Quality healthcare is vitally important, but with a lack of resources it can be hard for providers to meet these important needs. Health Services Innovation Tasmania is taking the challenge of providing quality healthcare via clinical redesign head-on, and helping healthcare professionals to better utilise existing healthcare resources
Ann Allanby is Assistant Director of Nursing, Cancer Services, THS Southern Region, and she took part in the HSI 5 day Applied Clinical Redesign Course.
Which HSI Tasmania workshop did you attend?
"The 5 day Applied Clinical Redesign Course held in 2016.
"My clinical redesign project aimed to improve after hours support for palliative care patients. We are only a small team and could not sustain the continual on call arrangements we were having to provide to deliver a high quality service. We wanted to improve our links with other providers to continue to meet our clients’ needs, respond in a timely manner using an appropriate provider and following a planned continuum of care."
What practical tools and techniques did you learn for health service improvement in your workplace?
"The problem solving tools and techniques (A4 methodology) were invaluable. They showed me how to break down a problem, analyse its causes and then use data to redefine the problem from what we thought it was, to what it actually is. The five-day course instilled in me the importance of using relevant data to help develop a solution to the problem I am trying to address – I hadn’t really given that enough emphasis before.
"Big picture process mapping sessions are an excellent way of getting all team members involved in analysing the problem we are trying to address. The sessions make people aware of the problem from different perspectives and help develop broad understanding of what influences others. The sessions keep everyone focussed on finding answers to problems and everyone is involved in developing ideas for solutions. These sessions really helped spread awareness and ownership across the whole group. We are now using big picture mapping ourselves, to start to engage a variety of stakeholders for possible change in other areas where we provide services (colorectal clinics)."
How have you benefitted personally from your attendance at HSI Tasmania courses?
"I feel much better equipped to balance the daily challenges of my role in cancer services. I have learned tools and techniques to assess a problem from a number of angles without jumping straight to a potential solution. This includes communication methods and the importance of evidence to justify a change I have made. The data analysis we undertook was excellent and I am much more inclined to question information before making a decision than I was before I completed the five-day workshop. Thorough data analysis provides a solid footing from which to make a change and helps get others involved in the change process when they can see the facts presented before them."
How has your team and workplace benefitted from the application of the clinical redesign methodology in your workplace?
"The problem we aimed to address was long standing and not sustainable from a staffing perspective. The redesign methodology helped us to assess the problem with a fresh mindset with consideration of the needs of all stakeholders and team members. It helped us to develop collective ownership of the program and for the solutions we devised to solve it.
"We only have a small palliative care team and we could not continue to support on call arrangements received direct from our clients over the long term. Initially, we used data analysis to ascertain the reasons why clients were calling our service directly (as opposed to their GP), peak times of demand, and ways in which we could divert demand to other service providers. We were able to identify the hours that our nurses needed to be available and then fill in gaps with after hours and primary providers including GPs and community nursing. We have been able to increase the links between community nursing, hospice@home and palliative care to continue to provide patients with excellent service while using a platform that is sustainable for staff in palliative care services.
"All our high needs clients now have a common after hours care plan which is developed by palliative care services, community nursing and other providers involved in their care. The after hours care plan drives agreed care strategies for each client and a consistent approach when care plans need to be changed or escalated to palliative care providers for advice. Working together in this way, we are able to continue to provide excellent services to our clients in a way that is sustainable for our staff."
We have continued to apply the tools and techniques from the 5-day course in a working group formed to develop required communications to all those affected by the changes we intend to make through my redesign project. The working group will also evaluate the changes made.
How have your patients benefitted from clinical redesign solutions implemented in your workplace?
"Our patients were receiving an excellent service but it the amount of work involved was not sustainable for our staff. Through the changes we are making, our patients will continue to receive excellent service but we will not need to increase our internal staffing numbers in order to deliver it."
Would you recommend HSI Tasmania workshops and courses?
"Yes, I would, the workshops provide excellent tools for assessing a situation and teach attendees how to practically apply those tools to address workplace problems."
Would you attend another HSI Tasmania course/workshop?
"Yes, with the five-day course, I tended just to pick tools and techniques that I could apply to my problem. I would consider attending another more intensive course where I can learn about all aspects of clinical redesign."
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