THE “NEAT” APPROACH Helen E. Stergiou

1. Innovation Poster Session HRT1210 – Patient Safety Sydney 14-15 June 2011 THE “NEAT” APPROACHHelen E. Stergiou Cougar

2. KEY PROBLEM OR MEASUREMENT AREA Emergency + Trauma Centre (E+TC) Overcrowding Opportunities to optimise Patient Access and Flow Concomitant actual and potential Clinical Risks Patient experience when “busy” department Staff experience when “busy” department Need to articulate the Core Business of the E+TC as that of managing Emergency Patients

3. AIM OF THIS INNOVATION Evolve Models of Care which would lead to: Improved Access + Flow to/through/from the E+TC Reduction in Overcrowding Impact on the attendant Clinical Risks Improvement in the Patient experience Improvement in the Staff experience Objective = “Improved Patient Care” not just “Meet the Target”

4. KEY CHANGES IMPLEMENTED Whole-of-Hospital engagement Leadership – Executive / Unit Heads / Emergency levels Emergency + Trauma Centre Defined E+TC Clinical Teams Streaming – ongoing evolution Internally to Fast Track To General Medicine To ICU Not yet “To Disposition” Stream-lining of Handover process Emergency to Ward

5. KEY CHANGES IMPLEMENTED Emergency + Trauma Centre Emergency Short Stay Unit (ESSU) Bed stock expansion Observational Medicine within Emergency domain Inpatient Models of Care Acute Medical Unit = pro-active + responsive

7. OUTCOMES SO FAR

8. LESSONS LEARNT Whole-of-Hospital engagement is fundamental to productively negotiate this terrain Develop Models of Care which facilitate Patients being seen as early as possible in the Patient journey by the most appropriate senior clinical decision-maker who will provide the ongoing care Clinicians will engage only when new Models of Care are centred around improving Patient Management and Clinical Outcomes rather than merely “Meeting the Target”