NHS Greater Glasgow Review of Acute Admissions

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NHS Greater Glasgow Review of Acute Admissions

• Steering Group
• 23 September 2002

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Outline of Presentation

• Scope of the Project
• Proposed Approach
• Next Steps

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Background

• In many hospitals acute/general medicine is under
  intense pressure causing problems for the
  hospital as a whole
• Many hospitals are responding with multiple
  initiatives to handle these pressures and
  problems
• Underlying challenges are rarely addressed
• A new approach is needed if this situation is to
  be resolved
• NHS Greater Glasgow is facing these common
  problems, but in the context of major strategic
  change

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Objectives of the Review

• Produce an accurate forecast of future activity
• Identify implement systems/process changes to
  improve management of acute medical admissions in
  the short-term
• Identify implement systems/process changes to
  support the long-term reduction of acute
  receiving sites
• Confirm the capacity infrastructure required to
  accommodate acute admissions
• Confirm the investment needed to provide the
  required capacity infrastructure
• Develop implement a change management plan to
  support the development of new service models

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Scope of the Project
What works well elsewhere?
What is the current position?
What will work in Glasgow?
New Model(s) of Care
Resources Required
Optimum Capacity
Implementation Planning
Short Term
Long Term
5 Sites
3 Sites
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Scope of the Project
Build on GGHB work to date
Practical examples
What works well elsewhere?
What is the current position?
What will work in Glasgow?
Core work of Project Team
New Model(s) of Care
Resources Required
Optimum Capacity
Implementation Planning
Capacity modelling
Workforce planning, costing, etc
Short Term
Long Term
5 Sites
3 Sites
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Current Position
Three-site long-term plans must be credible
Existing pressure on staff resources
Stobhill
GP
GRI
Home/ Intermediate Care etc
A E
Patients
Victoria
SGH
5 rise per annum in acute admissions
Ambulance
Is bed blocking a problem?
WI
Significant pressures at all sites
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New Models of Care Short Term
Do the 5 hospitals have the right
capacity/staffing/systems?
How to streamline/route referrals?
Stobhill
GP
How to manage flows through departments?
GRI
Home/ Intermediate Care etc
A E
Patients
Victoria
SGH
Ambulance
WI
Whats the scope for more rapid discharges?
How to make best use of new facilities?
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New Models of Care Long Term
Do the 3 hospitals have the right
capacity/staffing/systems?
Whats the scope for reducing referrals?
GP
GRI
Home/ Intermediate Care etc
A E
Patients
SGH
What facilities/staffing/systems/etc are needed
in the 2 departments?
Ambulance
Gartnavel (not A E, ambulance)
Whats the right capacity/location for
intermediate care facilities?
What are the alternatives to hospital admission?
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Overview of Project
Stage 1
Stage 1
Project
Project
Planning
Planning
Analysis of
Review of
Analysis of
Review of
Current
Alternative
Current
Alternative
Services
Service Models
Services
Service Models
Interim
Baseline
Assessment
Assessment
Stage 3
Stage 2
Stage 3
Stage 2
Short
-
Term
Long
-
Term
Short
-
Term
Long
-
Term
Service
Strategic
Service
Strategic
Planning
Planning
Planning
Planning
Change
Change
Change
Change
Implementation
Implementation
Implementation
Implementation
Programmes
Programmes
Programmes
Programmes

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Baseline Assessment
Articulate Desired Service Principles
Understand Facts About Patient Demand
Understand Causes of Delays Blockages
Understand Current Processes Resources
Design New Model(s) of Service (Stage 2)
Examples From Elsewhere
Ideas From GG Stakeholders
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Next Steps

• Information collection analysis - patient
  activity, staffing, capacity, etc
• Process mapping visits from Secta team to each
  site
• Meetings/interviews with key clinicians, managers
  stakeholders
• Service principles draft statement to be shared
  with clinicians etc
• Baseline assessment to be completed early November