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Improving Patient Flow and Access in Emergency Care at Rigel Hospital

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jonny
8 diapositives · 228 Views · Aug 28, 2014

This project at Rigel Hospital aimed to address the challenges faced under the NSW Health Sustainable Access Program, which resulted in poor performance in access and triage indicators. Despite implementing new emergency care models, the hospital struggled to meet benchmark targets. Key strategies included the introduction of Emergency Nurse Practitioners for fast tracks, triage and treat protocols, and an emphasis on organizational commitment to improving inpatient bed access. Outcomes indicated significant reductions in emergency department waiting times and enhanced patient flow, steering towards sustainable changes in care delivery.

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  1. Meeting DemandPresenter: Aileen LawtherHospital: Rigel 30 March 2007 - Auckland

  2. KEY PROBLEM • Under the NSW Health Sustainable Access Program, the hospital failed to achieve benchmark targets for Access and Triage indicators despite introducing new models of Emergency Care and Ward Jonah. • In 2005/2006 Triage Category 3 performance was 35% and Category 4 was 46% • Access was 65.6%

  3. AIM OF THIS PROJECT • To improved in patient flow, realign models of care and engage staff in sustainable change. • In the Emergency, inpatient units and in the organisation • By December 2006 • Within existing resources other than some S&W supplementation to regrade a CNS position to CNC grade 2.

  4. KEY CHANGES IMPLEMENTED • There were a number of strategies implemented: ED Access: • Emergency Nurse Practitioners 2.9 fte for Fast Track • Rapid assessment and early commencement of care (Nurse initiated) • Introduction of Triage and Treat • Promoting the message that data is an output and not a driver of activity. • Organisational commitment to improving inpatient bed access

  5. KEY CHANGES IMPLEMENTED Access: • Focus the ED on achieving the 8 hour timeline for care. • Realignment of the Rapid Assessment Model of Care for Aged Care. • Introduction of a Cardiology Patient Flow Coordinator. • Role out and refinement of Ward Jonah and work practice changes for Ward Nursing Unit Managers.

  6. OUTCOMES SO FAR ED Access: • DNW reduced from 7.4% in 2005/2006 to 3.7% in Feb 2007. • Total time in ED for admitted patients from 9.3hrs ytd March 05/06 to 6.45 hrs ytd March 06/07 or 18 %

  7. OUTCOMES SO FAR • Inpatient Access:

  8. PROJECT EVALUATION • Persistence. • Key messages. • Solutions should be simple and be supported be clear business rules. • Changes should be real and sustainable. • Outcomes should be achievable.