Streamlining The Care System – Improving the Patient Experience Mary Sherry, Director of Performance

1. Streamlining The Care System – Improving the Patient ExperienceMary Sherry, Director of Performance

2. Streamlining Care – Where are we? • Systems Thinking principles being applied by the leadership teams and starting to embed throughout the organisation • This means looking end-to-end at our processes to redesign and improve the patient pathway • Changes are happening in various ways across our pathways • Whole hospital metrics focus our attention on stages of patient journey as well as mandatory measures • Whole hospital transformation plan developed to realise benefit to: • Patient experience • Cost ANNUAL GENERAL MEETING, 29 JULY 2010

3. Streamlining Care – What has changed? Work is underway in the following areas: • Referral to Clinic (Diagnosis) • Elective Admission to Surgery and on to Discharge • Trauma Pathway • All work is directly with teams ‘on the ground’ using work place metrics to identify issues and plan and test solutions • Further work streams are planned from September onwards ANNUAL GENERAL MEETING, 29 JULY 2010

4. Streamlining Care – What has changed? Referral to Clinic (Diagnosis) • Appointments are being booked more quickly • Patient waiting times have reduced – a 15 steps reduced to 5, time reduced from 40 days to 10, flexible hours to contact patients more conveniently • Majority of patients requiring surgery are now pre-assessed on the same day as clinic • As administrative processes have reduced, so have costs ANNUAL GENERAL MEETING, 29 JULY 2010

5. Streamlining Care – Referral to Clinic New Booking Process Implemented ANNUAL GENERAL MEETING, 29 JULY 2010

6. Streamlining Care – Central Pre-Assessment Department ANNUAL GENERAL MEETING, 29 JULY 2010

7. Streamlining Care – What has changed? Elective Admission to Surgery and onto Discharge • Work place metrics in place on ward and in theatre to show staff what is actually happening and drive change – good example is start times • Admission lounge opened in order to increase patients being admitted on the day – more convenient to patients • Theatre start times tackled and new process implemented – to increase patients treated per list and reduce cancellations/overruns • Planning of lists being reviewed with consultants – to increase use of theatres, shorten waiting times • Review of admission and discharge process – to improve planning of admissions and discharges, giving more certainty to patients ANNUAL GENERAL MEETING, 29 JULY 2010

8. Streamlining Care – Theatres: Same Day Admission to C Wing, Elective Inpatients

9. Streamlining Care – Theatres: Admission to Theatre – PS & MF Elective Inpatients ANNUAL GENERAL MEETING, 29 JULY 2010

10. Streamlining Care – What has changed? Trauma Pathway • Key objective set that trauma patients, once fit for treatment, will be operated on within 24 hours, plus time elapsed from injury to treatment to be key focus • Trauma Co-ordinator appointed, to improve the management of patients through their pathway • Electronic Trauma board being designed, with process changes to improve the planning of trauma theatre lists • Reasons for cancellations being focussed on the drive change, potentially increasing availability of trauma operating time ANNUAL GENERAL MEETING, 29 JULY 2010

11. Streamlining Care – Trauma Pathway:Admission to Theatre PS & MF Inpatients ANNUAL GENERAL MEETING, 29 JULY 2010

12. Streamlining Care – What happens next? ANNUAL GENERAL MEETING, 29 JULY 2010 • Realignment of Executive role to focus on redesign • The establishment of a dedicated team to take this work forward September 2010 to March 2011 • New work streams to commence in September including cancer pathway and new : follow up appointments • The roll out of key metrics to management team so that patient experience is at the heart of management action to drive change