Post on 25-Dec-2014
description
Riding The Waves Of
Change –
The Queensland Update
Queensland Health
Laureen Hines
Clinical Access and Redesign Unit
The View From Above -
Overview
Turbulent Waters
Increased service demand
Growth outstripping supply
Shortfall of 3036 public beds for 2026
Increased cost
11% less efficient
A need to reduce staff
3 P’s Prince, Patel and Payroll
Streamlining Health Care
National Quality and Safety performance
targets
National and State funding reforms
Independent Pricing Authority has set
purchasing targets and prices for service
delivery
Creation of Health and Hospital Services
The Perfect Wave
The Blueprint for better healthcare in Queensland
Four principal themes:
• Health services focused on patients and
people.
• Empowering the community and our health
workforce.
• Providing Queenslanders with value in health
services.
• Investing, innovating and planning for the
future.
Past View
Transfer location Wards
9
ED
9
OPD
6
Admitting Doctor Inpatient team
8
ED SMO
1
HITH Doctor
0
Triage In person
7
Phone
2
Inclusion exclusion criteria similar
Multidisciplinary care Available
5
Not Available
4
Limited allied health on weekends
Medical Home Visits Available
3
Not available
6
Readmission process inconsistant
7 day Nursing All
24 hour on call Available
6
Not Available
3
Length of stay set on
admission
Yes
7
No
2
Funding Source Hospital
5
Community
3
Pharmacy not able to be tracked
Clinics Available
7
Occasional used
2
KPI inconsistent –incidents monitored
All require growth to meet 1.5% target
Transfer location Wards
9
ED
9
OPD
6
Admitting Doctor Inpatient team
8
ED SMO
1
HITH Doctor
0
Triage In person
7
Phone
2
Inclusion exclusion criteria similar
Multidisciplinary care Available
5
Not Available
4
Limited allied health on weekends
Medical Home Visits Available
3
Not available
6
Readmission process inconsistant
7 day Nursing All
24 hour on call Available
6
Not Available
3
Length of stay set on
admission
Yes
7
No
2
Funding Source Hospital
5
Community
3
Pharmacy not able to be tracked
Clinics Available
7
Occasional used
2
KPI inconsistent –incidents monitored
All require growth to meet 1.5% target
Supporting The Tide
Hospital In The Home (HITH)
•provides care in a community setting
(permanent or temporary residence)
•acute conditions requiring clinical governance,
monitoring and/or input
•that would otherwise require treatment in the
traditional inpatient hospital bed.
•Queensland Health Admission Policy
•focuses exclusively on acute admitted care
substitution.
Encouraging The Flow
Setting clear targets for activity levels
Supporting projects to maximise
efficiencies
Forums bringing clinical leaders together
HITH Utilisation - Year to date December 2012
0.0%
0.1%
0.2%
0.3%
0.4%
0.5%
0.6%
0.7%
0.8%
0.9%
1.0%
Cairn
s
Centr
al Qld
Childre
n's
Darlin
g Dow
ns
Gold C
oast
Met
ro N
orth
Met
ro S
outh
S Coas
t
West
More
ton
Wid
e Bay
Queensla
nd
% H
ITH
Uti
lisa
tio
n
HITH Utilisation (as % of total seps by
HHS)
A Drop In The Ocean
Percentage of HITH Utilisation
0.00
0.10
0.20
0.30
0.40
0.50
0.60
July Aug Sept Oct Nov Dec jan Feb Mar Apr May June
Month
Perc
en
tag
e
2010-11
2011-12
2012-13
Increasing The Volume
• HITH is in the Blueprint • Executive support HITH as a safe
and important model • Statewide advisory and working
groups • HITH funding model improvements • Innovation fund • PPP Funding
Supporting Safe
Practice
Implement guidelines
Early detection and direct referral strategies
Common processes
Develop state-wide tools
Increase ability to benchmark
Changing Tide of
HITH in Queensland
New patient cohorts
Engagement with general practice
Review possible public/private partnerships
Conversion of activity to HITH models
Support culture change due to increased accountability
Embed governance requirements
Support developing services
Standardise care where possible and initiate statewide tool development
Support existing services to grow
To all those who have contributed to reshaping and
expanding HITH in Queensland