Title: Making Numbers Real: The discharge journey
1Making Numbers Real The discharge journey
- Tania Geyer, Di Norris, Liz Prowse
- Noarlunga Health Services
- (now part of Southern Mental Health, SA)
2NUMBERS (blah blah blah)
KPI 9
KPI 12 65
KPI 8 50
KPI 3 27
KPI 11 mc2
KPI 2
KPI 7 5
3KPI 12 Follow-up within 7 days of discharge
- Why focus on this indicator?
- An across service indicator (involves inpatient
and community) - Clinical relevance
- We didnt seem to be very good at it
- Tapped into a number of processes around
discharge and transfer of care
4Baseline Rates of Follow-up
Us 48
5Identified Need of Attention from Benchmarking
Results
- Its a clinical problem not just a number!
- High time of risk
- Consumers falling through the gaps
- Missing link between inpatient and community
follow-up - Communication issues
- Links with other KPIs length of stay and 28
day readmission
6What did we do?
- Discussion/communication with Team Leaders and
clinicians - Working group with significant buy-in from
inpatient and community with project support - Recognition and understanding of the KPI and
clinical implications - Focus on the KPI measuring the consumer
experience of discharge
7Development of procedure
- Developed by working group high level of
engagement from teams - Move into line with general health follow-up,
e.g. phone call day after surgical discharge - Examples of procedure points
- Inpatient
- Confirm follow-up with consumer
- Document actions on discharge checklist and
journey board - Make contact and complete documentation
- Community
- Inpatient admission report become part of morning
handover - Confirm nature of discharge contact
8Implementation and Roll-out of procedure
- Paper based collection initially
- Enhancement of computer system to collect
contacts made by inpatient staff to discharged
consumers - Training
- Recommendation to change the KPI to collect any
contact made within 7 days - Examining and improving discharge/transfer of
care practice inpatient Journey Boards
9Journey Board - Goals
- Make the Consumers Journey visible to the whole
team by using visual management techniques - Introduce a standardised communication tool in
all Southern Mental Health units - Improve communication between inpatient wards and
the community teams - Facilitate making barriers to the journey visible
- Collect data regarding real barriers rather than
perceived barriers to improve treatment and
discharge plans
10Baseline Rates of Follow-up
11Referral Triangles
3. When the Psychologist, SW or OT has seen the
Consumer
- 1. When SW/Psychologist/OT was needed
2. When referred to SW/Psychologist/OT
21/7
21/7
23/7
12Referral Triangles - System
- Process Only rub out referral triangle if you
need to re-refer.
13Evaluation Summary
A total of 133 surveys were distributed to both
inpatient andcommunity staff SMH, 81 surveys
were returned for a 61 response rate.
14Evaluation cont..
- SMH staff showed a positive response with 65
agreeing that they would encourage other areas to
implement journey boards, 23 were unsure or
stated the question was not applicable and only
12 disagreed.)
- (95 of the general hospital staff surveyed were
enthusiastic about encouraging other areas to
implement journey boards only 2 disagreed 9
were unsure)
15Evaluation cont..
- Comments from General and MH Staff
- Easy access to information
- Keeps control of work load
- Gives a snapshot and an overall picture of
journey - Identifies the allocation of workload
163 Year Comparison
Us 48 to 59 to 68
17And
- Monthly monitoring, by each site and as a region
- Adding collection to residential rehab. centre
- Closing the loop/following up
- Further system enhancements, e.g. new discharge
screen
18Acknowledgements
- Journeyboarders particularly Anna Szynkar and
Denise Wright (Flow Coordinators) - Inpatient and community staff of Southern Mental
Health, in particular those based at Noarlunga - Information and project staff
- Consumers and carers of our service
- All Adult Benchmarking participants
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