20,000 Days Campaign JourneyLearning Session 1

25 June 2013

Diana Dowdle - Campaign ManagerDavid Grayson – Campaign Clinical Leader

By 9am on 1 July 2013 the Campaign aims to give back to our community 20,000 healthy & well days, so reducing hospital bed days

by 20,000.

20,000 Days Campaign

dashboard

Version: 1.1Dated: 07/06/2013

20,000 Days Campaign Dashboard

May 2013

Campaign Manager : Diana DowdleClinical Leader: David GraysonImprovement Advisor: Ian Hutchby & Prem Kumar

Contacts

Comments: Cumulative bed day saving as at 31st May is 20,612Comments: The graph shows the difference between the Predicted and actual cumulative bed days.

Comments: There were a Dot Days on 22nd May – this is showing as a special cause (outside the upper control limit) as the previous Dot day was in September 2012, which is longer than we expect based on previous data

Comments: Admissions are stable and only normal variation existsComments: Unplanned readmissions is stable and only normal variation exists

Dashboard Summary: Cumulative bed day saving of 20,612 is a reflection of the difference between actual bed day usage and the predicted growth. This is reflection of the system as whole.

EC presentations and occupancy are showing special causes in February with lower than expected values. All other measures are stable and exhibiting normal variation.

Comments: ALOS is demonstrating a special cause with the last 8 months lying below the centreline – May’s value is very close to the centreline, so it is advisable to see if the change is sustained before revising the centreline and control l imits.

Comments: EC Presentations are showing a special cause variation, with the last 8 months being below the expected centreline – and February being outside the lower control limit

Comments: The Occupancy data shows a single special cause in February, since then the data has continued to show normal variation

