Jess Project Manage Women’s and C Model of C “Bright Eyes - A Colla to Caring for Mothe Project Manage Sinead Tierney an Team Women’s and Childre St Georg July s Rojas er – Social Worker Children’s Health Care Project aborative Approach ers and Children” er – Social Worker nd Christina Antonas Leaders en’s Health Social Work ge Hospital y 2014
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Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital - Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
Jess Rojas, Christina Antonas & Sinead Tierney, St George Hospital delivered the presentation at the 2014 Discharge Planning Conference.
The 2014 Discharge Planning Conference - Assisting health services to adopt an integrated and consumer directed approach to discharge planning.
For more information about the event, please visit: http://bit.ly/dischargeplan14
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Transcript
Jess Rojas
Project Manager
Women’s and Children’s Health Model of Care Project
“Bright Eyes - A Collaborative Approach to Caring for Mothers and Children”
Project Manager
Sinead Tierney and Christina AntonasTeam Leaders
Women’s and Children’s Health Social WorkSt George Hospital
July 2014
Jess Rojas
Project Manager – Social Worker
Women’s and Children’s Health Model of Care Project
A Collaborative Approach to Caring for Mothers and Children”
Project Manager – Social Worker
Sinead Tierney and Christina AntonasTeam Leaders
Women’s and Children’s Health Social WorkSt George Hospital
July 2014
Bright Eyes - A Collaborative Approach to Caring for Mothers and Children
COLLABORATION
OPENNESS
RESPECT
EMPOWERMENT
A Collaborative Approach to Caring for Mothers and Children
COLLABORATION
OPENNESS
RESPECT
EMPOWERMENT
St George Hospital NSW
St George Hospital (SGH) -Health District, Southern Sector
A major trauma and teaching hospital in NSW
2nd busiest Emergency Department in NSW
44 full time social work positions
The St George Area of Sydney is one of the most culturally diverse areas in NSW
St George Hospital NSW
South East Sydney Local Health District, Southern Sector
A major trauma and teaching hospital in NSW
busiest Emergency Department in NSW
44 full time social work positions
The St George Area of Sydney is one of the most culturally
Social Work in Women’s and Children’s Health
2500 births in 2013
SGH is a high risk birthing unit
Team of 3 full time Social Work positions Team of 3 full time Social Work positions
Paediatric ward, Antenatal clinics, Postnatal ward, Gynaecology ward, Special Care Nursery
Social Work in Women’s and Children’s Health
SGH is a high risk birthing unit
Team of 3 full time Social Work positions Team of 3 full time Social Work positions
Paediatric ward, Antenatal clinics, Postnatal ward, Special Care Nursery
Reasons for referral to Women’s and Children’s Social Work Team
Child protection – drug and alcohol, mental health, domestic violence (DV)
Domestic violence
Young parents
Adoption
Sexual assault /trauma/refugees
Significant anxiety and adjustment issues regarding pregnancy and parenthood
Reasons for referral to Women’s and Children’s Social Work Team
drug and alcohol, mental health,
/trauma/refugees
anxiety and adjustment issues regarding
Reasons for referral to Women’s and Children’s Social Work Team
An increase in birth rate (approximately 25% over 10 years) at SGH and NSW Government policy protection and domestic violence significantly the Social Work role in Women’s and Children’s Health.
Social Work staff needed to be enhanced to the increasing antenatal outpatient caseload
Statutory requirements were unable to be met due to the high volume of inpatient and outpatient referrals.
Background
rate (approximately 25% over 10 years) at SGH and NSW Government policy changes for child protection and domestic violence significantly increased
Women’s and Children’s Health.
staff needed to be enhanced to keep up with antenatal outpatient caseload.
Statutory requirements were unable to be met due to the high volume of inpatient and outpatient referrals.
Background
Antenatal outpatients were left on a wait list of up to 3 months before they received Social Work intervention
The average response to referrals was 2 - 8 weeks
56% of waitlist cases had Statutory requirements
Background
How could we demonstrate the need for enhancement in this current budgetary
climate?
Difficult to secure any additional funding for enhancements
Model of Care Project Model of Care Project
I. Evidence based practice
II. Keeping accurate stats
III. Business plan
How could we demonstrate the need for enhancement in this current budgetary
climate?
Difficult to secure any additional funding for enhancements
Outline of Project
The 6 month Model of Care (MOC) project reviewed activity and demand in this clinical area.
It has informed service delivery priorities so patients have greater access to high quality antenatal and inpatient care.
This innovative MOC enabled a new exclusive Antenatal Project Manager position to be trialled, offering specialised intervention to high risk women, in collaboration with midwifery staff and other hospital and community partners.
A new weekend Social Work service was also piloted as part of this MOC project, exclusively for Women’s and Children’s Health patients.
Outline of Project
6 month Model of Care (MOC) project reviewed activity and demand in this clinical area.
has informed service delivery priorities so patients have to high quality antenatal and inpatient care.
This innovative MOC enabled a new exclusive Antenatal Project Manager position to be trialled, offering specialised intervention to high risk women, in collaboration with midwifery staff and other hospital and community partners.
