title: Strength in unity: the power of redesign to align the hospital team.
abstract: OBJECTIVE
  The aim of Queen Elizabeth II Jubilee Hospital (QEII) redesign project (QEII United) was to enhance timely access to an inpatient bed and maximise opportunities to value add during the inpatient episode of care.
  
  
  METHODS
  A tripartite relationship between the hospital team, system manager and external consultants. The team, QEII United, was formed to 'diagnose, solve and implement' change under the unifying metaphorical banner of a football team. A marketing strategy and communication plan targeted the key 'players' and outlined the 'game plan'. Baseline data were collected, analysed and reported in keeping with key aims. Strategies for systems improvement implementation were attached to key performance indicators (KPIs).
  
  
  RESULTS
  Thematic KPIs were developed to embed internal process change to reflect the contributions made towards the National Emergency Access Target (NEAT) at each stage of the patient journey. As such, access block of under 20%, morning discharge rates of 50% before midday, reduced length of stay for selected elective orthopaedic and general medical diagnostic related groupings (DRGs; i.e. relative stay index ≤1) and hospital in the home (HITH) utilisation rates 1.5% of all admissions were all met. Key to sustainability was the transfer of clinical redesign skills to hospital staff and the fostering of emergent ground up leadership.
  
  
  CONCLUSIONS
  QEII United's success has been underpinned by the development of themed solution areas developed by the hospital staff themselves. Robust baseline data analysis used in combination with nationally available benchmarking data provided a quantitative starting point for the work. The collaborative elements of the program re-energised the hospital team, who were kept informed by targeted communications, to establish quick wins and build trust and momentum for the more challenging areas.
authors.affiliation: Queen Elizabeth II Jubilee Hospital, Cnr Kessels and Troughton Roads, Coopers Plains, Qld 4108, Australia. Email: ; ; ; ;
authors.forename: Anthony
authors.initials: A
authors.lastname: Bell
authors.affiliation: Queen Elizabeth II Jubilee Hospital, Cnr Kessels and Troughton Roads, Coopers Plains, Qld 4108, Australia. Email: ; ; ; ;
authors.forename: Alastair
authors.initials: A
authors.lastname: Cochrane
authors.affiliation: Queen Elizabeth II Jubilee Hospital, Cnr Kessels and Troughton Roads, Coopers Plains, Qld 4108, Australia. Email: ; ; ; ;
authors.forename: Sally
authors.initials: S
authors.lastname: Courtice
authors.affiliation: Queen Elizabeth II Jubilee Hospital, Cnr Kessels and Troughton Roads, Coopers Plains, Qld 4108, Australia. Email: ; ; ; ;
authors.forename: Kathy
authors.initials: K
authors.lastname: Flanigan
authors.affiliation: Queen Elizabeth II Jubilee Hospital, Cnr Kessels and Troughton Roads, Coopers Plains, Qld 4108, Australia. Email: ; ; ; ;
authors.forename: Mandeep
authors.initials: M
authors.lastname: Mathur
authors.affiliation: Queen Elizabeth II Jubilee Hospital, Cnr Kessels and Troughton Roads, Coopers Plains, Qld 4108, Australia. Email: ; ; ; ;
authors.forename: Daniel
authors.initials: D
authors.lastname: Wilckens
mesh_terms: D017598:Efficiency, Organizational; D006786:Hospitals, Urban; D006801:Humans; D008505:Medical Staff, Hospital; D009936:Organizational Innovation; D010348:Patient Care Team / Q000458:organization & administration*; D011793:Queensland