Redesigning Care in the Paediatric Emergency Department CYWHS, SA - PowerPoint PPT Presentation

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Redesigning Care in the Paediatric Emergency Department CYWHS, SA

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Appointment of Clinical Project Officer (Nurse Specialist) and Team Leader ... Average patients per day 109 111. Average wait time 66min 49min ... – PowerPoint PPT presentation

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Title: Redesigning Care in the Paediatric Emergency Department CYWHS, SA


1
Redesigning Care in the Paediatric Emergency
Department CYWHS, SA
  • Presented by Ms Heather Gray
  • Chief Executive CYWHS
  • 25th November 2005

2
Patient First
  • A vision for improving the health of children,
    youth and women in South Australia

3
The Project Streams
  • Paediatric Emergency Services
  • Normal Vaginal Births
  • After Hours Hospital Care
  • Booking Process for Childrens Surgery

4
Paediatric Emergency Department Project Team
Mission Statement
  • Within 6 months, all patients presenting to the
    Paediatric Emergency Department will be assessed,
    treated and discharged (either home or to another
    ward) within 4 hours of their presentation
  • Acknowledgement to the PED Patient First Project
    and Guidance Teams

5
Problem worth solving
6
Problem worth solving
  • The Australasian Triage Scale represents an
    agreed set of national access performance
    indicators for Emergency Departments. The codes
    and performance thresholds are demonstrated in
    the table below

7
Project Plan
  • Appointment of Clinical Project Officer (Nurse
    Specialist) and Team Leader (Consultant) from PED
    staff
  • Empowering all staff to be involved in change
    workshops and focus groups formed
  • Clinical Project Officer facilitates
    communication and liaison between all staff
  • CPI methodology

8
See and Treat Seven days a week 1000 2200hrs
  • Triage nurse identifies See and Treat patients,
    based on set criteria
  • Approx 25 of presentations triaged as See and
    Treat
  • See and Treat patients seen in order of arrival
    not priority
  • Dedicated waiting and treatment area
  • Dedicated Experienced Medical and Nursing staff
  • initially commenced with 1.5 nurses and 1 RMO and
    1 Registrar, after staff feedback changed to 1
    Nurse and 1 Registrar
  • Experienced staff essential to maximizing
    potential of See and Treat

9
Patient Satisfaction Survey results Pre and
Post implementation of See and Treat
10
Patient Satisfaction Survey results Pre and Post
implementation of See and Treat
11
Overall impact on Paediatric Emergency Department
Seven week period late
September Mid November
2004 2005 Average patients per day
109 111 Average wait time
66min 49min Average length of stay 3 hr
20min 2hrs 45 min LOS gt 4 hrs
19 14 Did not waits 4
1 Presentations admitted
25 24
12
Overall impact on Triage data
13
Workforce development implications
  • Effective use of Nurse Specialists in See and
    Treat (as staffing numbers allow)
  • Nurse specialists role includes IV insertion,
    plaster application, nurse initiated analgesia.
  • Highlighted need for more Nurse Specialists or
    Extended Nurse Practioners
  • Nurse Practitioner role may impact on training
    opportunities for training doctors
  • No impact on training of RMOs noted at this
    stage

14
Workforce development implications
  • Anecdotal increase in staff morale and
    satisfaction will be confirmed with staff
    satisfaction survey
  • Anecdotal increase in engagement of staff in
    problem solving and decision making
  • All achieved in the midst of major redevelopment
    works

15
  • Questions?
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