Southern Adelaide Local Health Network CLINICAL RECONFIGURATION. February 2016

Transcription

1 CLINICAL RECONFIGURATION February 2016

2 Acknowledgement of Country > We would like to acknowledge that this land we meet on today is the traditional land of the Kaurna people, and that we respect their spiritual relationship with their country. We also acknowledge that the Kaurna people are the custodians of the Kaurna land, and that their cultural and heritage beliefs are still important to the living Kaurna people today. 2

3 Background > New strategies implemented by SALHN are reducing inpatient length of stay and reducing bed requirements across the Network. > Length of stay reductions have resulted in beds being regularly flexed down over recent months. > This provides opportunities to reconfigure clinical services across the Network to maximise inpatient space and clinical expertise. 3

4 Benefits of Clinical Reconfiguration > There will be no impact on patient care through the clinical reconfiguration > All clinical services provided by SALHN will continue to be provided > The clinical reconfiguration program will: Right size wards to optimise skill mix and availability of senior staff Enable patients to be located with their specialist team reducing unproductive time spent locating and caring for patients in other wards Improve patient care, outcomes and support improved patient flow and discharge processes Provide more single rooms for improved patient care and more purpose built areas to support specialty areas 4 Include minor capital works to maximise available inpatient spaces

5 Other supporting factors for clinical reconfiguration > To support the expected increase in demand over winter months > Provide SALHN with more single rooms, more efficiently configured spaces and flex capacity if required > To create necessary inpatient space at FMC and Noarlunga Hospital for the future transfer of services from Repatriation General Hospital > To undertake a minor capital works program as part of the clinical reconfiguration process before winter, RAH ramp down and transfer of services from RGH. 5 > To create a Day Procedure Unit to more appropriately care for patients rather than treat in inpatient beds

6 Strategies to reduce inpatient length of stay > Long stay strategy focussing on patients with an extended length of stay In November 2015, there were more than 100 patients at FMC with a length of stay greater than 14 days. This is now around 70 patients, many of whom are no longer receiving acute medical care. Improving internal processes for access to tests, procedures or aged care assessments and facilitating timely discharge has reduced length of stay for these patients. 6

7 Strategies to reduce in patient length of stay > Timely Aged Care Assessment Team (ACAT) assessments In 2014/15 the average wait time for ACAT assessment was over 8 days at FMC, 8 days at RGH and 5.5 days at Noarlunga Additional ACAT assessors have been recruited and changes have been made to the management of ACAT assessment appointments. 7 Length of stay for patients awaiting assessment to return home or to residential facilities has reduced significantly with two thirds of assessments now completed within two days a reduction of up to six days for some patients

8 Strategies for sustainability > Efficiencies gained by new strategies are being reinvested to support new models of care such as the Development of Medical Ambulatory Care Service (MACS) at GP Plus Super Clinic Noarlunga Provide rapid access to specialist care for patients, reducing hospital admissions and Emergency presentations 8

9 Strategies for sustainability > Standardisation of care for planned surgical activity Increased the number of patients that admitted on the day of surgery, admitted for day surgery and 23 hour stays More surgery provided as day cases reducing the demand for in-hospital beds 9 > Enhancing patient care Collocating services and specialist expertise supports patient flow and ensures more patients are located with their home teams, providing more timely care of patients, reduced length of stay and improved outcomes

10 Proposed Clinical Reconfiguration Flinders Medical Centre > The Trainee Medical Officer Lounge (located in Ward 4A) to be relocated to vacant office space on Level 2 (previous CEO and COO office space) after minor capital works > Merge 4GS (Elective Short Stay) and 5D (Emergency Short Stay) services into Ward 5D space Creating a dedicated surgical short stay ward to maximise clinical expertise and reduce duplication Substituting some previous 23 hour and procedure work to Day Of Surgical Admission (DOSA) cases and the Day Procedure Unit 10

11 Proposed Clinical Reconfiguration Flinders Medical Centre > Relocate Ward 6B and Ward 4A to 4G space. Creating a larger medical ward from two smaller wards Ensuring more patients are located with their home teams and minimises safari rounds. Providing more timely review of patients and better outcomes 11

12 Proposed Clinical Reconfiguration Flinders Medical Centre > Relocation of 4GP (Mental Health) to 6B with minor capital works (environmental transition only) Providing a dedicated space for mental health consumers and no longer sharing a ward with surgical patients > Relocation of day procedures from previous Haematology/Oncology Day Unit space on Ward 5G to Level 2 clinics area 12 Providing a dedicated Day Procedure Unit to substitute inpatient work and enabling capital works to be undertaken in Ward 5G

