Clinical process redesign for unplanned arrivals in hospitals

• Published in: Medical journal of Australia Vol. 188; no. S6; pp. S18 - S22
• Main Authors: O’Connell, Tony J, Bassham, Jane E, Bishop, Rod O, Clarke, Christopher W, Hullick, Carolyn J, King, Diane L, Peek, Carmel L, Verma, Raj, Ben‐Tovim, David I, McGrath, Katherine M
• Format: Journal Article
• Language: English
• Published: Australia Australasian Medical Publishing Company Proprietary, Ltd 17-03-2008
• Subjects: Communication; Continuity of Patient Care; Data analysis; Decision making; Emergency medical care; Emergency Service, Hospital - organization & administration; Emergency Service, Hospital - statistics & numerical data; Health Services Accessibility - statistics & numerical data; Health services administration; Health Services Needs and Demand - statistics & numerical data; Hospitals; Hospitals, Public - organization & administration; Humans; Length of stay; National Health Programs - organization & administration; New South Wales; Organizational Innovation; Outcome and Process Assessment, Health Care; Patient Care Management - organization & administration; Patient Care Management - statistics & numerical data; Patient Readmission - statistics & numerical data; Patient satisfaction; Performance evaluation; Performance management; Workforce; New South Wales
• ISSN: 0025-729X; 1326-5377
• DOI: 10.5694/j.1326-5377.2008.tb01669.x

*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.