length of stay….. it’s everyone’s business · 2018. 4. 17. · importance of understanding...
TRANSCRIPT
Length of Stay…..
It’s everyone’s business
Ben Wakeling, Whole of Health Program Lead, Wollongong Hospital
Dean Askew, Subject Matter Expert, WoHP Team
The Problem
2
The External Feedback
3
• 90 Day Challenge: Brad Astill
& Barbara Daly
• Dr Ian Sturgess
Answer: Complete LoS
System Review
Importance of Understanding Length of Stay
4
• Indicator of efficiency that influences a hospital’s
capacity to treat patients, not the only one…
• LoS and Unplanned Readmissions both
important to monitor
• Reducing LoS creates capacity to care for other
patients, particularly where there is increasing
demand
• Patients and families do not want to be in
hospital
• LoS above what is required, increases the risk of
harm
Structured management processes
5
• Few facilities systematically look at LoS strategically
• Dividing up actions by Short Term / Medium Term, and
Long Term LoS Management can help
• Understanding begins with good data and analysis.
Avoid clinician level data too early
• Non-onerous documentation is important to
track and also to build accountability
• Documenting LOS over time and good visual reporting
• Make links to others and identify sources of good practice
Interpretation support for teams is vital
The Projects Approach
6
MoH Assistance: Dean Askew
Project Methodology
Project Team
• Exec Sponsor
• Project Sponsor
• Stakeholders incl Op’s
Managers, Medical Clinicians,
Pt Flow Manager, NUM’s, MDT.
Beginning to better understand Length of Stay
7
• Reviewed best practice –
literature review
• Data review – Hospital,
Speciality, Ward, DRG,
Clinician
• Stakeholder feedback
Project Deliverables & KPI’s
8
Our Solution-The Policy/Flowchart
9
Short Term LoS
Short Term LoS
Medium Term LoS
Long Term/Strategic LoS - HRT
The Impact-Hospital Level
14
The Impact-Hospital Level RSI
15
Vic Hosp
NSW
Hosp’s
Vic Hosp
QLD Hosp
WA Hosp
ACT Hosp
NSW Hosp
NZ Hosp
The Impact-Speciality Level
16
General Medicine
Respiratory
General Surgery
RSI <100%
14/15 FY: 10/21
15/16 FY: 10/21
16/17 FY: 13/21
The Impact-Ward Level
17
17/18 FYTD
Bed Days Saved: 4,926
Productivity Saving:
$4,758,323
The Impact-Readmissions (Quality/Safety)
18
Project Enablers
• Medical Engagement
• Incentivising: Positive
Feedback, Competition &
making work fun!
• Culture & Leadership
19
Next Steps & beyond
20
Short term: Documentation &
updating the EDD Guides
Medium term: Expanded ePJB
Meetings & use of W4W
Long term: Expanded use of
HRT Data, adapting WoH
Meeting & transferring concept
Thank you for your time……
21
Ben Wakeling, WoHP Lead, Wollongong Hospital
Dean Askew, SME, NSW MoH