Clinical process redesign for unplanned arrivals in hospitals.
*Emergency department performance had been deteriorating in NSW Health facilities and at Flinders Medical Centre before a fundamentally new approach involving a redesign method, additional bed capacity and more rigorous hospital performance management was applied. *Redesign was undertaken in over 60 hospitals in New South Wales. *Numerous disconnections and misalignments in the process of care delivery have been uncovered during the diagnostic phase of this redesign. *Solutions addressed the entire patient journey through the hospital, to produce smoother patient flow along the continuum of care. *To achieve a sustained improvement in performance, numerous solutions must be simultaneously implemented in each hospital. *With this multipronged approach, a turnaround in NSW emergency access performance has been achieved in the face of rising demand for services; the improvement has continued over 3 years. *This article reports on our findings from system-wide redesign for unplanned hospital attendances.
O'Connell
Tony J
TJ
Health Services Performance Improvement, NSW Health, Sydney, NSW, Australia.
Bassham
Jane E
JE
Bishop
Rod O
RO
Clarke
Christopher W
CW
Hullick
Carolyn J
CJ
King
Diane L
DL
Peek
Carmel L
CL
Verma
Raj
R
Ben-Tovim
David I
DI
McGrath
Katherine M
KM
D003266:Continuity of Patient Care; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration; D009517:New South Wales; D009936:Organizational Innovation; D010043:Outcome and Process Assessment, Health Care; D010346:Patient Care Management / Q000458:organization & administration* / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data