Pilot Case Study

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Pilot Case Study
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Melbourne Health Approach

• Melbourne Health is fully engaged and committed
  to achieving the aims of the Patient Flow
  Collaborative
• Real opportunity to built on 3 years of
  improvement activity

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Background to Pilot

• Many great initiatives through HDM and HARP
  including the Short Stay Unit, MAPU, Day of
  Surgery Admissions,
• Resulted in reduced bypass and decreased waiting
  lists and hospital initiated postponements
• Our experience is that while this approach brings
  improvements, it shifts the pressure from one
  area to another
• The Health Round Table has had a similar
  realization

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Currently we still have delays in.

• Access to wards
• Access to diagnostic services
• Access to Theatres
• Access to specialist review
• Access to Sub acute services
• Working to fix problems in isolation
• Results in friction between Departments and
  campuses
• Considerable scepticism and anxiety

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Patient Centred Care

• We are striving for a quality health service
  across the whole patient journey
• Past experience has shown that a whole of
  service approach is the only way to address and
  fix problems

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The Melbourne Health Approach

• Objectives
• Embrace as a Melbourne Health project not just
  an RMH project
• Follow the patient journey across all services,
  including RMH, MECRS and community based
• Engage Divisional leadership and obtain active
  support at an Executive Management level
• Involve and seek input from staff at all levels,
  across all disciplines
• Adopt the project methodology as an organization
  wide approach for ongoing improvement activities.

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The Melbourne Health Approach

• Use existing structures and processes
• Patient Management Taskforce
• Operational Planning Process
• Incorporate program measures in Balanced
  Scorecard
• Report through Melbourne Health Executive
• Executive staff in coordination groups
• Cross section of senior clinical staff in
  Clinical Area teams who were nominated and
  endorsed by relevant Directors and includes
  Executives.

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Teams to support the work
Executive Team
Clinical Area Team
Clinical Area Team
Clinical Area Team
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Structure

• Executive Team led by Julian Maiolo, Executive
  Director, Operations Management
• Clinical Area teams led by Senior Clinical staff
  and supported by facilitators from the Executive
  Team

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Clinical Teams

• Access to Sub acute Rehabilitation Services
• - Stephen Davis, Director Neurology
• Access to Radiology Services Brian Tress,
  Director, Radiology Services
• Communication between Medical Units and amongst
  Clinicians Peter Brennan, Executive Director,
  Medical Services
• Access to the Operating Theatre Bruce Mann
  General Surgeon, specializing in trauma and
  oncology
• Bed Accessibility through Systems Process
  Improvements Gavin Becker, Divisional Director,
  Medicine.

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Team Approach

• Diagnostics
• to understand the process and problems
• Scope Innovations
• using tools and processes that are available
  through the Collaborative
• Plan, do, study, act
• implement and test improvement
• Spread
• start in one area, then introduce to whole of
  organization once proven
• Mainstream
• so that it becomes part of the culture.

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Patient Delay Tracking Tool Pilot

• First innovation to be implemented within a few
  weeks
• Web based (paper based in ED currently)
• Encompass all areas Emergency, acute and
  subacute wards
• Promote pull rather than push system.
• Good means of data collection
• Reasons for delay can be tracked and managed
• Gives a view of who is waiting
• Allows for prioritization

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Leadership and Communication

• Clear message that this project is a major
  priority
• Executive Commitment
• Staff involvement
• Board sub-committee and community involvement
  through the Community Advisory Committee and
  Safety Service Improvement Committee
• Regular Updates
• Intranet site

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Questions?