seESaW: Elective Surgical Waitlist
20 April 2016 Last updated:
28 April 2016
seESaW: Elective Surgical Waitlist
This project developed a virtual elective surgery waitlist for 10 surgical sites in Murrumbidgee Local Health District (MLHD) using data interface software.
View a poster of this project from the Centre for Healthcare Redesign graduation, April 2016.
To improve access to and wait times for elective surgery in MLHD by centralising elective surgery waitlist management.
- Provides a standardised approach to waitlist management across the local health district.
- Provides a timely and comprehensive assessment of patients.
- Enhances support of rural surgical site coordinators and provides a specific and robust escalation pathway.
- Increases transparency and communication between facilities.
- Improves ability to measure and evaluate operational activity.
- Provides complete vertical and horizontal collaboration across all surgical sites in the local health district.
Due to the vast geographical distances within MLHD, each of the 10 surgical sites in the district has historically operated in partial isolation. This has led to a significant variation in how, where and when elective surgeries are provided, including:
- different wait times for procedures at different facilities
- a lack of continuity in service delivery across MLHD
- variation in processes for managing surgical waitlists, including allocations, preadmission and scheduling
- site-specific business rules that oversee the governance and monitoring of the MLHD waitlist in each facility.
It was determined that the following objectives would reduce these variations and increase equitable access to elective surgery across MLHD:
- meet Elective Surgery Access Targets set by the NSW Ministry of Health at each surgical facility in MLHD by 31 December 2016
- reduce non-urgent elective surgery wait times from 370 days to 357 days by March 2016
- increase the number of patients who choose to receive elective surgery at a rural site instead of Wagga Wagga Base Hospital, by 10% by December 2016.
- An OPERA technology system and WATTLE teleconference system was introduced, to provide virtual waitlist capabilities that allow for accountability and transparency across the district.
- A Surgical Services Matrix was developed by clinicians and executives to improve operational efficiency.
- Clear identification of all surgical services stakeholders was undertaken and documented.
- A full assessment of support services and audit of surgical infrastructure at each site was undertaken.
- A new operating suite at Tumut Hospital was constructed and recovery rooms at Young Hospital were upgraded.
- A working party was established to establish a second operating theatre at Griffith Base Hospital.
- Wagga Wagga Rural Referral Hospital approved the Director of Surgery and Director of Anaesthetics to be functional de facto directors for MLHD.
- SurgiNet clinical technology was implemented into the electronic medical record (eMR) system at 7 of 10 surgical sites, which increases the visibility of sites and transparency of data. Further rollout to remaining sites will continue in 2016.
- Implementation - the initiative is ready for implementation or is currently being implemented, piloted or tested.
- April 2015 – December 2016.
- All 10 surgical sites in MLHD.
- Southern NSW Local Health District
- Centre for Healthcare Redesign
- A full evaluation will take place in December 2016 to determine whether the project objectives have been achieved.
- As of April 2016, all 10 surgical sites are successfully using the virtual waitlist technology with consistent results.
- Fortnightly teleconference meetings are in place to report on data and provide an opportunity to escalate results to the executive team if required.
- An assessment of surgical roles will take place in the first half of 2016, in line with implementation of the MLHD Surgical Services Matrix. This enables sites to determine appropriate surgical patients and procedures at a multi-facility level.
- Wagga Wagga Rural Referral Hospital had difficulty meeting Elective Surgery Access Targets and as a result is looking to complete a perioperative journey efficiency project.
- There has been improved discussion between management, clinicians and operational staff as a result of the project.
- Stakeholders are more willing to have confidence in projects if you meet face-to-face, educate them on the goals of the project, follow up regularly and keep them in the loop when decisions are being made.
- We found that it’s common to accidentally miss stakeholders in discussions, but we tried to rectify this by recognising the problem, apologising and engaging them in the process as soon as possible.
- We found the methodology combined with robust data has contributed to the success of the project to date.
- ACI. Operating Theatre Efficiency Guidelines
- NSW Health. High Volume Short Stay Surgical Model Toolkit (GL2012_001)
- Australian College of Operating Room Nurses. ACORN standards for perioperative nursing 2014-2015
- NSW Health. Rural Surgery Futures 2011-2021
- NSW Health. NSW Rural Health Plan: Towards 2021
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