improving patient flow – an integrated approach presentation.pdf · improving patient flow – an...
TRANSCRIPT
The Problem
• ALOS > National Peers
• Large % > 30 days LOS
• No change in the proportion of Atypical
cases >30 days
• No change in avoidable patient days
The Solution
Utilization Management System• Based on validated criteria set determines the
appropriateness of admission
• Based on validated criteria set determines the
appropriateness of setting
• Is patient specific and based on the individual patient’s
severity of illness (SI) and intensity of service (IS). Thus, applies to simple and complex cases
• Captures reasons for stay related to Acute Provider reasons (Physician and Hospital); and Community
reasons
Readiness For Discharge
(RFD) Assessment
© Continuum Solutions
If RFD met,
patient considered
medically
stable for discharge.
However, patient may
not be
functionally
ready for discharge.
Assessing the Integration of
Patient Flow
Suter, E., Oelke, N.D., Adair, C.E., & Armitage, G.D. (2009). Ten Key Principles for Successful Health Systems Integration. Healthcare Quarterly, Vol. 13.
Comprehensive Service across Care Continuum
• Patient Flow Forums with Hospitals and Community Areas
• Minimum biannual meetings between hospital and geographic community partners
• Uncapped TPN Volumes
• CPTP Expansion
• Community teams as part of discharge plan
• Long Term Ventilator spaces at 1010 Sinclair
• Panel Process Review initiated
Patient Focus
• Admit according to goals of admission (not
diagnosis)
• ELOS documented
• Flight Board
• Whiteboard at patient bedside
• Transition best practices
• Dignity based care
Geographic Coverage and Rostering
• Enhancing hospital – community
partnerships
• Access algorithms for rural regions i.e. Orthopedics
• Rural – Urban Utilization Committee
• Hospitalist Model and Clinical Teaching
Units – 2 Community sites
Standardized Care Delivery through Interprofessional Teams
• Oxygen Titration protocols
• End of Life Care
• Sharing of specialized expertise
• IECPCP initiatives
• Team Training
• Care Maps
Performance Management
• Data from UM System shared monthly
with hospitals and regional program teams
• Data shared with community teams as needed
• Development of indicators to measure flow
integration
Information Systems
• Jasper Patient Flow Dashboard
• Developing Cognos Cube for UM System
data
• Link data in Cognos UM Cube with data in
Cognos DSS (ICD-10 Abstracted data)
• Data Warehousing
Organizational Culture and Leadership
• Patient Flow Forums
• Flow and Access part of Strategic
Priorities
• Commitment; Awareness;
Responsiveness; Modeling the Way;
Stewardship
Physician Integration
• Primary Care Networks; Physician
Integrated Networks
• Leadership at CMO level
• Provincial Director of Patient Access:
Catalogue of Services; BGSC; PART;
Booking Ahead
Governance Structure
• VP Clinical Services and Integration
• Clarification of Accountability Matrix
• Flow and Access part of Strategic
Priorities
Financial Management
• Regional Health plans based on current
and projected volumes
• New funding requests must be supported by strong evidence base
• The cost of institutional vs community care