Peninsula Health:

1. Peninsula Health: Peninsula Health Specialist clinics Access policy Implementation 22/05/2014 Currently submitting Specialist Outpatient Activity for 180 clinics

2. Peninsula Health: 7.1 First appointment for urgent patients • The baseline • How the health service was previously operating in regards to the target processes • A large area of PH SCO clinics were already complying with the Access policy targeted time frame (30 days – Urgent) Some Departments had implemented their own Triaging systemto suit internal requirements as the baseline is yet to be set for Routine appointments • 12/13 Data to illustrate baseline • Please note: We are looking at our • Implementation year data. • 13/14 data should reflect an • Improved timeframe. • Please note: The figures displayed • exclude the Orthopaedic clinic • Challenges identified in changing the way things were done within the health service • One of the biggest challenges we faced was the mindset of staff regarding the interpretation of the Priority values. • SCO areas had previously worked on three priority levels 1 Urgent/ 2 Semi urgent/ 3 Non urgent • The Access policy however has two priorities only – urgent and routine which has meant a change in not only the mindset but also the Triaging process. This is a great challenge as clinicians feel that a portion of these apt should qualify at Semi urgent? • We have attempted to overcome this is by reviewing individual department processes and implementing the 2 clinical priority categories. • Urgent within 30 days/ Routine (PH endeavour to have Routine patients wait no longer than 90 days.) • Another challenge we continually face is the system we use (iPM) to collect the VINAH OP data elements. iPM is also used to collect referral information for other extracts which do not follow the same priority categories as VINAH. No centralisation of Referrals make it difficult to obtain consistency.

3. Peninsula Health: 7.1 First appointment for urgent patients Action plan Description of initiatives that have been undertaken and supported by the Specialist clinics access policy implementation funding initiative Where are these changes taking place: We are currently in the process of ensuring Specialist clinic areas now use the priority schedule of Urgent or Routine. Who is involved :Program Managers / Clinicians and Admin staff What is happening: Report created to assist easy identification of patient wait times for appointments and Review of Policies and Guidelines relating to SCO clinical Triaging prioritisation with Program Managers. The use of this report is in the early implementation stages. Summary of what your nominated milestones were for the target processes Manual Audit on Referrals i.e. priority v apt date - iPM v DMR (scanned medical record) Education process rolled out to all SCO areas. Ensuring focus is made with regard to compliance of the Access policy priority categories – again in its early implementation stage. Report created to assist Auditors and Program Managers for management of Appointment wait times. Summary of how you have been tracking and evaluating your progress Manual audits have been carried out where we have compared the patient’s actual App date on iPM vs referral date on referral document. We were assisted in this with the report that was created. Early findings of these audits indicates that we need to focus more on ensuring the data entry on iPM actually validates the hard copy referral. For 12/13 our main focus was getting the data in and correct for reporting. We believe we have climbed that mountain and are now focusing on validity and processes.

4. Health service: 7.1 First appointment for urgent patients Progress to date What you have achieved so far, if you have met your evaluation milestones Initial evaluation milestones have been met. The reports we have created have helped to identify this. It is evident that program Managers and Admin staff will require support and assistance to achieve compliance. Any challenges you have encountered ? SCO areas throughout PH have developed internal Department clinical prioritisation schedules to suit the programs screening process. This is a big challenge as it requires resources and a change in business process. Reducing the prioritisation of a patient appointment when Triaging from 4 priority categories to 2. Are you on track to aligning with the Access Policy by 1 July 2015?. We believe that this is achievable with sufficient resources and support from Program Managers / Admin staff. PH are currently reviewing and or creating clinical Referral prioritisation guidelines for all Specialist Outpatient Services. The emphasis here is on sufficient resources and along with all other health services our budget dictates this.

5. Peninsula Health: 9.6 Patient notification of new appointment date where health service has cancelled scheduled appointment • The baseline • How the health service was previously operating in regards to the target processes • When a patient’s appointment requires HIP rescheduling the patient is given a new appointment at the earliest available time. The Patient is notified by phone on the day and a letter sent confirming appointment rescheduling. • 12/13 Data to illustrate baseline • Note: 12/13 implementation • of data collection. • Routine wait days of 90 days is • a PH baseline until DOH have • implemented wait times.. • Data displayed excludes • Orthopaedic clinics • Challenges identified in changing the way things were done within the health service • This is a clinician driven process and one over which Program Managers have little controlplus they need to have available Clinic appointment slots in which to reschedule required appointments. The figures displayed reflect that at PH our clinic managers endeavour to source another clinician or location to reduce the requirement for rescheduling of patient appointments. Rescheduling appointments has a domino effect requiring multiple appointment moves. This has a high impact on the clerical staff as additional patient rescheduling may be required to accommodate those moved to keep within the clinically approved timeframe.

6. Peninsula Health: 9.6 Patient notification of new appointment date where health service has cancelled scheduled appointment Action plan Description of initiatives that have been undertaken and supported by the Specialist clinics access policy implementation funding initiative Where are these changes taking place: All SCO clinics Who is involved: Program Managers, clinicians and clerical staff What is happening: Created a report to assist easy identification of patient appointment rescheduling and to ensure appointments are met within the appropriate time frame. The intention with this report is for the program managers to run it on a daily basis to enable easy identification of patients that may lie outside the appropriate timeframe and amend if required Summary of what your nominated milestones were for the target processes Manual Audit on Referral priority v apt date - iPM v DMR (scanned medical record) As this process of rescheduling was already in practice we have carried out audits to ensure compliance with the Access policy guidelines. Report created to assist Auditors and also Program Managers for monitoring of Appointment rescheduling. Summary of how you have been tracking and evaluating your progress Manual audits have been carried out for some clinics comparing the patient’s initial App time vs rescheduled appointment. We were assisted in this with the report that was created.

7. Peninsula Health: 9.6 Patient notification of new appointment date where health service has cancelled scheduled appointment • Progress to date • What you have achieved so far, if you have met your evaluation milestones • Correct process already in practice for most areas with the Access policy time frames met for a large percentage. Audits will continue to be completed to ensure a consistent and successful compliance across all SCO programs. Initially this will need to be supported by us but with guidance for future self audits by program managers. • Any challenges you have encountered ? • In order to reschedule appointments within the required time, additional resources are sometimes necessary. Busy clinics may require additional rescheduling for review patients in order to make time slots available, this is partly due to availability of clinic sessions. • Are you on track to aligning with the Access Policy by 1 July 2015? • We believe that this is achievable if sufficient resources are available and with support from clinician / Program Managers and Admin staff.