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Achieving NEAT Forum 2013 “Transforming NEAT Performance: The Executive Role

Achieving NEAT Forum 2013 “Transforming NEAT Performance: The Executive Role. Dr Richard Ashby AM Chief Executive Metro South Health Brisbane, Australia. Metro South Health. 3856 sq Km 4 Local Government Areas 122 SLAs >1,000,000 Residents 2.1% Indigenous 28% Born Overseas

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Achieving NEAT Forum 2013 “Transforming NEAT Performance: The Executive Role

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  1. Achieving NEAT Forum 2013“Transforming NEAT Performance:The Executive Role Dr Richard Ashby AM Chief Executive Metro South Health Brisbane, Australia

  2. Metro South Health 3856 sq Km 4 Local Government Areas 122 SLAs >1,000,000 Residents 2.1% Indigenous 28% Born Overseas 22% Socially Disadvantaged 12,000 staff $1.85 Billion Introduction and Background Health in Metro South • 7 Public Hospitals • 17 Community Health Centres • 1 Residential Aged Care Facility and 2 Special PurposeFacilities • Plus • 600 General Practices, Allied Health Clinics and Community Pharmacies • 5 Private Hospitals • >150 NGOs

  3. Metro South Health Metro South activity in 2012-13 • 186,886 hospital admissions • 42,804operations • 713,238 outpatient attendances • 249,608 emergency department attendances • 464,874 community health occasions of service • 8.9 million Medicare services (Commonwealth)

  4. Metro South Health • Governance • New Board, Executive Structure, 47 new functions • Funding • Upfront Productivity Dividend $60m • 2012/13 MYEFO cuts ($18.8m) • 2013/14 Growth (1.5%) • 2013/14; 2014/15 ABF Funding • Activity • Compound activity growth 3-4% pa, ED growth 6% (Population 2.4%) • Time Limited Redundancy Program • Mandatory MOHRI Reduction = 650FTE The Challenge 2012-13 • +Complex Services returning • Organ and Tissue Transplantation • TB Services • Public Health

  5. Metro South Health Overall Performance Highlights 2012-13 • Operating Surplus $19.3m (2010/11 $41m deficit) • MOHRI FTE 710 (6.5%) • Activity exceeded target by 6260 WAU ($25m) • Total productivity dividend >$100m • NEAT 52%  73% (PAH 28%  66%) • NEST Cat 1 8% • Cat 2 3% Cat 3 10%

  6. Metro South Health Overall Performance Highlights 2012-13 cont’d • Ambulance “bypass” ceased, ramping reduced >50% • Emergency Department “DNW’s “reduced 50% • Hospital Standardised Mortality Rate <70 all facilities • Relative Stay Index <90 all facilities • Cost per WAU < National Efficient Price • Patient Satisfaction >90% • PAH –”best clinical governance system in Australia” (ACHS 2013) (45% “Met with Merit”, No recommendations) • Highest research funding ever.

  7. Transforming NEAT Performance Princess Alexandra Hospital

  8. Wooden spoon Courier Mail 14/12/12 NHPA report 2011-12

  9. Metro South Health What was happening at PAH? • 840 bed tertiary hospital serving Metro South HHS • Trauma Centre, Cardiac Centre, Transplant Centre, Cancer Centre • 40% admission rate with 90% occupancy • 56,000 ED presentations at PAH; 50% arrive by ambulance; • New ED opened November 2010 • 25 acute cubicles and 5 resus bays • Mental Health Assessment Unit • Ambulatory Care, 14 bed Short Stay Ward • In-house Radiology • New Medical Assessment and Planning Unit (MAPU) opened February 2011 • 30 beds (including Chest Pain Centre)

  10. Ramping at Princess Alexandra Hospital Early Initiatives

  11. Metro South Health February 2012 – “a seminal moment” • Royal Perth Hospital 90% of discharged patients meet NEAT • Princess Alexandra Hospital 26% of discharged patients meet NEAT

  12. 2012 ED Cultural Change

  13. Metro South Health KPMG Its Time Project – Jan-Aug 2012: • February 2012: NEAT Forum; Clinical Council • March 2012: ED Short Stay Ward process • June 2012: ED consultant in Ambulatory Care • June 2012: Changes to Mental Health patient processing and rapid transfer to MH waiting area • June 2012: Avoidance of unnecessary transit through ED for some admissions

  14. Metro South Health Other Interventions • NEAT Taskforce; NEAT Clinical Review • Improved data and reporting (Daily) • Improved patient flow and bed management • Logistics Nurses • “No bypass” rule (October 2012) • Study Tour – Royal Perth, SCG, Alfred etc.

  15. Metro South Health Outcomes: PAH: • NEAT February 2012 (27.6%)  October 2013 (65%) • NEAT Admitted (31%), NEAT Discharged (78%) • ED Waiting Times ATS1 100% ATS2 88.8% ATS3 76.1% ATS4 88.1% ATS5 97.7% • Patient off stretcher 30 minutes (90%) • Did not wait 0.9% (2011- 8%)

  16. Metro South Health

  17. Metro South Health The Challenge:

  18. Metro South Health

  19. Metro South Health Executive Role: Lead Change!! • Create “burning platform” . (Reputation, quality, funding) • Establish diagnostic and clinical redesign processes – no two hospitals are the same! • Establish and empower clinician-led change group (NEAT Taskforce) • Focus on largest cohorts with the worst performance • Monitor safety • Reinforce success!

  20. Metro South Health Thank you….. Questions?

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