Balmain Hospital General Practice Casualty (GPC) is an urgent care centre providing acute care for patients with minor injuries and illnesses. The department also runs multiple outpatient clinics to streamline the care provided. Over the last five years there has been a marked increase in the number of presentations to the service, an increase in the average length of stay of patients within the department and an increase in the volume of patients who did not wait for care. Service provision is undertaken by a small workforce and the rising demand has resulted in several challenges in the department.
The project aims to improve patient experience by providing an equitable, responsible, culturally safe, integrated and competent model of care in GPC, whilst simultaneously increasing the efficiency and capacity of the service and enhancing staff experience by July 2024.
Patient journeys (n=64) were mapped across seven days capturing both walk-in presentations and clinic presentations, confirming the primary bottleneck in access to care is the dependence on the single treating doctor. Historical complaints were analysed, with 60% related to extended wait times and the delay in accessing services provided within a single doctor model of care.
The key issues identified within the diagnostic phase of the project include:
- access to care, prolonged wait time and transit through the department
- continuity of care and external stakeholder engagement
- education and professional development
- internal communication and process issues
- workforce challenges in GPC
- patient comfort.
To address the issues identified in the diagnostic phase, the below actions will be explored as potential solutions:
- implement the use of ED Discharge Referral eMeds V2 Power form to improve external stakeholder access to discharge documentation and pending results to enhance continuity of care
- development of an education framework
- consider the inclusion of a nurse practitioner into the model of care
- explore a technical solution to improve transparency of patient acuity between the waiting room and clinical area.
Implementation of solutions is planned to commence in the latter part of 2023, with evaluation of the project to begin in July 2024.
View this project's poster from the Centre for Healthcare Redesign graduation August 2023.
