PFC 2005 Executive summary

What is the Patient Flow Collaborative?

The Patient Flow Collaborative is an ambitious innovation program designed to minimise waiting throughout the patient journey and to improve the quality and safety of patient care.

The Patient Flow Collaborative is a joint initiative between the Clinical Innovation Agency (CIA) and the Hospital Demand Management (HDM) team from the Metropolitan Health and Aged Care Service. The collaborative will build upon and be integrated with the existing work and processes undertaken through HDM projects to date.

All metropolitan and large rural health services from Victoria will be provided an opportunity to participate in the 18-month collaborative project.

Why is the Patient Flow Collaborative different from other collaborative projects?

The Patient Flow Collaborative will use a whole system approach to innovation, focusing on improving service delivery across the entire healthcare system.

This change from other innovation projects will ensure that patient flow is effective across the whole system. Innovation will be delivered to smooth any unnecessary delay in the patient journey.

The Patient Flow Collaborative will work with health service boards and front line staff teams using a cohesive change agenda that is tailored to local service needs.

The Patient Flow Collaborative will also embed the tools and techniques for continuous improvement with health services, once the collaborative is completed. A learning program for project team facilitators, health service collaborative teams and clinical area leaders will support ongoing improvements in patient flow. Additional action learning sets will be designed on a needs basis during the Patient Flow Collaborative to spread and sustain improvement in patient care.

How the Patient Flow Collaborative will measure improvement

The Patient Flow Collaborative will be measured against four distinct areas that will improve patient care:

• quality and safety
• patient and staff satisfaction
• access to services
• value for money.

Specific measures will be agreed with each health service to measure and demonstrate improvements against these aims.

Who will participate from the health service?

An executive team and clinical area team will be established with each health service. The executive team will provide leadership and direction for the collaborative.

Members will include:

• Chief executive officer
• Chief nurse
• Medical director
• Clinical director for surgery

Up to three clinical area teams will be established, at any one time, to improve patient flow. The areas for improvement will be identified through the rigorous diagnostic phase.

The clinical area team would include:

• A general manager
• Clinician
• Nurse

The Patient Flow Collaborative will work towards strengthening existing relationships between primary, acute and sub-acute service providers. Radical change will be achieved when there is collaboration between all parties within the patient journey.

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What is the process for the Patient Flow Collaborative?

The Patient Flow Collaborative will provide 18 months of whole system innovation and capacity building with improvement leads based onsite. The program aims to provide the template for organisational continuous improvement and build networks of innovation that will continue well past the length of the formal collaborative.

How does the whole system approach work?

The whole system approach is implemented in four key phases:

• diagnostic - conduct rigorous diagnosis to identify whole system constraints
• innovation - develop and test innovations to minimise patient flow constraints and agree upon an improvement plan
• improvement skills building - develop service improvement skills and techniques within health services
• mainstream - spread innovation across other clinical areas and hospitals, ensure sustainability and embed innovation practice into service system.

Benefits of using a whole system approach

The diagnostic phase is undertaken by each health service and will identify and establish a comprehensive understanding of significant patient flow constraints. The diagnostic phases comprises:

• identifying key constraints
• using sample data techniques to understand key constraints
• mapping patients journeys
• developing statistical process control charts to understand patient flow
• creating capacity and demand profiles.

The Patient Flow Collaborative will use a range of tools to test and measure patient flow processes. Statistical process control charts will be used to collect relevant data through the collaborative. These charts will be used for the diagnostic phase and also for monitoring improvements across the collaborative project.

A data analyst will be available to work with each health service team.

What support will be provided by the Clinical Innovation Agency project team?

Each health service team will be supported by an improvement lead and planning group member, who will assist with the development and implementation of the improvement plan.

A clinical champion will also be available to provide advice and guidance on engagement and innovation strategies. Self assessment of project coordinators and an organisational innovation review tool will provide valuable information for the organisational improvement plan.

Action learning sets will run alongside the collaborative learning sessions providing further training to resolve key patient process constraints.

Key topics will include:

• emergency care
• surgical access – admission through to discharge
• medical access – admission through to discharge
• operating theatre capacity and utilisation
• diagnostic and imaging episodes
• allied health services
• bed management.

Contact Details

Lee Martin
Collaborative Director
Patient Flow Collaborative

Tel: 03 9616 7859

Email: Lee.Martin@dhs.vic.gov.au

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