Published on March 10, 2014
Riding The Waves Of Change – The Queensland Update Queensland Health Laureen Hines Clinical Access and Redesign Unit
The View From Above Overview
Turbulent Waters Increased service demand Growth outstripping supply Shortfall of 3036 public beds for 2026 Increased cost 11% less efficient A need to reduce staff 3 P’s Prince, Patel and Payroll
Streamlining Health Care National Quality and Safety performance targets National and State funding reforms Independent Pricing Authority has set purchasing targets and prices for service delivery Creation of Health and Hospital Services
The Perfect Wave The Blueprint for better healthcare in Queensland Four principal themes: • Health services focused on patients and people. • Empowering the community and our health workforce. • Providing Queenslanders with value in health services. • Investing, innovating and planning for the future.
Past View Transfer location Wards 9 ED 9 OPD 6 Admitting Doctor Inpatient team 8 ED SMO 1 HITH Doctor 0 Triage In person 7 Phone 2 Inclusion exclusion criteria similar Multidisciplinary care Available 5 Not Available 4 Limited allied health on weekends Medical Home Visits Available 3 Not available 6 Readmission process inconsistant 7 day Nursing All 24 hour on call Available 6 Not Available 3 Length of stay set on admission Yes 7 No 2 Funding Source Hospital 5 Community 3 Clinics Available 7 Occasional used 2 KPI inconsistent –incidents monitored All require growth to meet 1.5% target Pharmacy not able to be tracked
Supporting The Tide Hospital In The Home (HITH) •provides care in a community setting (permanent or temporary residence) •acute conditions requiring clinical governance, monitoring and/or input •that would otherwise require treatment in the traditional inpatient hospital bed. •Queensland Health Admission Policy •focuses exclusively on acute admitted care substitution.
Encouraging The Flow Setting clear targets for activity levels Supporting projects to maximise efficiencies Forums bringing clinical leaders together
A Drop In The Ocean HITH Utilisation (as % of total seps by HHS) HITH Utilisation - Year to date December 2012 1.0% 0.9% 0.7% 0.6% 0.5% 0.4% 0.3% 0.2% 0.1% sla nd Percentage of HITH Utilisation 0.60 0.50 0.40 Percentage e Ba y Qu ee n on or et W id oa st tM W es h So SC ut h o et r M M et r o d Co No rt as t ns Go l s Do w ng ild re n' Da r li Ch s Ca irn ra lQ ld 0.0% Ce nt % HITH Utilisation 0.8% 2010-11 0.30 2011-12 2012-13 0.20 0.10 0.00 July Aug Sept Oct Nov Dec jan Month Feb Mar Apr May June
Increasing The Volume • HITH is in the Blueprint • Executive support HITH as a safe and important model • Statewide advisory and working groups • HITH funding model improvements • Innovation fund • PPP Funding
Supporting Safe Practice Implement guidelines Early detection and direct referral strategies Common processes Develop state-wide tools Increase ability to benchmark
Changing Tide of HITH in Queensland New patient cohorts Engagement with general practice Review possible public/private partnerships Conversion of activity to HITH models Support culture change due to increased accountability Embed governance requirements Support developing services Standardise care where possible and initiate statewide tool development Support existing services to grow
To all those who have contributed to reshaping and expanding HITH in Queensland
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Laureen Hines, Queensland Health: Queensland State HITH ...
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