Assessment and Observation

unit in EC

EHB Phase 2Gastro, 35N

EHB Phase 1

Ward 33,34

Assessment and Observation

unit in EC

EHB Phase 2Gastro, 35N

EHB Phase 1Ward 33,34June 2009

Assessment and Observation

unit in EC

EHB Phase 2Gastro, 35N

EHB Phase 1Ward 33,34June 2009

Assessment and Observation

unit in EC

EHB Phase 2Gastro, 35N

EHB Phase 1Ward 33,34June 2009

Days between Dot Days

0

50

100

150

200

250

300

29/0

6/20

09

16/0

6/20

10

04/0

8/20

10

12/0

1/20

11

01/0

3/20

11

26/0

5/20

11

13/0

6/20

11

21/0

6/20

11

15/0

8/20

11

27/0

2/20

12

27/0

6/20

12

10/0

7/20

12

23/0

7/20

12

04/0

9/20

12

14/0

9/20

12

22/0

5/20

13

Date of Dot Day

Day

s be

wte

en D

ot D

ays

CL = 13 LCL = 0

UCL = 196

Admissions

UCL

CL

LCL

80

90

100

110

Jul 2

009

Oct

200

9

Jan

2010

Apr

201

0

Jul 2

010

Oct

201

0

Jan

2011

Apr

201

1

Jul 2

011

Oct

201

1

Jan

2012

Apr

201

2

Jul 2

012

Oct

201

2

Jan

2013

Apr

201

3

Jul 2

013

Ave

rage

Dai

ly A

dmis

sion

s

Average Length of Stay

UCL

CL

LCL

3.40

3.60

3.80

4.00

4.20

4.40

4.60

4.80

5.00

Jul 2

009

Oct

200

9

Jan

2010

Apr

201

0

Jul 2

010

Oct

201

0

Jan

2011

Apr

201

1

Jul 2

011

Oct

201

1

Jan

2012

Apr

201

2

Jul 2

012

Oct

201

2

Jan

2013

Apr

201

3

Jul 2

013

ALO

S

Special cause – 8 consecutive months below the centreline

Readmission rate

CL

UCL

LCL

3%

4%

5%

6%

7%

Jul 2

009

Oct

200

9

Jan

2010

Apr

201

0

Jul 2

010

Oct

201

0

Jan

2011

Apr

201

1

Jul 2

011

Oct

201

1

Jan

2012

Apr

201

2

Jul 2

012

Oct

201

2

Jan

2013

Apr

201

3

Jul 2

013

Rea

dmis

sion

Rat

e

Cumulative Bed Days Saved Since June 2011

-2,000

-

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

22,000

Jun-

11

Aug

-11

Oct

-11

Dec

-11

Feb-

12

Apr

-12

Jun-

12

Aug

-12

Oct

-12

Dec

-12

Feb-

13

Apr

-13

Jun-

13

Actual vs Predicted Bed Days

120000

125000

130000

135000

140000

145000

150000

155000

160000

165000

170000

Jul-0

9Au

g-09

Sep-

09O

ct-0

9No

v-09

Dec-

09Ja

n-10

Feb-

10M

ar-1

0Ap

r-10

May

-10

Jun-

10Ju

l-10

Aug-

10Se

p-10

Oct

-10

Nov

-10

Dec-

10Ja

n-11

Feb-

11M

ar-1

1Ap

r-11

May

-11

Jun-

11Ju

l-11

Aug-

11Se

p-11

Oct

-11

Nov-

11De

c-11

Jan-

12Fe

b-12

Mar

-12

Apr-

12M

ay-1

2Ju

n-12

Jul-1

2Au

g-12

Sep-

12O

ct-1

2N

ov-1

2De

c-12

Jan-

13Fe

b-13

Mar

-13

Apr-

13M

ay-1

3Ju

n-13

Jul-1

3

Tota

l Bed

day

util

isatio

n ov

er a

rolli

ng 1

2 m

onth

per

iod

Actual bedday cumulative total Predicted bedday cumulative total

Occupancy

UCL

CL

LCL

10000105001100011500120001250013000135001400014500

Jul 2

009

Oct

200

9

Jan

2010

Apr

201

0

Jul 2

010

Oct

201

0

Jan

2011

Apr

201

1

Jul 2

011

Oct

201

1

Jan

2012

Apr

201

2

Jul 2

012

Oct

201

2

Jan

2013

Apr

201

3

Jul 2

013To

tal M

onth

ly B

ed D

ays

Occ

upie

d

EC Presentations-Growth

UCL

CL

LCL

6200

6700

7200

7700

8200

8700

9200

9700

10200

Jul 2

009

Sep

200

9

Nov

200

9

Jan

2010

Mar

201

0

May

201

0

Jul 2

010

Sep

201

0

Nov

201

0

Jan

2011

Mar

201

1

May

201

1

Jul 2

011

Sep

201

1

Nov

201

1

Jan

2012

Mar

201

2

May

201

2

Jul 2

012

Sep

201

2

Nov

201

2

Jan

2013

Mar

201

3

May

201

3

Jul 2

013

Tota

l Mon

thly

Pre

sent

atio

ns

Special cause – 8 consecutive months below the centreline

Alignments

Localities

Achieving the Aim by:• Building the Will – motivating health care

providers to think beyond the status quo & imagine a better system

• Harvesting the Ideas –finding, cultivating or inventing new approaches for better patient care

• Getting the Results – providing the support, methods & tools for teams to take action

Collaborative Structure

Select Topic

Expert Meetings

Identify Change

Concepts

Pre work

LS 125 June

LS 231 Oct -1 Nov

Collaborative Teams

Supports: emails/ visits/ reports/ sponsors / meetings/ assessments / conference calls

PA D

S

The Breakthrough Series: IHIs Collaborative Model for Achieving Breakthrough Improvement

LS – Learning Session

LS 06 May 2013

LS 3April 2014

Spread in

LocalitiesDivisions

WardsSectors

PA D

S

PA D

S

16 Collaboratives

• SMART• Well Managed Pain• Supporting Life after

Stroke• Enhanced Primary Mental

Healthcare• Inpatient care for people

with diabetes• Gout Busters• ACE -Acute Care for the

Elderly

• Franklin Co-ordination Service

• Mental Health Short Stay• Memory Team• Healthy Skin• Environmental Cleaning• Saving Feet• Helping At Risk People• Medical Assessment Unit

Campaign Milestones

Dragons’ Den session 25 March 2013

Interventions selected 5 -19 April 2013

Collaborative Teams established April/ May 2013

Learning Session 0 6 May 2013 (4 hours)

Learning Session 1 25 June 2013 (1 day)

Learning Session 2 31 October – 1 November 2013

Learning Session 3 April 2014

Celebration of Achievements June 2014

Savings Achieved 1 July 2014