Title: Redesigning Care in the Paediatric Emergency Department CYWHS, SA
1Redesigning Care in the Paediatric Emergency
Department CYWHS, SA
- Presented by Ms Heather Gray
- Chief Executive CYWHS
- 25th November 2005
2Patient First
- A vision for improving the health of children,
youth and women in South Australia
3The Project Streams
- Paediatric Emergency Services
- Normal Vaginal Births
- After Hours Hospital Care
- Booking Process for Childrens Surgery
4Paediatric 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
5Problem worth solving
6Problem 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
7Project 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
8See 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
9Patient Satisfaction Survey results Pre and
Post implementation of See and Treat
10Patient Satisfaction Survey results Pre and Post
implementation of See and Treat
11Overall 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
12Overall impact on Triage data
13Workforce 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
14Workforce 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
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