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5-6 December 2005 - Melbourne

Acute Assessment Unit Presenter: Josie Kitch Hospital: Centauri Key contact person for this project: Josie Kitch, Director AHD, Unit, josie.kitch@fmc.sa.gov.au. 5-6 December 2005 - Melbourne. KEY PROBLEMS. Redesigning Care identified issues around short and sort type functions of the hospital

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5-6 December 2005 - Melbourne

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  1. Acute Assessment UnitPresenter: Josie KitchHospital: CentauriKey contact person for this project: Josie Kitch, Director AHD, Unit, josie.kitch@fmc.sa.gov.au 5-6 December 2005 - Melbourne

  2. KEY PROBLEMS • Redesigning Care identified issues around short and sort type functions of the hospital • Devised short stay ward (4D) and AAU (sort ward) • Target of AAU trial are to reduce ED Dr review to ED discharge to 3 hours • Maintain 12-24hr flow through AAU • Provide comprehensive nursing, medical and AH assessment and early discharge planning for Gen Med and Aged Care patients in first 24 hours

  3. HOW WE DID IT • AAU started in Feb 2005, initially for a 3 month trial • Staffing:3.8 FTE of AH covering 5 disciplines (PT,OT,N&D,SW,SP) • Funding: Extra funding for this service was obtained via DOH • Duration: Ongoing

  4. INNOVATIONS IMPLEMENTED • Key changes: • Development of assessment to discharge planning tool (medical, AH and nursing) • Development of Assessment role for Nursing staff • Development of screening tool and early discharge planning tool for AH • Following initial trial developed flow coordinator role to assist access to AAU from ED and transfer from AAU to ward

  5. OUTCOMES SO FAR • AH seen in first 24 hours prior to AAU – • PT 18.75%, OT 0%, SP 0%, DN 0%, SW 3.7% • Now 46% of all complex patients screened by AH in first 24 hours* • 38% discipline specific assessments completed in first 24 hours* • 84% time discpline specific assessment completed in first 48 hours • 76% of time AH made accurate prediction of d/c destination and needs • *data includes weekends where service not provided so skews information

  6. LESSONS LEARNT • Changing culture in ED takes time – willingness to let patients go • Very important to build relationships between AH and Nursing staff around new assessment role • Need to do further work on what is the core role of AH in this unit and further develop AH KPIs (no. of screens and early discharge plans completed, accuracy of early discharge)

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