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A/Prof. Douglas Fahlbusch, MBBS, FANZCA, GDM,
GAICD
Reimagining Healthcare Transitions in Care
Calvary Adelaide Hospital Grand Round, 6 MAY 2021
What this talk is about
❖ Handover of data
❖ Human element of healthcare
❖ Making sense of healthcare complexity
❖ Examples of success
❖ Examples for possible improvement
You’re a Patient
❖ Health data with GP
❖ Health data with Surgeon/Specialist
❖ Health data with Hospital
❖ Process repeated in admissions,
holding bay, theatre, ward, discharge
Grocott et al. Perioper Med (Lond). 2017; 6: 9. (Open Access - Creative Commons Attribution 4.0 International
License)
Data Siloes - repeats in
hospital
Largely inaccessible
Repeated data entry
Minimal cross-checking
The Case for Better Use of Healthcare Data
What Do People Want?
Patients
- Information
- Know we care
(Not forms)
Healthcare Workers (HCW)
- Helping patients
- Enjoyable/Meaningful work
(Not forms)
Source: Australian Institute of Company Directors
Has healthcare kept
up?
Not everything has evolved at
the same rate
Healthcare is complex
How do we pursue
this?
Identify things that matter to:
- Patients
- HCW
Typically:
- Safety
- Efficiency
- Great Patient/HCW Experience
www.ichom.org - patient & HCW-centred care - worldwide
Over 80 Disease Sets
Data Sharing
Accessible data
Singular data entry
Cross-checking
Pre-operative (preflight) check
What can we do
Adapt safety/compliance initiatives to
local - our - conditions
Case Example
Team Time Out
Von Willebrand’s Disease
- preop Factor VIII
Spinal Cord Stimulator
- switch off in theatre
No mechanism to ensure this critical information handed
over - even though appropriate actions had been taken
Post-operative (Pre-landing) Check
Team Sign Out
Previous Case Example applies:
- no mechanism to ensure critical data handed
over
- no mechanism to gather team input to potential
problems and improvements
What about preparing for the next case?
- time-saved by alerting relieving staff member
Putting it into practice
Reinventing Healthcare
How do we achieve this
Find a process: something that matters to patients
and/or HCW
Organise a team: critical for innovative ideas
Don’t reinvent the wheel!
Document variations: some necessary, some not
so much
Hypothesise an improvement - to test
13
What this talk was about
❖ Handing over data is important
❖ Humans in healthcare are important
❖ Improve something meaningful
❖ Follow a process
–W. Edward Deming
“94% of failure is a result of the system … Not people.”
Further information, downloads and email newsletter:
www.douglasfahlbusch.com

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Care Transitions 2021.pptx

  • 1. A/Prof. Douglas Fahlbusch, MBBS, FANZCA, GDM, GAICD Reimagining Healthcare Transitions in Care Calvary Adelaide Hospital Grand Round, 6 MAY 2021
  • 2. What this talk is about ❖ Handover of data ❖ Human element of healthcare ❖ Making sense of healthcare complexity ❖ Examples of success ❖ Examples for possible improvement
  • 3. You’re a Patient ❖ Health data with GP ❖ Health data with Surgeon/Specialist ❖ Health data with Hospital ❖ Process repeated in admissions, holding bay, theatre, ward, discharge
  • 4. Grocott et al. Perioper Med (Lond). 2017; 6: 9. (Open Access - Creative Commons Attribution 4.0 International License) Data Siloes - repeats in hospital Largely inaccessible Repeated data entry Minimal cross-checking
  • 5. The Case for Better Use of Healthcare Data What Do People Want? Patients - Information - Know we care (Not forms) Healthcare Workers (HCW) - Helping patients - Enjoyable/Meaningful work (Not forms)
  • 6. Source: Australian Institute of Company Directors Has healthcare kept up? Not everything has evolved at the same rate
  • 7. Healthcare is complex How do we pursue this? Identify things that matter to: - Patients - HCW Typically: - Safety - Efficiency - Great Patient/HCW Experience
  • 8. www.ichom.org - patient & HCW-centred care - worldwide Over 80 Disease Sets
  • 9. Data Sharing Accessible data Singular data entry Cross-checking
  • 10. Pre-operative (preflight) check What can we do Adapt safety/compliance initiatives to local - our - conditions
  • 11. Case Example Team Time Out Von Willebrand’s Disease - preop Factor VIII Spinal Cord Stimulator - switch off in theatre No mechanism to ensure this critical information handed over - even though appropriate actions had been taken
  • 12. Post-operative (Pre-landing) Check Team Sign Out Previous Case Example applies: - no mechanism to ensure critical data handed over - no mechanism to gather team input to potential problems and improvements What about preparing for the next case? - time-saved by alerting relieving staff member
  • 13. Putting it into practice Reinventing Healthcare How do we achieve this Find a process: something that matters to patients and/or HCW Organise a team: critical for innovative ideas Don’t reinvent the wheel! Document variations: some necessary, some not so much Hypothesise an improvement - to test 13
  • 14. What this talk was about ❖ Handing over data is important ❖ Humans in healthcare are important ❖ Improve something meaningful ❖ Follow a process
  • 15. –W. Edward Deming “94% of failure is a result of the system … Not people.” Further information, downloads and email newsletter: www.douglasfahlbusch.com