Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of...

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Manly Hospital the Fairy Tale….. “NEAT and Tidy on the Northern Beaches” Deb Stewart Sue Hair Clinical Redesign Manager Director of Nursing NBHS & HKHS Manly Hospital

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Susan Hair, Director of Nursing and Midwifery, Manly Hospital, NSW and Deb Stewart, Manager of Clinical Redesign, Northern Beaches and Hornsby Ku-ring-gai Health Services, NSW delivered this presentation at the 2014 Hospital Bed Management & Patient Flow Conference, Australia's foremost patient flow improvement meeting, showcasing innovative case studies and pioneering best practice in the nation’s hospitals. Over 150 hospitals and state and federal departments of health throughout Australia and New Zealand have attended this conference over the past years. For more information about the annual event, please visit the conference website: http://www.healthcareconferences.com.au/bedmanagement14

Transcript of Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of...

Page 1: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

Manly Hospital the Fairy Tale…..

“NEAT and Tidy on the Northern

Beaches”

Deb Stewart Sue Hair

Clinical Redesign Manager Director of Nursing

NBHS & HKHS Manly Hospital

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Manly, NSW

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Setting the Scene

Once upon a time in a land far, far away there was a

majestical place called the Ministry of Health

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In the Ministry there was a fiefdom known as

Northern Sydney Local Health District

Ruling over 800,000 loyal subjects and covering

some 900 square kilometres, the LHD was rightly

proud of its premier place in the Ministry

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Five “castles” in the Local Health District

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Royal North Shore Hospital

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Ryde Hospital

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Hornsby Hospital

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Mona Vale Hospital

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Manly Hospital

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Manly Hospital

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Manly Hospital

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Manly Hospital

Page 14: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

Manly Hospital

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The interior was sadly as tired and worn

out as the exterior …..

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Setting the scene……

Manly Hospital and its community health services have served

the loyal subjects of Manly and Warringah since 1896.

Treats over 25,000 wounded warriors through our ED and almost

one third go on to require a stay at the inn

Within the castle we provide acute care services -including critical

care, emergency medicine, obstetric, medical, psychiatric,

surgical and orthopaedic services.

Non-acute services- include oncology, rehabilitation, drug and

alcohol services, stroke management, cardiac rehabilitation

and

A range of Community Health services.

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The journey from frog to handsome prince

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Galvanising our troops

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Transforming Manly into the Jewel in the

Crown

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Strategy

We had a strategy to move us from a poor performing hospital to

one of the best that we and our community could be proud of.

Our goal was and is to improve the quality of care our patients can

expect and the way our hospitals function.

Our strategy did not have a fairy godmother or a magic wand

but involved taking a whole of hospital approach to redesign our

processes and care systems.

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Whole of Hospital Strategy

to implement and embed new models of care and improve

our care processes

ED Access

Inpatient Flow

Capacity Management

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We couldn’t implement our strategy

without our “3C”s

Strategy

Leadership and

followership

Commitment

“Can do”

attitude

Culture

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Strategy: ED and Access Projects

ED Models

ED SASS

Triage and registration

Fast Track

Voice recognition

ED and Access

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In 4 hours you can………

Cook a 13kg Turkey

Watch Gone with the

Wind

Fly from Sydney

to Fiji

Cook 120 packets of 2

minute noodles

Have a Kate Middleton

Hairdo

Travel from London

to Paris on the

Chunnel

Run 5 City to Surfs

Listen to the

Beethoven’s

5th eight times

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Voice Recognition Project

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Voice Recognition Project

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Voice Recognition Project

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Length of Stay in the Emergency Department-hours

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Service Access and Patient Flow – NEAT by

Facility for Peer Group B (report Dec 2013)

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Transfer of care 2013-14

Page 33: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

Arrival to Clinician Seen Time in Emergency- minutes

Page 34: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

Strategy: Patient Flow

Transit Unit

ED Direct to Ward Admission Project

Fractured NOF Project

Interhospital Transfer

Patient Flow

Page 35: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

Transit Unit

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Short Stay Unit Admissions

Page 37: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

Transit Unit Utilisation

Page 38: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

Comments from our Transit Unit

patients

“Overall I feel it was a very well run little unit”

“Manly Hospital is great & we have nothing to complain

about…our healthcare system could not be better”

“No complaints from me, everything was so well explained

and I was very comfortable while I waited to go home”

“Felt for staff here…what a run down hospital, but the

staff could not have been better!”

“Noted D/C letter did not include important bloods but TU

nurse was able to retrieve”

Page 39: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

Strategy: Capacity Management

Discharge Program (Inc. Patient Journey

Boards)

Telemetry Project

Pharmacy Project

Patient Flow Unit Restructure

Capacity Management

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Patient Journey Boards and rapid

rounding

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Rapid Rounding at the Boards

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Patients discharged within 24 hours of EDD

Page 43: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

Inpatient Length of Stay

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Challenges-% of discharges by time of day

Page 45: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

Themes from open ended question

Overall positive response across all staff groups

“great for staff and patients as a quick reference”

“the boards have significantly improved communication”

“has been positively accepted by all staff on my ward”

“the PJBs are one of the tools that make a real difference

to care”

“great to have all allied health staff in one place at one

time”

Page 46: Susan Hair & Deb Stewart, Manly Hospital: ‘NEAT and Tidy on the Northern Beaches’: A New Wave of Patient Flow and Capacity Management Initiatives to Improve Patient Outcomes and

The happy ending …


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