Improving Patient Pathways
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How to optimise systems & processes to deliver a cost effective service that works for both patients & staff alike, whilst achieving 'must do' targets.
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Improving Patient Pathways
- 2. Outline of Presentation BackgroundBackground RequirementsRequirements Our ApproachOur Approach Advantages of Working with Co- Creating Balance Advantages of Working with Co- Creating Balance SummarySummary
- 3. Background: NHS Plan [DoH 2000] 1. Our aim is to redesign the system around the patient 1. Our aim is to redesign the system around the patient 2. This involves: ï Looking at services from the way the patient receives them ï Planning the pathway that a patient takes from start to finish ï Best, modern clinical practice is identified & decisions made about which professional should best carry out which function 2. This involves: ï Looking at services from the way the patient receives them ï Planning the pathway that a patient takes from start to finish ï Best, modern clinical practice is identified & decisions made about which professional should best carry out which function
- 4. Care Pathways People and perfect processes make a quality health service â a poor quality service results from a badly designed and operated process, not from lazy or incompetent health care workersâ John Ovretviet, Health Service Quality, 1992 People and perfect processes make a quality health service â a poor quality service results from a badly designed and operated process, not from lazy or incompetent health care workersâ John Ovretviet, Health Service Quality, 1992
- 5. ICPs â what are they? 1. A tool & a concept that embed guidelines, protocols & locally agreed, evidence-based, patient centred, best practice, into everyday use for the individual patient 1. A tool & a concept that embed guidelines, protocols & locally agreed, evidence-based, patient centred, best practice, into everyday use for the individual patient 2. ICPs record deviations from planned care in the form of variance 2. ICPs record deviations from planned care in the form of variance
- 6. ICPs aim to have: ïthe right peopleïthe right people ïdoing the right thingsïdoing the right things ïin the right orderïin the right order ïAt the right timeïAt the right time ïIn the right placeïIn the right place ïWith the right outcomeïWith the right outcome ïAll with attention to the patient experienceïAll with attention to the patient experience
- 7. Bolt on to Current Services
- 8. Bolt on to Current Services
- 9. Bolt on to Current Services
- 10. Background: Each Area 2. Visit G.P2. Visit G.P 3. Local Hospital 3. Local Hospital 5. Rehabilitation Team5. Rehabilitation Team 4. Regional Hospital 4. Regional Hospital 6. Community Team 6. Community Team 1. Patient1. Patient 7. Specialist Team 7. Specialist Team 1. Patient1. Patient 7. Specialist Team 7. Specialist Team Each area is completely concentrating on their own roles and targets Each area is completely concentrating on their own roles and targets Are they managing an integrated patient pathway? Are they managing an integrated patient pathway?
- 11. Bolt on to Current Services
- 12. Requirements 1. Visit G.P1. Visit G.P 2. Local Hospital 2. Local Hospital 3. Regional Hospital 3. Regional Hospital 4. Community Team 4. Community Team 5. Specialist Team 5. Specialist Team 6. Rehabilitation Team6. Rehabilitation Team
- 13. Requirements 3. Regional Hospital 3. Regional Hospital 4. Community Team 4. Community Team 6. Rehabilitation Team6. Rehabilitation Team 1. Visit G.P1. Visit G.P 2. Local Hospital 2. Local Hospital 5. Specialist Team 5. Specialist Team
- 14. Create a Strong Base Implement Change Our Approach Overview of problem
- 16. Bolt on to Current Services
- 17. Current Pathway for Specialist Respiratory Services Tuesday, 16 Feb 2010 4 weeks4 weeks 5-6 weeks5-6 weeks 3-4 weeks3-4 weeks 2 weeks2 weeks 3 months 3 months 3 mths 3 mths 3 mths 3 mths 6 mths 6 mths 6 months6 months 6-8 weeks6-8 weeks S&S snoringS&S snoring Obstructive sleep apnoeaObstructive sleep apnoea About 10-20% require home visits for which there is no provision at present About 10-20% require home visits for which there is no provision at present Signs & symptoms Obese? Sleepy? Apnoea? Snoring? Signs & symptoms Obese? Sleepy? Apnoea? Snoring? Tests BMi ESS ABG Book SS Tests BMi ESS ABG Book SS Equipment dispensed at this appt Equipment dispensed at this appt Ongoing care by physios via telephone (helpline and/or face to face Ongoing care by physios via telephone (helpline and/or face to face Phone/see Physio plan Phone/see Physio plan Annual replacement consumables Annual replacement consumables Annual engineers CPAP service Annual engineers CPAP service 20% of patients 25% of patients 75% of patients EntEnt Referral to Ent Referral to Ent DischargeDischarge CPAPCPAP Discharge from medical follow up Discharge from medical follow up PCT 1° care appointment PCT 1° care appointment Referral via choose & book Referral via choose & book 1st OPA1st OPA Home sleep study (SS) Home sleep study (SS) 2nd OPA2nd OPA CPAPCPAP UrgentUrgent RoutineRoutine 3rd OPA3rd OPA IssuesIssues OPAOPA No issuesNo issues OPAOPA 80% of patients
- 18. One Stop Clinic Dr & Physio multidisciplinary Dr & Physio multidisciplinary This could be face to face or via telemedicine This could be face to face or via telemedicine Issues to be addressed Referred Proforma Choose & book process Backlog on CPAP Space for equipment storage SS admin Any other resources Issues to be addressed Referred Proforma Choose & book process Backlog on CPAP Space for equipment storage SS admin Any other resources 11 22 âą How many physios required for this? âą How many engineers required? âą How many physios required for this? âą How many engineers required? 33 1 wk1 wk 1 wk1 wk SSSS 1st OPA1st OPA Physio contact ongoing as required Physio contact ongoing as required Annual Physio consumables and also engineers review Annual Physio consumables and also engineers review EntEnt DischargeDischarge Dr OPADr OPA Physio Helpline 75% of patients 25% of patients ENTENT GPGP CPAPCPAP
- 19. Summary You have a need to improve âŠâŠ. You have a need to improve âŠâŠ. We have shown how our methodology will help We have shown how our methodology will help We provide a cost effective solution We provide a cost effective solution
- 20. Thank You