Dr S Rochow

Clinical Lead, Triage Unit

Woodend Hospital

Unscheduled Care Meeting, 10th June

Triage Unit• Opened July 2009• 10 beds on ward 15; 5M/5F• Principal outcome measures;

– % seen by Consultant within 24 hrs– ave. length of stay

• Daily Consultant ward round a.m.• Evening review by the on call registrar

No. of Admissions

Jan – May

2010

May – Aug 2010

Aug – Dec 2010

Jan – Dec 2010

601 611 793 2005

Triage 2010• Total Admissions – 2005• 336(17%) – not admitted to assessment bed• 220(11%)- home• 51%(2.5%)- direct to rehab• 41(2%) – transferred to ARI/RCH• 17(1%) – died• 7(0.04%) – Community Hospital

Outcome of Triage assessments

220

51 41 17 7

1669

0

200

400

600

800

1000

1200

1400

1600

1800

2010

Home

Rehab

ARI/RCH

Died

C. Hosp

Assessment

Transfers to ARI/RCH (May-Dec 2010)

Total = 41

RCH 4

ITU 5

CCU 5

AMAU 5

A&E 3

1,11,13,12,44,39,19,31,33,

46,49,47

1 each = 12

26 3

34 2

40 2

Snap Audit – 18.1.2011

• Review of medical notes of patients in wards 15,16,19,20,21,22 & 5N

• 107 case notes reviewed; 93(87%) had documented Consultant input within 24 hrs

10

0

17

3

15

1

15

2

14

4

14

3

8

1

0

2

4

6

8

10

12

14

16

18

W15 W16 W19 W20 W21 W22 W5N

YES

NO

Consultant reviews within 24hrs

% seen by Consultant within 24 hrs

• June 2008, Soiza et al (pre-triage) – 45%

• November 2009 – 80%

• January 2011 – 87%

45%

55%

80%

20%

87%

13%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Pre Triage Prev Audit This Audit

Yes

No

0

200

400

600

800

1000

1200

1400

1600

1800

2000

Year

No

of P

atie

nts

Dis

cha

rge

d

0

5

10

15

20

25

30

Number and ALOS of Geriatric Medicine Patients Discharged between 2007 and 2010 from WGH (Jan to June only).

Day

s

A No Patients 1750 1454 1393 1539

ALOS 21 25 24 16

2007 2008 2009 2010

Number of Geriatric Medicine Patients Discharged between 2007 and 2010 from WGH (Jan to June only).

0

50

100

150

200

250

300

350

400

Month

Num

ber

of P

atie

nts

2007 273 262 299 277 336 303

2008 228 213 202 248 269 294

2009 213 188 263 246 233 250

2010 231 232 265 281 256 274

Jan Feb Mar Apr May Jun

Summary

– Since opening of Triage;

• Patients seen by a Consultant within 24 hrs increased by 52%

• Average length of stay across DOME reduced by 30- 50%