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

Pharmacy not able to be tracked

Clinics Available

7

Occasional used

2

KPI inconsistent –incidents monitored

All require growth to meet 1.5% target

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

Pharmacy not able to be tracked

Clinics Available

7

Occasional used

2

KPI inconsistent –incidents monitored

All require growth to meet 1.5% target

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

HITH Utilisation - Year to date December 2012

0.0%

0.1%

0.2%

0.3%

0.4%

0.5%

0.6%

0.7%

0.8%

0.9%

1.0%

Cairn

s

Centr

al Qld

Childre

n's

Darlin

g Dow

ns

Gold C

oast

Met

ro N

orth

Met

ro S

outh

S Coas

t

West

More

ton

Wid

e Bay

Queensla

nd

% H

ITH

Uti

lisa

tio

n

HITH Utilisation (as % of total seps by

HHS)

A Drop In The Ocean

Percentage of HITH Utilisation

0.00

0.10

0.20

0.30

0.40

0.50

0.60

July Aug Sept Oct Nov Dec jan Feb Mar Apr May June

Month

Perc

en

tag

e

2010-11

2011-12

2012-13

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