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Enhancing Multidisciplinary Care in Internal Medicine: Key Insights and Innovations

This presentation by Julie Hulcombe from Panther Hospital outlines the Enhanced Multidisciplinary Care (EMC) model implemented between October 2002 and June 2003 to address key issues in internal medicine, such as inefficient acute lengths of stay (LOS) and staff satisfaction concerns. Through innovations like team organization changes, increased resources, and early patient assessments, the average acute LOS was reduced from 7.35 days to 6.7 days. The findings emphasize the need for senior staff sponsorship, dedicated project management, and ongoing cultural change to ensure sustainability and effectiveness of allied health services.

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Enhancing Multidisciplinary Care in Internal Medicine: Key Insights and Innovations

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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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