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Length of Stay….. It’s everyone’s business Ben Wakeling, Whole of Health Program Lead, Wollongong Hospital Dean Askew, Subject Matter Expert, WoHP Team

Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

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Page 1: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Length of Stay…..

It’s everyone’s business

Ben Wakeling, Whole of Health Program Lead, Wollongong Hospital

Dean Askew, Subject Matter Expert, WoHP Team

Page 2: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Problem

2

Page 3: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The External Feedback

3

• 90 Day Challenge: Brad Astill

& Barbara Daly

• Dr Ian Sturgess

Answer: Complete LoS

System Review

Page 4: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Importance of Understanding Length of Stay

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• Indicator of efficiency that influences a hospital’s

capacity to treat patients, not the only one…

• LoS and Unplanned Readmissions both

important to monitor

• Reducing LoS creates capacity to care for other

patients, particularly where there is increasing

demand

• Patients and families do not want to be in

hospital

• LoS above what is required, increases the risk of

harm

Page 5: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Structured management processes

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• Few facilities systematically look at LoS strategically

• Dividing up actions by Short Term / Medium Term, and

Long Term LoS Management can help

• Understanding begins with good data and analysis.

Avoid clinician level data too early

• Non-onerous documentation is important to

track and also to build accountability

• Documenting LOS over time and good visual reporting

• Make links to others and identify sources of good practice

Interpretation support for teams is vital

Page 6: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Projects Approach

6

MoH Assistance: Dean Askew

Project Methodology

Project Team

• Exec Sponsor

• Project Sponsor

• Stakeholders incl Op’s

Managers, Medical Clinicians,

Pt Flow Manager, NUM’s, MDT.

Page 7: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Beginning to better understand Length of Stay

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• Reviewed best practice –

literature review

• Data review – Hospital,

Speciality, Ward, DRG,

Clinician

• Stakeholder feedback

Page 8: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Project Deliverables & KPI’s

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Page 9: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Our Solution-The Policy/Flowchart

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Page 10: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Short Term LoS

Page 11: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Short Term LoS

Page 12: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Medium Term LoS

Page 13: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Long Term/Strategic LoS - HRT

Page 14: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Impact-Hospital Level

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Page 15: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Impact-Hospital Level RSI

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Vic Hosp

NSW

Hosp’s

Vic Hosp

QLD Hosp

WA Hosp

ACT Hosp

NSW Hosp

NZ Hosp

Page 16: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Impact-Speciality Level

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General Medicine

Respiratory

General Surgery

RSI <100%

14/15 FY: 10/21

15/16 FY: 10/21

16/17 FY: 13/21

Page 17: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Impact-Ward Level

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17/18 FYTD

Bed Days Saved: 4,926

Productivity Saving:

$4,758,323

Page 18: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

The Impact-Readmissions (Quality/Safety)

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Page 19: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Project Enablers

• Medical Engagement

• Incentivising: Positive

Feedback, Competition &

making work fun!

• Culture & Leadership

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Page 20: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Next Steps & beyond

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Short term: Documentation &

updating the EDD Guides

Medium term: Expanded ePJB

Meetings & use of W4W

Long term: Expanded use of

HRT Data, adapting WoH

Meeting & transferring concept

Page 21: Length of Stay….. It’s everyone’s business · 2018. 4. 17. · Importance of Understanding Length of Stay 4 • Indicator of efficiency that influences a hospital’s capacity

Thank you for your time……

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Ben Wakeling, WoHP Lead, Wollongong Hospital

Dean Askew, SME, NSW MoH