This program evaluates and re-invents St Vincent's Hospital’s weekly rapid discharge rounds model.
This is carried out by introducing ward-level clinical leads and creating better documentation around discharge plans.
The goal is to improve safe and timely patient discharges.
Aim
By February 2020, the aim is for St Vincent’s Hospital (SVH) in Sydney to see a 10% decrease in the relative stay index and a 2% decrease in average length of stay for acute patients; in line with published health roundtable data.
The goal that drives this aim is to instil an ethos of safe and efficient discharge planning, within an informative and comfortable setting.
Benefits
- Patients will return home sooner, with the services and supports they need.
- This reduces the time spent in an acute hospital bed, through careful and expert discharge planning.
- Allied health staff and resident medical officers will further their skills in facilitating patient flow.
- This has a positive knock-on effect, right through to the emergency department; with the potential for cost benefits and increased patient satisfaction.
Background
The TICTOC (Timely in-patient care co-ordination and transfer of care) rounds were created approximately five years ago to facilitate the well-known benefits of efficient patient flow.
However, over time, the model reported 48% user satisfaction. This undermined the initiative’s key driver, which was to enable patients to spend a minimum time in an acute hospital, while returning home safely with the support and services they need.
By re-inventing this whole of hospital model, the aim is:
- to increase the skills of our clinical teams
- to make discharge planning more informative and commonplace
- in doing so, to increase user satisfaction so this tool is used in all lines of clinical work.
Implementation
Implementation outcomes are as follows.
- The name, ‘TICTOC’, has now become known as 'clinical patient flow rounds'.
- The number of people attending has been more than halved.
- A sticker for the patient file has been introduced to enable the sole allied health ward champion in attendance to follow-up with colleagues on suggestions made through the week.
- An education program has been introduced to all resident medical officers regarding the importance of discharge planning.
- The location of the rounds has moved to allow a more peaceful and less stressful environment, which allows meetings to be more focused.
Status
Implementation - The initiative is ready for implementation, is currently being implemented, piloted or tested.
Dates
February 2019 to February 2020
Implementation site
St Vincent's Hospital, Darlinghurst Sydney.
Partnerships
St Vincent's Health Network
Evaluation
A second consumer survey will be conducted one year after the roll-out of the new model, alongside analysis of roundtable health data.
Lessons learnt
- Sustainability is integral to the success of this project. This requires an ongoing investment of time and enthusiasm.
- An enthusiastic team allows delegation that results in action.
- Consumer engagement proved to be a challenge, but this is critically important, given it reflects the success of this project.
Contact
Simon Mosalski
Rehabilitation Staff Specialist
St Vincent's Hospital
St Vincent's Health Network
Phone: 0449 890 556
simon.mosalski@svha.org.au
