F - Demand and Capacity Planning. Laurence Keenan, Service Improvement Manager, Whole System Patient Flow Improvement Programme

Transcription

1 F - Demand and Capacity Planning Laurence Keenan, Service Improvement Manager, Whole System Patient Flow Improvement Programme 1

2 Session Agenda Welcome Dr Tom Jarosz-Cromie, Capacity Planning Programme Manager, NHS Tayside Jonathan Todd, Head of Information Management & Derek Phillips, Information Manager, NHS Greater Glasgow and Clyde Group Discussion

3 In the last decade Improved understanding and use of DCAQ methodology Significant reduction in waiting times Reduced financial budgets available Enhanced technology to support analysis, modelling and dissemination of DCAQ to those who need it most Remaining challenges to operationalise DCAQ information to achieve optimal patient flow and sustainable delivery of targets for services.

4 NHS GG&C DCAQ Specialty Analysis Presentation I M P R O V I N G P A T I E N T F L O W I N S C O T L A N D O C T O B E R Jonathan Todd, Head of Information Management & Derek Phillips, Information Manager, NHS Greater Glasgow and Clyde

5 DCAQ Methodology Demand, Capacity, Activity and Queue (DCAQ) is a service improvement methodology used to: Analyse waiting list management. Define and regulate service capacity. Monitor patient throughput. Support effective demand management. The overall goal of the DCAQ methodology is to manage capacity and demand appropriately and effectively. Source:

6 DCAQ Definitions Demand is all referrals, walk ins, ambulance cases, etc coming in from all elective sources e.g. GPs, A&E, OPs, etc. Capacity is all the resources available to do the work required e.g. OP slots, IPDC theatre slots, etc. Activity is the work undertaken e.g. scheduled OP attendances, scheduled IPDC theatre admissions etc. Queue is the previous demand that has not yet been dealt with showing itself as a waiting list. Every time your demand exceeds your capacity you carry forward the excess demand as a queue. Source:

7 Service Involvement and Output Service involvement is required from directors, general mangers, clinical services managers and waiting list administration staff. Communication is required when establishing subspecialty level information, identifying WLI clinics/sessions, determining and validating service capacity and interpreting results. Each service/speciality is unique and managed differently and each have their own specified recommendations on how the format of final report should be displayed. The final report format must be tailored towards various service recommendations and results of the report must be accurate and resonate with the services to be meaningful. Various clinical decisions can be made using the report output.

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10 Any Questions? I M P R O V I N G P A T I E N T F L O W I N S C O T L A N D O C T O B E R

11 Dr Tom Jarosz-Cromie, Capacity Planning Programme Manager

12 Hospital Flow How do we know our Hospitals are functioning well? What are the key measures? How are they connected? How do we visualise this?

13 The Key Relationship Admissions/Discharges Length of Stay Beds Capacity = Volume x Duration Utilisation Occupancy

14 How does it work? In a 40 bedded Unit, 40 admissions per day with an average Length of Stay of 1 day and 100% Occupancy Capacity = Volume x Duration Utilisation 40 = 40 x 1 1 To achieve an Occupancy of 90% for example: Options 1. Increase no. beds 2. Decrease no. admissions 3. Decrease LoS 40 = x Target Occupancy

15 Exploring Options 1 and 3 Option 1. Increase the Beds 40 x = 45 beds required to achieve 90% Occupancy Option 3. Decrease Average Length of Stay 40 = 40 x? 0.9? = 40 x = 0.9 of a day = 21hrs 36mins Target Length of Stay to achieve 90% Occupancy

16 The Matrix Patient Flow A&E Assessment Unit Acute Wards Community Wards No. Admissions 1000 attendances 200 Admissions 150 Admissions 25 Discharges Length of Stay 180 minutes 25 hours 6.4 days 42 % Occupancy n/a 91% 95% 99% Trigger Points Pressure

17 Matrix Measures by Flow Medical and Surgical, Emergency and Elective Admissions Length of Stay Occupancy Are we getting it right? What are the barriers to flow?

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22 Elective Flow Traditional Capacity Planning

23 DCAQ Demand Referrals Received/Additions to List Capacity Clinic Slots/Theatre Time Available Activity Outpatients seen/ipdc Admissions plus Removals Other Than Treatment Queue Waiting List Size

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27 The Capacity Planning Team Name Job Title Ext. No. Dr Tom Jarosz-Cromie Capacity Planning Programme Manager Jaime Lyon Capacity Planning Project Manager Aarthi Rajendran Capacity Planning Project Manager Nikki Singers Information Analyst Chris Kinnear Information Officer Kenny Kyles Information Officer

28 Table Discussions What are the key interventions your Board/area of work has introduced, or are working on, to improve the operational effectiveness of DCAQ information? What are the main barriers to this?

29 Breakout Sessions Sessions A Patient Turnaway What Is It and How Do We Reduce It? B Criteria Led Discharge C Flowopoly Re-Enacting Patient Flow Using Table-Top Scenarios D Measuring Flow for Improvement E 7 Day Services F Demand and Capacity Planning G Patient and Staff Engagement to Support Redesign of Services H Flow is a Safety Issue I Implementing IHO s Methodology in Scotland Room Erskine Fintry Mull Glendevon Callander Dollar Allanwater Hermitage Blairlogie Ochil Blair Atholl 29

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