Download Minister of Health Announces Funding Under the Elective Services

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Minister of Health Announces Funding Under the Elective Services
Productivity and Workforce Programme – Round One
1. A total of $6.921 million in 2010/11 and $1.868 million in 2011/12 has
been awarded to 13 District Health Boards, covering 30 projects
addressing significant productivity initiatives to support increases in
elective surgery.
2. The projects were selected by an Evaluation Panel including key
representation from the health sector outside the National Health Board,
and endorsed by the Programme’s sector-led Steering Group.
3. The projects cover a range of areas from operational and management
efficiencies, to redesigned patient pathways and to revised peri-operative
techniques.
4. Eight DHBs have been funded to implement The Productive Operating
Theatre programme, in which the management and infrastructure
processes intrinsic to the running of each operating theatre are optimised,
enabling fewer cancellations and greater cost efficiencies. Six of these
have commenced the Programme, and the remaining DHBs will
commence within the next months.
5. Ten DHBs will undertake the redesign of their pre-admission procedures,
enabling a focus on care and discharge planning, more efficient use of
specialist clinical (anaesthetist) time, and greater patient engagement in
the process. These redesigned pre-admission processes may focus upon
one or a selection of services, but the contractual commitment is to roll
them out across all the DHB’s elective services.
6. Two DHBs will work together in the development of Enhanced Recovery
After Surgery pilots, in which up-skilled nursing staff will support the
patient through treatment with a focus upon post-operative planning and
care which enables easier discharge for the patient, in keeping with
patient safety standards.
7. Key Performance Indicators have been proposed by the sector and
accepted by the Evaluators, which will maintain a focus upon long-term,
sustainable improvements in productivity, contributing significantly to
DHBs’ efforts to reach the Government’s growth target of an average of
4000 surgical discharges per year.
8. DHB experience will be shared within the sector, to encourage the widest
possible capture of the benefits of the projects.
Contacts: Elective Services Productivity and Workforce Programme
DH B ( al pha bet i ca l
ord e r)
AD H B
AD H B
AD H B
Title
The Productive Operating Theatre (TPOT).
The TPOT programme examines and refines
operating theatre processes and assumptions,
relationships and structures to improve
throughput and eliminate organizational
blockages.
Pre-admission Process Redesign. These
redesigns enable trained staff (usually but not
necessarily nurses) to undertake basic preoperative assessment according to standards set
by anesthetists and other senior medical staff,
and to undertake the necessary admission and
discharge planning. This frees up senior medical
officer time, increases patient commitment and so
significantly reduces day-of-surgery cancellations.
Theatre productivity. Parallel to TPOT, this
project looks at patterns of usage in Greenlane
Surgical Unit’s theatres to identify and rectify
systemic causes of under-utilization from DHB
average The aim is to identify more effective
scheduling and usage to maximize that
productivity.
B o PD HB
Contacts
Justin Kennedy-Good
[email protected]
Justin Kennedy-Good
[email protected]
Justin Kennedy-Good
[email protected]
Bronwyn Anstis
[email protected]
Lisa Skeet-Smith
[email protected]
The Productive Operating Theatre
CD HB
delayed
Pre-admission
CM DH B
Gill Cossey
[email protected]
CM DH B
CM DH B
Pre-admission
Investigating and resolving systemic causes of
booking cancellations at all points of the patient
pathway. This project looks at the system issues
affecting patient commitment (ie, not just those
characteristics unique to CMDHB) at an individual
case level to identify and implement improved
systems and patient interface protocols.
Enhanced Recovery After Surgery (ERAS)
ERAS deploys specifically trained nurses to act
on a ‘case management’ basis especially with
known complex cases, to plan recovery and
discharge requirements and oversee their
implementation. A key outcome is to minimize
further interventions or readmissions at the 30-
Gill Cossey
[email protected]
Gill Cossey
[email protected]
day-post-discharge point.
HB DH B
Julie Ball
Pre-admission
HB DH B
Kath Johnson
The Productive Operating Theatre
Hu tt D H B
Hu tt D H B
[email protected]
[email protected]
t.nz
Kay McDonald
The Productive Operating Theatre
Pre-admission
[email protected]
Regan Spillane
[email protected]
Lak es D H B
Greg Vandergoot,
[email protected]
Martin Thomas
[email protected]
Jane James
Pre-admission
MC DH B
[email protected]vt.nz
Shirley-Anne Gardiner
[email protected]
vt.nz
MC DH B
Pre-admission
Designing and implementing a patient-focused
bookings system. Building upon some earlier
analysis into patient experience among Maori or
rural populations, the DHB will design and
implement a booking system from access to FSA
through to admission which is responsive to
individual patient requirements. Key measures
include a redesign of how clinics are organized
and staff resources deployed to ensure the best
usage of resources.
S ou th er n ( I n v)
Shirley-Anne Gardiner
[email protected]
vt.nz
Lynley Irvine
[email protected]
Judith Kissell
Pre-admission
S ou th er n ( I n v)
[email protected]
Lynley Irvine
[email protected]
Sharon Turner
The Productive Operating Theatre
T air a wh it i
[email protected]
Angela Freschini, Clinical
Lead
[email protected]
Sue Macpherson, Project
Lead
[email protected]
The Productive Operating Theatre
W aik ato
W aik ato
W aik ato
Demonstration site: pre-admission. Waikato
will provide support to other DHBs implementing
preadmission process redesign.
Demonstration Site: Capacity Management.
Waikato is implementing a comprehensive
capacity-management system (based on a model
from Air NZ). The NHB is keen to encourage
similar approaches (without specifically endorsing
the particular model at this point) and Waikato will
make resources available for demonstration
purposes
Elective care complex case management. Upskilled nurses will be allocated specific complex
cases (ie, those who pre-admission assessment
identifies as needing greater focus) and will plan
their individual pathways according to senior
medical officer assessments, resource availability
and patient circumstances.
W aitem ata
Debi Whitham
[email protected]
Mark Spittal
[email protected]
Debi Whitham
[email protected]
Debi Whitham
[email protected]
Debbie Holdsworth
[email protected]
ovt.nz
Pre-admission
W aitem ata
W aitem ata
Dr Andrew Love
The Productive Operating Theatre
New models of care. This project extends to
other services the lessons learned from a pilot of
a new approach in managing simpler versus more
complex hip joint cases.
W aitem ata
[email protected]
Debbie Holdsworth
[email protected]
ovt.nz
Dr Matthias Soop
[email protected]
W aitem ata
W aitem ata
W aitem ata
Enhanced Recovery After Surgery
Shoulder Soft Tissue Reconstruction – cost
savings in operating technique. This pilot trials
whether in some cases more traditional surgical
techniques are more effective (in outcome and
cost terms) than the deployment of modern
technology for its own sake.
Day-stay surgery for laparoscopic
cholecystectomies. This pilot will conduct such
procedures on a ‘day-stay’ basis. Evaluation will
consider applicability to other procedures.
Managing acute demand to enable more
elective discharges. Acute demand proves to
be statistically predictable. This pilot trials a
series of protocols to be able to deliver key
resources to elective surgery efficiently, through
longer-term planning.
W hanga n u i
Debbie Holdsworth
[email protected]
ovt.nz
Debbie Holdsworth
[email protected]
ovt.nz
Debbie Holdsworth
[email protected]
ovt.nz
Judith Bothma
The Productive Operating Theatre
W hanga n u i
[email protected]
Jan Denman
Pre-admission
[email protected]