Poster Session HRT1317 Innovation Awards November 2013 Brisbane

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1 Poster Session HRT17 Innovation Awards November 20 Brisbane Presenter: Keren Harvey, Clinical Director Rehabilitation and Geriatric Medicine, TPCH Visibility enhancing the Geriatric & Rehabilitation Liaison Service (GRLS). Refer and Exodos The Experience at The Prince Charles Hospital. Hospital Code Name:

2 KEY PROBLEM Written or typed referrals faxed to one office (fax machine) Problems; completion of referrals delayed due to time consuming process. Problems; information content poor as referrer unable to locate accurate information or took too long. Problem; referral information not legible. Problems; Stationary fax machine but a mobile team meant delays in receiving and processing new referrals. Manual data collection of each patients referral phases in an excel spreadsheet, manually collate monthly and quarterly reports and disseminate via as time permitted.

3 AIM OF THIS INNOVATION Develop a web-based referral tool to support intra and inter hospital referrals to subacute care. Streamline referral processes by developing an electronic Refer system. Have data automatically collated into a reporting system - Exodos. Provide access to all relevant staff so that reports can be generated as required with live information.

4 BASELINE DATA - Screen Shots of old referral and data entry systems.

5 Screen shots of new refer referral system and reporting system

6 KEY CHANGES IMPLEMENTED Referrals are now sent to a generic meaning that multiple staff can access (not person dependent) from any PC around the facility (not location dependent). Connectivity with existing data sources meaning less error in referral entry and data fields being self-populated Number and location of acute patients awaiting subacute care is live. Status of the referral to subacute is visible, transparent and live. Information and data is available to all staff at the time it is required.

7 OUTCOMES SO FAR Metro North HHS Collaboration across the HHS to meet the patients needs in the right place, the first time. Better planning, organisation and awareness of patients by both the receiving and transferring wards. Visibility and transparency across the health service; Subacute bed availability, Referral numbers and waiting time for transfer, Referral locations and target wards. Patient demographic information available.

8 OUTCOMES SO FAR TPCH Specific Reduction in total waits (days) in FY - across all referral sources and destinations. Reduction in total waits (days) in FY - across all phases of the transfer process (refer consult, consult decision, decision accept, accept transfer). Reduction in wait times transfer once listed for GEM and Rehab at TPCH Reductions in length of stay (ALOS) in the GEM and Rehabilitation Unit and Geriatric Evaluation and Management (GEM) Unit.

9 GEM ALOS (20- Current) ALOS (days) Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Rehabilitation Unit (ALOS) 20 - Current Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun-

10 Breakdown waits for different phases of acute to subacute transfer process for all subacute destinations (Y axis =days) Ref to consult consult to decision decision to accept accept to transfer Q3 20 Q4 20 Q1 20 Q2 20

11 Average total wait times for TPCH GEM and Rehabilitation FY - GEM takes ~40% and Rehab 25-30% of all TPCH referrals to subacute Rehab Gem Q3 Q4 Q1 Q2

12 LESSONS LEARNT Use of existing data sources and meaningful information Don t add layers, complexity or duplication. Staff were already doing the referrals give them meaningful information as results. Visibility and transparency of information is vital. Access to data to know how we re doing (EXODOS). Not only important for the referrers, but also the wards receiving the patients. Acknowledgements; Cam Bennett, Mary Slattery, Ian Missenden, Evon Greener, Karly Missenden, Jon Fraser, Keren Harvey, Shannaen Gilbert, Monique Parkinson.

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