analysis  Improved visibility of available appointments allows better distribution of bookings  5. Introduction of a central pager for communication of chemotherapy readiness  Nurse in charge of each shift carries and serves as key point of contact for sterile pharmacy, therefore increasing efficiency and decreasing interruptions 6

7. The Health Roundtable OUTCOMES SO FAR  Significant impact on improving patient waiting times  Improved communication of chemotherapy readiness  Transfer of pathology tests to outpatient pathology therefore ensuring maximal best use of ‘chair time’  Development of triage guidelines to support clinical prioritisation of bookings  Environmental modifications 7

8. The Health Roundtable LESSONS LEARNT  Great rewards in working collaboratively with process owners  Small changes can have major impact  Consumers enjoy being asked for their input and can have great ideas  IT solutions can take a very long time to implement 8