Brendon Gardner and Dr Shyaman Menon - Peninsula Health - Driving Change...

Driving Change

Located South East of Melbourne

Peninsula Health

An Overview of Peninsula Health

• Frankston & Mornington Peninsula’s public hospital & health care service

• Operating revenue of $450million

• >900 beds and growing

• Serves a population of 295,000 plus holiday visitors

• 4900 staff and over 800 volunteers

• Providing services across 13 major sites

• All services except major Trauma, Neurosurgery, Ophthalmology, Cardiac Surgery

Services across the Southern Peninsula

Board of Directors

Chief ExecutiveMs. Sue Williams

Executive Directors

A/Prof Jan ChildChief Operating Officer

RoMANCCC

Mr. Brendon

GardnerChief Operating Officer

Frankston Hospital

Dr. Fergus KerrExecutive Director

Medical Services

Mr. Simon Brewin Executive Director

Planning &

Infrastructure

Professional Issues

Medical Susannah Ahern

Nursing Jan Child

Allied Health Jan Child

Legal David Goldberg

Mr. David

AndersonExecutive Director

Finance

Ms. Kelly GilliesExecutive Director

Human Resources

Public Relations Andrew Heslop

1. Person centred care is at the core of what we do.

2. Service Planning - to deliver timely and appropriate care.

3. Partnering to support the health and wellbeing of our community.

4. Our Workforce - Attracting, retaining and developing high quality staff and volunteers.

5. Safety and Quality - We prioritise patient safety in everything we do.

6. Learning, teaching and research.

7. Strengthen our sustainability to support core activities.

Most Disadvantaged

Frankston North

Rosebud West

Hastings

Rosebud

Tootgarook

Frankston

Most Advantaged

Portsea

Arthurs Seat

Mt Eliza

Merricks North

Red Hill South

Mt Martha

Extremes of Wealth and Poverty

Frankston North ranked as the 7th most disadvantaged area in Victoria

Frankston and the Mornington Peninsula measure notably worse on a number of health inequality indicators compared to the Victorian Average

• High Smoking rates 17.4% - FCC, Vic average 15.5%• High Dementia rates • High #’s Early school leavers FCC 36.8%; State 27.9%• High #’s Single Parent Families • Lower breastfeeding rates 30% - FCC, State 39% • High numbers of teenage pregnancies FCC - 16.4/1000, State 10.6/1000 • Low Health literacy -57% population below optimal• High Unemployment - Frankston 6.5% :State 5%• High Rates Child Protection Orders and family violence (3rd highest in state)• Higher Crime rates Frankston (above state average for all offences except burglary,

robbery and road fatalities)• High gambling machine losses• Higher rates of disengagement from education and employment for Frankston

youth (15-24) FCC 14.8% ; State 10.7%

Our Community

Made improvements prior with some changes but with the opening of a new block. 2 wards, a new Emergency Department. Opportune time to review our models of care.

Review via the lens of a patient’s journey

Frankston Hospital Stage 3

92 new acute beds

New Emergency Department

Why Change?

The need for change

Poor patient flow is associated with

- poor patient outcome

- decreased patient satisfaction

- decreased staff satisfaction

Time based targets are a surrogate marker to these which are our primary outcomes

Our Challenges

Environment

EDIS

Principles of Care

Building our Priorities

Principles

Models of Care

Collaboration

IT Enablers

Data

Right Treatment by the

Right Team at the

Right Time

Our Change Principles

Patient Centered Care - Patients are our focus. What would we want

our patients to experience?

Patient Care is a Continuum and not done in “silos”.

The Right Environment

Emergency - The role of the ED - Resuscitate, Risk Stratify, Treat.

Patients who no longer need ED treatment need to have a timely

decision and disposition plan

Acute Assessment and Admission Unit - Care is clinically handed

over. Majority of our ward admissions are via this path.

Emergency Short Stay Unit - Optimising utilisation

The WardsOperational Readiness

Ward Units

SSSU Short stay surgery

ESW Short stay surgery

AAA (4GS) Acute Assessment & Admissions Unit

4GN Gastroenterology / General Medicine

5GS Neurology / General Medicine

5GN

5FN Respiratory / Renal / Infectious Diseases

5FS Oncology / ACE / Endocrinology

Westernport NL2 Cardiology / Chest pain / Vascular

Bass NL3 Surgery

Port Phillip NL4 Orthopaedics / Plastics

Opportunity = Realignment of specialties with wards

Triage

Waiting Rooms including a dedicated Paediatr ic Waiting Room

Resuscitat ion Cubicles 5 cubicles

STAT Cubicles 7 cubicles

Acute 8 cubicles with Bariatr ic capacity

Paediatr ics 4 cubicles

Fast Track 9 Cubicles

Emergency Observation Unit 17 beds

3 Treatment Rooms

Paediatr ic Waiting Room

Bariatr ic patients

Our new Emergency Department

Medical/Surgical

patients to EDTriage

review in “stat” area

Home ESSU Resus Acute ED

Comprehensive Ax & Mgt in ED

AAA Unit

Home/NH HITH Subacute Ward

Outpatient

GP / Specialist /

NH

Emergency Department Information System (EDIS)

Investment into a new EDIS

Aim for a complete paperless system

User friendly interphase with robust database backend

Integration within health system

PH ED – One of the EDs which have gone almost completely electronic.

Implementation – Project development with end user customisation, Training, Launch, Ongoing training.

Implementation better than expected. Anticipated inefficiencies on launch settled very quickly.

EDIS

Need. Staff were wanting something new.

Generational

Benefits

Transparency/ Reduction of duplication

IT Enablers

Emergency Department Information

System

Touch On Touch Off Capability

Emergency Dashboard

Data Reports

Data Driven Change

Data – friend of foe

KPIs

Accountability

Clinician’s take on data. Perceived to always be negative. Evidence based medicine.

Data skeptics – Data needs to be accurate but also need to understand what data is being used for.

Data rich

Systems in place to be able to capture and extract data

Needs to be easy on front face but be robust in the back end

DATA

Elite Sports

Personal Dashboards

PH Reports

PH Levels of Data

PH Levels of Data

ED Dashboard

AAA Dashboard

What works

Engaged Health Service - uniform goal

Trust

Communication

Information

Old “habits”- Keeping to our principles

Consistency

Surge

Demand

Challenges

Key is the team to accept the need for change.... It

needs to come back to patient care.

Keep reviewing process. Change will always need to

occur as our circumstances will change, we need to be

flexible but wary of change fatigue .

Use opportunities for timing of change where possible

Data is your friend.

Displayed data needs to be customized and be

meaningful to the team who is looking at it

Key Learnings

Board of Peninsula Health

Chief Executive Officer, Ms Sue Will iams

Chief Operating Officers

Executive Support

MIS and HIS Team

Staff of Peninsula Health

Consumers

Acknowledgements