A number of actions have been identified to improve patient flow and maximise emergency department efficiency as a result of last week’s Access Solutions Meeting.
Our hospitals are extremely busy and our hardworking staff are doing an incredible job under unprecedented increased demand. The Action Plan that’s been developed is about working together to support the system as a whole, streamlining collaboration between hospital departments, improving culture and empowering staff to implement change within hospital environments, and ensuring accountability.
The Plan includes short-term, medium-term and long-term solutions. The immediate actions, which will be implemented within two weeks, include:
- Medtasker – Improving access to data to drive quality of care, communication and service efficiency through the implementation of Medtasker to medical staff at the Royal Hobart Hospital. This program allows staff to very clearly understand where a patient is and what that patient’s next requirement is to complete their journey through the Tasmanian inpatient system.
- Patient Assessment – Support staff to commence progressively implementing the principles of timely and quality care, that will underpin any decisions made to improve flow:
- All patients will be seen within 30 minutes on arrival at the ED by an interdisciplinary team member, led by the ED Team Leader, who will initiate assessment, investigations and treatment.
- Within two hours of triage, a decision will be made by the ED Team Leader to discharge or admit the patient, in accordance with endorsed admission guidelines.
- Patients will be reviewed by the inpatient team within one hour of being referred for admission.
- Patients will be admitted to a bed in the most appropriate clinical place, the first time.
- Patients will be reviewed daily by a senior decision-making clinician, and patients and their carers will be actively engaged in their care, to help ensure they are in hospital for only as long as is clinically necessary.
- Private Hospitals – Convene a workshop group with the private hospitals to establish a formal interface between the public and private hospitals.
Short-term actions, which include admission and communication improvements, will be implemented by the end of July.
This includes developing a plan for the number and type of additional beds that should open immediately on the commissioning of K-Block – on top of the existing beds that transfer into the facility.
Some of the medium and longer-term plans include:
- Developing a new acute level hospital in the home service.
- Trialling part-time additional pharmaceutical support.
- Commissioning inpatient wards in K-Block, including beds at the RHH.
- Implementing a model for an integrated approach for mental health services, including a hospital avoidance program.
These actions are supported by the $30 million provided in the 2019-20 Budget to meet increased patient demand.
In short, the best and only effective way to tackle our demand challenges is to work together, set aside political stunts and ensure that hospital culture and patient flow management changes in a way that results in better patient outcomes.
The Action Plan can be found here: https://www.dhhs.tas.gov.au/news/2019/rhh_access_solutions_meeting