Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding...

21
Length of Stay….. It’s everyone’s business Ben Wakeling, Whole of Health Program Lead, Wollongong Hospital Dean Askew, Subject Matter Expert, WoHP Team

Transcript of Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding...

Page 1: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Length of Stay…..

It’s everyone’s business

Ben Wakeling, Whole of Health Program Lead, Wollongong Hospital

Dean Askew, Subject Matter Expert, WoHP Team

Page 2: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Problem

2

Page 3: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The External Feedback

3

• 90 Day Challenge: Brad Astill

& Barbara Daly

• Dr Ian Sturgess

Answer: Complete LoS

System Review

Page 4: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

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

Page 5: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

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

Page 6: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

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.

Page 7: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Beginning to better understand Length of Stay

7

• Reviewed best practice –

literature review

• Data review – Hospital,

Speciality, Ward, DRG,

Clinician

• Stakeholder feedback

Page 8: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Project Deliverables & KPI’s

8

Page 9: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Our Solution-The Policy/Flowchart

9

Page 10: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Short Term LoS

Page 11: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Short Term LoS

Page 12: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Medium Term LoS

Page 13: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Long Term/Strategic LoS - HRT

Page 14: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Impact-Hospital Level

14

Page 15: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Impact-Hospital Level RSI

15

Vic Hosp

NSW

Hosp’s

Vic Hosp

QLD Hosp

WA Hosp

ACT Hosp

NSW Hosp

NZ Hosp

Page 16: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

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

Page 17: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Impact-Ward Level

17

17/18 FYTD

Bed Days Saved: 4,926

Productivity Saving:

$4,758,323

Page 18: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Impact-Readmissions (Quality/Safety)

18

Page 19: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Project Enablers

• Medical Engagement

• Incentivising: Positive

Feedback, Competition &

making work fun!

• Culture & Leadership

19

Page 20: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

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

Page 21: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Thank you for your time……

21

Ben Wakeling, WoHP Lead, Wollongong Hospital

Dean Askew, SME, NSW MoH