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15 th – 16 TH March 2005

Cross Chapter Health Roundtable Developing Appropriate Models of Ambulatory Care for Acute & Rehabilitation Inpatients. 15 th – 16 TH March 2005. Agenda – Tuesday 15 th March. Agenda – WEDNESDAY 16 TH March. Knowledge Explosion. Funding Squeezes. Technology.

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15 th – 16 TH March 2005

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  1. Cross Chapter Health Roundtable Developing Appropriate Models of Ambulatory Care for Acute & Rehabilitation Inpatients 15th – 16TH March 2005

  2. Agenda – Tuesday 15th March

  3. Agenda – WEDNESDAY 16TH March

  4. Knowledge Explosion Funding Squeezes Technology Service Demand & Staffing Rigidity External Pressure Health Sector

  5. Isolated Expertise

  6. Shorten Search for Answers HRT

  7. Similar Hospitals – Similar Problems – Useful Innovations • The Health Roundtable – 30 Major Teaching Hospitals in Three Chapters • Additional Hospitals by Invitation • Non-profit membership organisation controlled by CEOs • Focus on operational improvement within existing financial constraints • Share innovative ideas

  8. The Health Roundtable All Stars Chapter Flinders Medical CentreBarwon Health, Geelong HospitalTownsville District Health ServiceFremantle Hospital and Health Service (Inactive 2004)St George HospitalRoyal Hobart HospitalSir Charles Gairdner HospitalAustin HealthWestmead HealthCapital and Coast District Health Board (Wellington) • Founding Chapter Royal Adelaide HospitalCounties Manukau DHB (Middlemore)Royal Perth HospitalThe Alfred Hospital (Bayside)Melbourne HealthRoyal North Shore and Ryde Hospitals (Inactive 2004)Canterbury District Health BoardLiverpool Health ServicePrincess Alexandra HospitalRoyal Brisbane and Women's HospitalJohn Hunter Hospital Olympian Chapter St Vincent's Hospital (Sydney)The Canberra HospitalSt Vincent's Hospital (Melbourne)Prince of Wales HospitalAuckland City Hospital, Auckland DHBGold Coast Health Service DistrictHealth WaikatoRoyal Darwin HospitalSouthern Health (Monash Medical Centre) + Metropolitan Hospitals Round Table Regional Health Improvement Network NAHBC HRT-AHBG MHBG

  9. An Innovation Clearinghouse • Share problems • Share solutions • Avoid reinventing wheels • “Seed” large scale projects • Provide CEO network Health Roundtable UHC IHI

  10. 5. Confirmation 2. Persuasion 3. Decision 3. Decision How to speed up action? 1.Knowledge 4. Implementation

  11. Expectations • No “Perfect Hospital” • But, each excellent at something • Lots of variation • No single “right answer” • No “magic bullet” solutions • Confidential, frank discussions • Find one idea to take back and implement

  12. Membership Honour Code • No member shall criticise the performance of other member hospitals, or use any of the information to the detriment of a fellow member. • No external distribution of data or conclusions based on SBG workshops or data is made without the unanimous consent of the Directors of the Spinal Units from all participating hospitals. • Failure to abide by this honour code will result in exclusion from the SBG and forfeiting of fees paid

  13. Overview of The Chronic Care Model – Ed Wagner 2. Health System Organisation of Health Care 1. Community Resources & Policies 5. Decision Support 6. Clinical Information Systems 3. Self Management Support 4. Delivery System Design Informed Activated Patient Prepared, Proactive Practice Team Functional & Clinical Outcomes

  14. Our Framework for Levels of Care

  15. Issues (high) Causing Review of Models of Care

  16. Other Issues Rated as High • Changes in Clinical Practice – especially technology • High ALOS • Changing patterns of Disease • Cultural Issues • Current Work practices – demarcation between groups causing duplication

  17. Most Commonly Used Strategies 2.7 General Hospital Care Faster Assessment of Patient in ED (9)

  18. Strategies of Most Interest

  19. 3.1 World’s Best Practice - Innovation 1 • Rigel - Respiratory Coordinated Care Program • patiens are seen in their home by a range of health professionals • respiratory assessments, including lung function conducted

  20. World’s Best Practice - Innovation 2 Fury - District Chronic Care Management Program (based on US and UK models) • a structured program involving • 4 free GP visits and six hours free nursing time per annum.

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