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Making Numbers Real: The discharge journey

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Making Numbers Real: The discharge journey Tania Geyer, Di Norris, Liz Prowse Noarlunga Health Services (now part of Southern Mental Health, SA) NUMBERS – PowerPoint PPT presentation

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Title: Making Numbers Real: The discharge journey


1
Making Numbers Real The discharge journey
  • Tania Geyer, Di Norris, Liz Prowse
  • Noarlunga Health Services
  • (now part of Southern Mental Health, SA)

2
NUMBERS (blah blah blah)
KPI 9
KPI 12 65
KPI 8 50
KPI 3 27
  • KPI 5 N/A

KPI 11 mc2
KPI 2
KPI 7 5
3
KPI 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

4
Baseline Rates of Follow-up
Us 48
5
Identified 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

6
What 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

7
Development 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

8
Implementation 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

9
Journey 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

10
Baseline Rates of Follow-up
11
Referral 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
12
Referral Triangles - System
  • Process Only rub out referral triangle if you
    need to re-refer.

13
Evaluation Summary
A total of 133 surveys were distributed to both
inpatient andcommunity staff SMH, 81 surveys
were returned for a 61 response rate.
14
Evaluation 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)

15
Evaluation 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

16
3 Year Comparison
Us 48 to 59 to 68
17
And
  • 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

18
Acknowledgements
  • 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

19
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