A new weekend Social Work service was also piloted as part of this MOC project, exclusively for Women’s and
Goals of the Project Create a 7 day week service ensuring continuity of care for
patients
Positive impact on patient care and safety
Patients have greater access to high quality antenatal and inpatient careinpatient care
Reduce unnecessary length of stay
Safer and quicker discharge for Midwifery Support Program
Increase weekend and Monday discharges
Positive impact on patient flow in meeting NEAT & NEST targets
Goals of the ProjectCreate a 7 day week service ensuring continuity of care for
Positive impact on patient care and safety
access to high quality antenatal and
Reduce unnecessary length of stay
Safer and quicker discharge for patients eligible for
Increase weekend and Monday discharges
Positive impact on patient flow in & NEST targets
Goals of the project
Decrease wait list for Antenatal women requiring Social Work services
Meet all Statutory requirements in accordance with NSW Health, Child Protection and Domestic Violence Policies
Improve multidisciplinary team work Improve multidisciplinary team work
Formalise partnerships with various community agencies
Creation and implementation of innovative ideas
Collect & analyse data on social work referrals, interventions and typology
Goals of the project
Decrease wait list for Antenatal women requiring Social
all Statutory requirements in accordance with NSW Health, Child Protection and Domestic Violence Policies
Improve multidisciplinary team workImprove multidisciplinary team work
Formalise partnerships with Child Protection Services and community agencies
Creation and implementation of innovative ideas
Collect & analyse data on social work referrals,
Outcomes of Weekend Service Weekend referrals to SW increased by 56.4%
We demonstrated that this service facilitated the discharge of 67 patients on a weekend or Monday morning, over the 6 month trial period.
There was a total potential saving of $46,854 There was a total potential saving of $46,854
Cost for the weekend service for the 6 month period was $17,649
The safety benefits and cost effectiveness of the 7 day/week service were recognised by the Hospital Executive and the Weekend service built into 2014 budget
Outcomes of Weekend ServiceWeekend referrals to SW increased by 56.4%
We demonstrated that this service facilitated the discharge of 67 patients on a weekend or Monday morning, over the
potential saving of $46,854 potential saving of $46,854
Cost for the weekend service for the 6 month period was
The safety benefits and cost effectiveness of the 7 day/week service were recognised by the Hospital Executive and the Weekend service built into 2014 -15
Outcomes for Antenatal position
Early intervention
Improved care coordination
Equity and access to services Equity and access to services
Improved patient and staff experience
Continuity of social work care for antenatal patients when they birth in the hospital
Outcomes for Antenatal position
and integration of services
servicesservices
Improved patient and staff experience
Continuity of social work care for antenatal patients when
Outcomes of Antenatal position
100% of Statutory requirements are now being met in accordance with priority guidelines of 72 hours72 hours
100% of cases are assessed prior to the 36 week review
Increase in referrals of 54.8% since commencement of MOC project
Outcomes of Antenatal position
Innovation – Management
Developed to ensure that all high risk antenatal cases have a step by step plan in place prior to delivery
case management which is streamlined and coordinated
improved access to relevant information
more effective partnerships with other
implemented across the Sector at St George and Sutherland Hospitals.
Management Plans
all high risk antenatal cases have a step by step plan in place prior to delivery
case management which is streamlined and coordinated
access to relevant information
effective partnerships with other disciplines
implemented across the Sector at St George and
Patient Journey
Antenatal booking in visit
Referral to MCDReferral to MCD Allocated to Social Work
Management plan
Disclosed DV at 32 weeks
Psychosocial and Child Protection AX
Information gathering - Federal Police, FACS, solicitor
Frequent SW Intervention and DV
counselling
Patient Journey - Rebecca
Management plan completed in
collaboration with Complex Care
CMC
Postnatal Assessment done in delivery suite
Discharged to safe
house on MSP from delivery
suite
SW Antenatal Case Management
Ongoing liaison with FACS
Innovation- Staff Survey
“Since the commencement of the new Social Work Antenatal role, I have noticed a significant improvement in the identification and support process of the women. I feel it is a vital aspect of women centred care
“It is comforting to know that we have social workers over the weekend who know the area and problems faced by our clients and ourselves…Whereas before we had to consult emergency social workers” (Nurse)
Staff Survey
the commencement of the new Social Work Antenatal role, I have noticed a significant improvement in the identification and support process of the women. I feel it is a vital aspect of women centred care” (Midwife)
It is comforting to know that we have social workers over the weekend who know the area and problems faced by our clients and ourselves…Whereas before we had to consult
” (Nurse)
What we achieved
Through evidence based practice we were able to demonstrate the benefits to patients, staff and cost effectiveness of the 7 day/week service and increases to antenatal service.
We were given the opportunity to showcase the project to hospital executives and submitted a business plan.
What we achieved
Through evidence based practice we were able to demonstrate the benefits to patients, staff and cost effectiveness of the 7 day/week service and increases to
We were given the opportunity to showcase the project to hospital executives and submitted a business plan.
What we achieved
We were successful in securing funding of a weekend service which now continues to generate a high level of referrals and facilitates patient flow.
An Allied Health review has been conducted across St An Allied Health review has been conducted across St George Social Work Department. Clinical allowed for 2 days permanent to be allocated to the antenatal caseload.
What we achieved
We were successful in securing funding of a weekend service which now continues to generate a high level of
and facilitates patient flow.
review has been conducted across St review has been conducted across St epartment. Clinical redesign has
allowed for 2 days permanent to be allocated to the