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5-6 December 2005 - Melbourne

Enhanced Multidisciplinary Care (EMC) Model of Care – Internal Medicine Presenter: Julie Hulcombe Hospital: Panther Key contact person for this project: Susan Laracy, Director OT, 3636 7100, Susan_Laracy@health.qld.gov.au. 5-6 December 2005 - Melbourne. KEY PROBLEMS. Efficiency

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5-6 December 2005 - Melbourne

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  1. Enhanced Multidisciplinary Care (EMC) Model of Care – Internal MedicinePresenter: Julie HulcombeHospital: PantherKey contact person for this project: Susan Laracy, Director OT, 3636 7100, Susan_Laracy@health.qld.gov.au 5-6 December 2005 - Melbourne

  2. KEY PROBLEMS • Efficiency • acute LOS exceeded HRT by 1.1 days • Access • waiting lists for several AHP disciplines • Staff satisfaction • poor morale and dissatisfaction with communication

  3. HOW WE DID IT • Project Started: Oct 2002- June 2003, controlled trial then rollout to all units July 2003 and about to rollout 5th Unit • Staffing: 1FTE project staff, 10.4 FTE redistributed • Funding: $250,000 additional funds and 3.8FTE existing staffing resources redistributed • Duration: 9 months initial controlled trial

  4. INNOVATIONS IMPLEMENTED Key changes that were implemented • Team organisation changes: • consistent membership • unit-based care • increased resourcing • Work practice changes: • early patient assessment • regular meetings • specified discharge date

  5. Resourcing change per unit

  6. OUTCOMES Phase 1 AVERAGE ACUTE LOS REDUCED FROM 7.35 DAYS TO 6.7 DAYS

  7. Cumulative Readmission

  8. LESSONS LEARNT What we recommend to other hospitals on this topic • Senior level sponsorship including medical staff • Dedicated project management • Resources for clinical service • Regular quality meetings

  9. What we would do differently • Ongoing responsibility for the principles and orientation • Senior AHP positions more clearly defined, leadership in Allied Health teams • Nursing “buy-in” at ward level • Cultural change re: providing service to outlier wards • More targeting of AHP services • Sustainablity difficult in high demand, LOS now 7.3 days.

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