In the 1999-2000 financial year, participating Health Care Networks
and hospitals were required to allocate a minimum of 10 per cent of their
Hospital Access Program bonus funds to be spent on specified initiatives
to enhance patient access to elective surgery, emergency and critical
care services. Projects could be focussed on one or more of the individual
areas of elective surgery, emergency and critical care services, or take
an integrated approach to enhancing access across the three areas. Networks
and hospitals have provided details of the projects funded under this
initiative.
| Organization |
Project Title |
Funds |
Project Purpose and Description |
Success Indicators and Target Outcomes |
| Austin & Repatriation Medical Centre |
Pre-admission Clinics and Liaison Nurse |
$229,868 |
To streamline the admission process for all patients; to support
bed management project; to improve community and GP liaison; to improve
data accuracy and organizational communication system. |
Improved access, patient and staff satisfaction and better internal
processes. Maximize HAP bonuses to 80%. |
| Ballarat Health Services |
Perioperative Service |
$156,814 |
To coordinate and streamline management of elective surgery patients |
80% admitted on day of surgery; all Day Surgery & Day of Surgery
patients pre-admitted; 3% rise in elective surgery throughput in 99/00
over 98/99. |
| Barwon Health |
1. Enhanced Waiting List Management Project |
$50,000 |
To provide clinicians with more accurate and timely waiting list
info; to implement new Waiting List management software; to improve
reporting and communications; to improve patient access and decision
making. |
Meet DHS targets; error rates below 1%; 90% customer satisfaction;
95% Executive reporting satisfaction; ESIS reports submitted within
DHS deadlines. |
| |
2. Emergency Department Nurse Staffing |
$137,000 |
To increase Emergency Dept staffing by 3.9 EFT RN Div 1 staff; to
meet increasing patient demand and increase capacity of unit. |
Maintain 24-hour triage nurse; increase staffing; maintain effective
response to trauma while continuing to fulfil other functions of dept;
reduce average waiting times meet HAP targets; reduce patient complaints. |
| |
3. Anaesthetic Staffing Enhancements |
$37,000 |
To appoint additional full-time anaesthetist; permit additional
in-hours emergency surgery. |
Reduced emergency waiting times; reduced elective surgery cancellations;
reduced weekend and out-of-hours surgery; increased patient satisfaction. |
| Bendigo Health Care Group |
Elective Admission Pre-Admission Clinic (EAPAC) |
$74,389 |
To provide pre-admission assessment and preparation for elective
surgery patients; to make patients available to anaesthetists and
other professionals; to enable patient admission on day of surgery. |
Increase day-of-surgery admissions to 90%, reduce cancellations,
reduce length of stay, improve bed management, decrease post-op complications. |
| Goulburn Valley Base Hospital |
Length of Stay Project |
$50,000 |
To review processes which affect length of stay, including older
persons' care coordination, antenatal clinic, lactaction clinic, respiratory
service, theatre review, step-down ward, skill levels in emergency
department. |
Shorter lengths of stay for certain DRGs, fewer inappropriate admissions,
improved quality of care in ED, increased theatre throughput with
reduced costs, greater GP cooperation, improved communication with
community, enhanced role for allied health services, development of
ideal service pathways. |
| Inner & Eastern Health Care Network |
1. Alfred: Perioperative redesign for elective patients |
$190,832 |
To re-engineer and coordinate process for elective surgery patients
from decision to operate to admission to theatre; to appoints preadmission
medical director, perioperative coordinators, improve IT support and
physical colocation of related services. |
Maintain Day of Surgery admission rate at 75%; increase number of
patients arriving in op room on time, fully prepared and documented;
reduce cancellations & rescheduling. |
| |
2. Alfred: Enhancement of quality of emergency care |
$148,050 |
To recruit additional emergency nursing staff, ward liaison nurse,
extra registrar and extra trauma surgeon sessions. Part of strategy
to address access block. |
Improved coordination and patient care during treatment in Emergency
Department |
| |
3. Angliss: Redevelopment of Emergency Department |
$70,764 |
To redevelop and physically expand Emergency Department; to develop
Observation Unit to help manage ED patients; to further develop discharge
planning from ED by recruiting Aged Care Liaison Nurse and developing
role to Disposition Nurse for all patients. |
Increased size of ED; operation of Observation Unit; employment
of Disposition Nurse. |
| |
4. Box Hill: Establish Surgical Admissions Area. |
$695,000 |
To set up pre-admissions ward where patients can be checked by anaesthetists
and surgeons prior to surgery. |
Improved patient satisfaction; streamlined process of admission
reducing burden on other wards; increased patient throughput; increased
staff satisfaction with process. |
| |
5. Box Hill: Intensive Care Bed Opening |
$270,000 |
To increase number of Intensive Care beds from 4 to 5 with 2 step-downs,
thereby reducing number of ICU refusals from 1 in 5 to 1 in 20. |
Reduction of ICU refusals to 1 in 20. |
| |
6. Box Hill: Infection Control Improvement Practices |
$15,000 |
To add infection control resources to maintain strict surveillance
and control of VRE and MRSA in Box Hill; appoint new Infection Control
Consultant. |
No closure of wards due to infectious disease outbreaks; control
of VRE and MRSA with aim of zero spread between patients. |
| |
7. Box Hill: Influenza Vaccination Campaign |
$10,000 |
To reduce staff absenteeism by encouraging universal influenza vaccination.