13 Proposed Clinical Reconfiguration Noarlunga Hospital > Establishment of a Medical Ambulatory Care Service (MACS) at GP Plus Super Clinic Noarlunga will substitute some inpatient activity > Relocation of Whittaker Ward general medical services to Ward 4A at Flinders Medical Centre > Whittaker Ward will be utilised for another purpose in the future as the profile of Noarlunga Hospital changes 13

14 Clinical Reconfiguration proposed Timelines > February June 2016 > Proposed timings for moves Relocation of TMO Lounge - February 2016 Establish MACS April 2016 Merger of 4GS and 5D April 2016 Relocation of 6B to 4G April 2016 Relocation of 4GP to 6B May 2016 Merger of 4A with Ward 6B and relocation to 4G May 2016 Relocation of Whittaker Ward to Ward 4A at FMC June 2016 Relocation of Day Procedures to Level 2 clinics area June

15 In scope staff for Clinical Reconfiguration 15 Nursing Division of Medicine, Cardiac and Critical Care Division of Surgery and Perioperative Medicine Division of Mental Health Noarlunga Whittaker Ward (Medicine) Medical Trainee Medical Officers Division of Medicine, Cardiac and Critical Care FMC Surgical and Perioperative Medicine Division of Mental Health Noarlunga Whittaker Ward Allied Health FMC and Noarlunga Hospital Patient Services Assistants FMC and Noarlunga Hospital Administrative Ward Clerks/Admin Assistants at FMC and Noarlunga Hospital

16 Staff impacts of the proposed clinical reconfiguration > Some staff will be required to relocate across sites (NH to FMC) and within FMC > Vacancies will be held to give preference to staff in scope. > Some reporting lines will change > There will be no TVSPs and no forced redundancies 16

17 Staff impacts of the proposed Clinical Reconfiguration > Whittaker ward staff who transfer to FMC may have a change in reporting lines > Relevant staff in scope will be invited to put in their preference for work location as a result of clinical reconfiguration and ward location changes > In the event that the number of staff preference for positions is greater than the number of positions available, there will be a merit based process > HR Principles will be developed in consultation with stakeholders. 17

18 Staff impacts of the proposed clinical reconfiguration For RN3 staff: Options will be discussed with relevant staff as part of the consultation process Current vacancies within the Divisions may allow for agreement between affected staff on temporary placements Alternatively, a merit based process can be undertaken now, or in the future for affected Level 3 staff 18

19 Staff impacts of the proposed clinical reconfiguration For EN, RN1 and RN2 staff: Staff will be invited to submit their preference for relocating or remaining in a divisional or site based (for Noarlunga Hospital) bank roster A merit based Expression of Interest process will be undertaken if the number of staff preference for positions is greater than the number of positions available The bank rosters are virtual wards. Staff working in the bank rosters will be rostered according to their contracted hours across all shifts. Bank roster staff will work according to their rostered shifts but it may be in different areas. 19

20 Staff impacts of the proposed clinical reconfiguration For Allied Health staff Redistribution of roles across FMC Staff in scope at Noarlunga will be invited to submit their preference to transfer to FMC with Whittaker Ward A merit based Expression of Interest process will be undertaken and if the number of staff preference for positions is greater than the number of positions available Unallocated allied health staff will be matched to appropriate work across SALHN and will get first preference for vacancies across SALHN For Patient Services Assistants staff Staff at FMC will be reallocated to other areas within FMC Staff at Noarlunga Hospital will be reallocated to other areas within Noarlunga Hospital 20

21 Staff impacts of the proposed clinical reconfiguration For clerical staff In scope staff will be invited to submit their preference A merit based Expression of Interest process will be undertaken where applicable Unallocated staff will be matched to appropriate work and will get first preference for vacancies across SALHN 21

22 Consultation on Proposed Clinical Reconfiguration > Face to face meetings with in-scope staff > Staff forums will be held at FMC, Noarlunga and RGH on Tuesday, 16 February 2016 > A presentation of the proposed Clinical Reconfiguration will be delivered at divisional meetings. > In-scope staff identified as on long term leave will be written to, at their home address. > Feedback on the proposed Clinical Reconfiguration can be forwarded to the Chief Executive Officer via address Health.SALHNCEOOffice@sa.gov.au 22

23 Consultation on proposed Clinical reconfiguration > Feedback on the proposal commences from today until Friday 4 March > CEO News Bulletin will be issued to all staff advising of feedback process and timeframe, with a link to the presentation delivered at the staff forum. > Frequently Asked Questions (FAQ s) will be developed as required > Employee Assistance Program support services will be made available to staff during the consultation and implementation process. > Line manager and HR support will be available for employees. 23

24 Questions 24