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26/27 June 2008 - Brisbane

Health Roundtable Redesigning Hospital Care: Diagnostic Imaging Presenter: Shelly Park Hospital: Southern Health. 26/27 June 2008 - Brisbane. Office of the Chief Executive Corporate Counsel Fundraising Executive Director, Public Affairs & Communication Internal Audit.

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26/27 June 2008 - Brisbane

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  1. Health RoundtableRedesigning Hospital Care: Diagnostic ImagingPresenter: Shelly ParkHospital: Southern Health 26/27 June 2008 - Brisbane

  2. Office of the Chief Executive • Corporate Counsel • Fundraising • Executive Director, Public Affairs & Communication • Internal Audit • Executive Director • Information Technology • IT Strategy & Planning • IS Governance • IT Enterprise Project Office (EPO) • IT Service Delivery • Enterprise IT Architecture • HealthSMART Program • Executive Director • Human Resources • Recruitment & Retention • Performance Management • Employee Relations • EEO • OHS / WorkCover • Remuneration & Rewards • Organisational Development • Leadership & Management Programs • Training & Development • HR Management Information • Acting Executive Director • Continuing Care • RASP • Primary Care • Executive Director • Mental Health • Child & Adolescent Mental Health • Southern Adult Mental Health • Southern Mental Health Evaluation & Research Centre • Executive Director • Nursing & Midwifery • Nursing Research & Practice • Nursing Support • Nursing Education & Research • Executive Director • Strategy Performance & Planning • Quality Unit • Clinical Information Management • Strategy & Service Planning • Innovation, Service Improvement • Access & Demand • Health Information Services • Jessie McPherson • Executive Director • Medical Services • Research • Library • Human Ethics & Research • HMO Office • Infection Control Executive Director Acute Sectors • Executive Director • Shared Services • Clinical Support • Diagnostic Imaging • Pathology • Pharmacy • Strategic Procurement • Materials Management • Hotel Services • Infrastructure • Engineering • Health Technology • Services • Capital Works • Executive Director • Corporate Financial Services • Financial Accounting • Business Analysis • Finance systems • Financial Planning & Reporting • Treasury & Cash Management • Transactional Accounting • Taxation • Operational Financial Support • Payroll Southern Health Professional Responsibility Ensure appropriate credentialling, registration , training, education and other support structure are provided to relevant professionals across Southern Health to ensure quality clinical and business outcomes Note: Each area is shown below under the relevant Executive Director columns Chief Executive • Dandenong • Casey • Cranbourne • MMC Clayton & Moorabbin Professional Responsibility: Business Managers Professional Responsibility : Doctors Professional Responsibility : Nurses Professional Responsibility: Psychologists, Neuro psychologists Professional Responsibility:: Allied Health, Dentists May 2008

  3. Key problem: The Noise (waste) in a patient’s journey These flags represent the amount of noise at each step of the process. The noise is equal to 564 hours of staff time across Monash Medical Centre Clayton 1 Request for MRI 6 Report MRI 2 Book MRI 5 Return patient from MRI 3 Transport to MRI 4 Perform MRI

  4. “Noise” in hours at each step of the journey Return patient to ward Patient preparation and transport to MRI Performing MRI Request for MRI Report MRI Book MRI

  5. AIM OF THIS INNOVATION Objective • To show that lean principles can be successfully applied in health care, to identify and reduce the level of noise Methodology • Identification of the overall patient journey • Detailed analysis of the process and noise • Measurements • Steering Committee • Continuous engagement of stakeholders • Ownership and sustainability

  6. KEY CHANGES IMPLEMENTED 40 days saved per month • Centralised communication point at ward level • Enhanced ward handover • Formalise ward contact to diagnostic Imaging if patient condition changes • 5S on wards • Diagnostic Imaging regularly attends Medical Assessment and Planning Unit and bed meetings • Sedation undertaken in diagnostic Imaging • Review of request and screening forms • Introduction of a nurse navigator • Diagnostic Imaging framework for improvement

  7. Outcomes to date MRI Reporting 60% 50% 40% 30% Number of links manually fixed 20% 10% 0% Pre implementation Post implementation Numberof scans missing links to MRI final report/week MRI Communication 40% 50% Improvement 30% Percent of noise in process 20% 10% 0% Pre implementation Post implementation Noise in process related to communication between MRI and ward 78% Improvement

  8. EVALUATION • Significant ‘waste’ evident in our health system • Waiting • Duplication • Re-work • Simple improvements, with system wide impact, at minimal cost • Establish the right core measures at an early stage • Value of an improvement team and infrastructure • Visible executive and clinical support is vital • Local engagement is key to spread and sustainability • Need to take a system wide view: engagement, education and application of lean methods • Demonstrating that service improvement is a catalyst to improve performance

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