|
Vaccination of all clinical staff; reduction in absentee rates. |
| |
8. Maroondah: Transit Lounge |
$91,000 |
To establish transit lounge to streamline admission and discharge
procedures, assisting with bed block; place for patients to await
transport. |
Increase discharges by 11:00am; decrease bed block in Emergency
Department. |
| |
9. Maroondah: Emergency Department Data Clerk |
$20,000 |
To recruit data clerk to capture timely and accurate admission and
discharge data for VEMD; enable timely analysis of problems. |
Decrease in bed block in Emergency Department; increase VEMD data
accuracy. |
| Latrobe Regional Hospital |
Aged Care Discharge Improvement |
$37,987 |
Improve assessment, clinical pathways and discharge of aged persons;
recruit nurse to assess patients re discharge planning, liaison with
external service providers, community support. |
Thorough assessment of ED patients; development of suitable discharge
plan; use of common transfer form; respite care funded by DVA; staging
of forum between Latrobe Reg Hosp and local residential care facilities
|
| North Western Health Care Network |
1. Royal Melbourne Hospital: Bed Management Team, Redesign of Emergency
Presentation Desk |
$337,331 |
To appoint additional nursing and clerical staff exclusively to
allocate beds. To cover 7-day-week, 15 hours per day. |
HAP Admission Block targets met, Day-of-Surgery cancellations reduced
to 0.1%, theatre utilisation increased to>80%, increase in DOSA to
>70%. |
| |
2. Northern Hospital: Operations Director for Waiting List & Theatre
Management |
$129,750 |
Separation of Theatre Management Director from Chief Nursing Officer
role. Additional position created to ensure focus on this area. |
Better information to meet Key Performance Indicators, reduction
of Day-of-Surgery cancellations to .1%, production of Strategic Capacity
Plan. |
| |
3. Western Hospital: Discharge Planning/ Social Work Service in
ED |
$50,000 |
To appoint full-time social worker to screen and commence discharge
planning of Emergency Department "chronic medical type" patients in
winter. |
Reduced length of stay, reduced admission block and ambulance bypass,
reduced critical care exit block and inter-hospital transfers, reduced
Day-of-Surgery cancellations, increased bed availability. |
| |
4. Western Hospital: Hospital Staff Exchanges |
$20,500 |
To introduce systematic staff shadow programs to enhance links between
hospital staff and community workers in the field. |
Increased referrals to community providers, shorter response time
to referrals, reduced length of stay, improved information for community
agencies, enhanced staff satisfaction. |
| |
5. Western Hospital: Additional beds for elective patients. |
$313,525 |
Additional 10-bed area, as extension of surgical ward, opened for
patients with expected length of stay of less than 48 hours. |
Reduced waiting list numbers, improved access for emergency patients,
reduced admission blocks and Day-of_surgery cancellations. |
| Peninsula Health Care Network |
1. Enhancement of Emergency Services |
$221,672 |
Increase allocation of human resources (nursing establishment) to
Emergency Department; reduce staff turnover and stress levels. |
Improved quality care, reduced waiting times, staff stress and access
block. Reduced sick leave; improved staff retention; improved HAP
performance. |
| |
2. Expansion of preadmission service |
$15,000 |
To streamline and enhance pre-admission process by having junior
medical staff do pre-admission assessment, work-up, etc. Needs extra
paid hours for staff. |
Smoother admission/discharge process. Reduction of time and staff
needed to admit elective cases on day of surgery; junior medical staff
available to attend to discharge priorities. |
| |
3. Establishment of admission & discharge lounge |
$100,735 |
To staff new admission/discharge lounge, streamlining admissions,
improving patient comfort, permitting pre-op assessment, reducing
demand on ward beds. |
Increased day-of -surgery admissions; reductions in cancellations,
reduction in need for ward staff; improved patient comfort and privacy.
|
| Southern Health Care Network |
1. Community-based pre-admission (all campuses) |
$629,908 |
To promote, extend and review community-based pre-admission of elective
surgery patients by general practitioners. |
Reduced cancellations, increased day-of-surgery admissions (85%),
increased GP involvement (50%), early start to discharge planning |
| |
2. Bed management trial (all campuses) |
$255,571 |
To trial coordinated bed management throughout the Network by mapping
admission process, enhancing information processes, streamlining admissions/discharges
and benchmarking length of stay for certain DRGs. |
Reduced cancellations, emergency waiting times, lengths of stay,
waiting time for elective surgery and number of patients waiting >
12 hours. |
| St Vincent's Hospital |
Day-of-surgery/day surgery pre-admission project |
$216,095 |
To establish Preadmission, Investigation, Education and Research
(PIER) centre and appoint waiting list coordinator; to streamline
pre-admission process and enhance waiting list management. |
Increase day-of-surgery admissions to 80%, increase elective surgery
patients pre-admissions to 80%, increase theatre utilisation to 80%
and reduce elective cancellations to < 5%. |
| Women's & Children's Health Care Network |
1. RWH: Service Access Centre |
$33,272 |
To establish centre for patients choosing to access services normally
provided under HITH, but who are not fully compliant with HITH criteria;
offer greater patient choice, improve bed utilisation, decrease admission
rates, increase flexibility. |
Increased patient and staff satisfaction, statistical evidence of
improved bed management and reduced use of inpatient beds. |
| |
2. RCH: Bed Management Initiative |
$69,814 |
To streamline and coordinate bed management practices, to speed
allocation of emergency beds, to re-engineer administrative processes
so that actual current bed status is always available. |
Reduced time taken to allocate beds for elective and emergency placements;
reduced time in Emergency Department for new arrivals to see doctor.
|
| |
GRAND TOTAL |
$4,676,877 |
|
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