Complete
This was an improvement partnership supported by the former Better Care Victoria Innovation Fund.
Participating organisations
- Alfred Health
- Barwon Health
- Eastern Health
- Goulburn Valley Health
- Melbourne Health
- Mercy Health
- Monash Health
- Northern Health
- Peninsula Health
- St Vincent’s Health
- Western Health
Summary
In 2016, the Improving emergency access collaborative brought 11 health services together to jointly develop and implement solutions to address constraints in patient flow. These constraints were impacting health services’ ability to deliver timely care to emergency department (ED) patients, making it challenging to discharge them within the statewide target of four hours.
The improvement partnership enabled teams from different health services to build meaningful relationships where they could learn from one another while developing their capability to engage in and carry out improvement initiatives at their respective services. Participants were also supported by industry coaches who were recognised experts in improvement science.
The participating health services, which were primarily from the metropolitan area, treated 43 per cent of all emergency department (ED) presentations in Victoria, so a large proportion of the Victorian population was able to benefit from the partnership’s work.
Aim
Address constraints in patient flow through the collaborative to improve patients’ ED experience and access to care.
Outcomes
Across the entire collaborative:
- six health services reduced the length of time patients spent in the ED before being admitted
- three health services reduced the length of time patients spent in the ED before being discharged
- one health service improved its capacity to treat patients in time
- two health services reduced the time taken to transfer a patient from an ambulance to the ED.
Participating health services implemented a range of different solutions suited to their organisational needs.
Examples of some individual achievements are listed below:
- Northern Health reduced average ambulance offload times by more than 5.5 minutes and enabled ambulances to spend 2,570 more hours out in the community over 12 months by implementing a strategy to maximise the time ambulances spend on the road.
- Peninsula Health increased discharges before 10am by 30 per cent by implementing a ‘countdown to discharge’ process. This strategy encouraged staff to plan for patient discharge from the day of admission and used an innovative process that allowed all multidisciplinary care team members to track a patient’s journey through the hospital.
- St Vincent’s Hospital Melbourne reduced its average time to treat from 31 minutes to 21 minutes by establishing a rapid assessment team, with a senior ED consultant and nurse staffing ‘virtual cubicles’ for early assessment and treatment.
- A ‘daily operating system’ (DOS) process – a daily assessment to determine whether a health service is ready and able to deliver safe, effective care over the coming day – had a positive impact on patient flow across a number of health services.