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The Health Roundtable. New Zealand. Aim / Title: Allied Health Managing the Fluctuations of Inpatient Demand Across the Hospital – Using Priority Tools & Workload Sharing Mechanisms. 1 Allied Health Making a Difference. Presenter: Lyndell Keating Hospital Name: The Alfred Hospital
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The Health Roundtable New Zealand Aim / Title: Allied Health Managing the Fluctuations of Inpatient Demand Across the Hospital – Using Priority Tools & Workload Sharing Mechanisms 1 Allied Health Making a Difference Presenter: Lyndell Keating Hospital Name: The Alfred Hospital Key contact for this project: Lyndell Keating l.keating@alfred.org.au
Key Problem • Increasing demand & fluctuations between units • 12.1% un-met demand for allied health yet this varied significantly between units – from 0EFT for some units up to 2.65EFT for the trauma unit • Some departments didn’t have flexible workload allocation methods to manage short term or long term fluctuations in demand or clear leave cover strategies • Departments that did have priority tools had inconsistencies within the discipline and these weren’t consistent across disciplines
Key Strategies / Ideas Implemented • Draft inpatient priority tools developed with a uniform approach • Used stats to look at the difference between EFT allocated and EFT provided • Collection of un-met demand data by unit which was used to aid communication to staff re the problem • Collection of un-met demand data by priority (mid-way) which was used to aid in communication to staff re the problem • Strategies developed re flexible workload sharing
Priority Ratio –Implementation Example • Ideally the high priority un-met OOS should have been seen • Wall efficiency ratio of 76.5% • Efficiency = (Capacity - Potentially Met Demand) / Capacity
Key Outcomes Achieved • Priority tools across PT, OT, SP, Nut, Orthotics, SW & SP – uniform tools that can be easily communicated to stakeholders • Improved sharing of workloads across units – less variability in un-met demand • E.g. pre-implementation unmet demand varied from 0 - 1.2EFT between units for SW • post-implementation unmet demand varied from 0 - 0.4EFT for SW • Less un-met demand for high priority patients – better “efficiency score”
Priority Ratio – Post-Implementation Example • Wall efficiency ratio = 93.4% • A shift towards more of the high priority pts being seen
Lesson Learned • Challenging discussions to develop the priority tools re importance and urgency • Flexible workload allocations need to be balanced with skill mix requirements and need for continuity of care • Data is a useful tool to communicate to staff re inequitable caseloads