“The medical patient journey is a high volume cohort of patients that can present opportunities for improvement of systems and processes and therefore improve access to beds sooner for admitted patients. Two large bodies of work were instigated in the south and north of Tasmania. Extensive diagnostics included, big picture mapping, auditing ward rounds and multi-d meetings, pulling data from existing IT systems and surveying staff and patients. Solutions were very similar across the state and they included aligning the medical teams with wards, this allowed medical ward rounds to occur in a timelier manner. Restructuring multi-d meetings to include a senior decision maker and increased to daily. These initiatives led to a saving of 2980 bed days in the south and approximately 1500 in the north.
“It feels like we’re much more organised now; we know exactly what the plan is for the Gen Med patients.” CC
To maximise improvements in the Outpatient setting we used the Rapid Improvement event methodology. The first round consisted of five units, specifically chosen because of long wait lists/times, high DNA and cancellation rates. Teams from each unit spent two days together, reviewing current state, learning some key “ Lean thinking” principles and possible solutions. By the end of day two, the teams had clear action plans to move forward. They benefited by being able to cross pollinate ideas. Over the next 6 months the units implemented their changes which included defining discharge criteria, promoting DNA policy, instigating “non-acceptance letters, redefining core business and instigating clerical audits. Outcomes: 42% reduction in Colorectal waitlists, 49% reduction ion ophthalmology waitlists, 35% in plastics waitlists, freed up 400 + appointments in Ophthalmology.
The applied Lean Thinking in Healthcare course provides the student with opportunity to work on their own problem from their healthcare area. They utilise the diagnostic techniques to get to the root cause of their problem and then apply solution techniques to improve the journey for the patient and manage work/life balance for staff as well. We were also available for mentoring as required.” Great course. Essential learnings in any discipline, especially in the public health system”