Objective 1: Integrated Health and Social Care Agree baseline - 2015/16? Greater numbers of people being cared for in their own home Hospital admisson rates Care at home users / hours (client group, town / postcode, type of provision) ANNUAL, District nurse referral numbers, Number of persons with remote consultations, Number of registered users with telecare Reduced length of stay in hospital Average Length of Stay (by type) combined Portree / Broadford, Readmission rates, Delayed discharges ANNUAL Reduce unmet need for community services Admission to care home later in life (as able to stay in own home for longer) Average Length of Stay (by type, annual measure) Average age of admission, decrease in number of admissions at residential rate 5YRLY MEASURE Increased range of options for patient to access care locally Flexible bed use and why, admission rates by village / town New service, no baseline Reduced number of over 65s hospital admissions (unscheduled care) Emergency hospital admission rates by hospital and GP Practice Service users able to access services quickly and easily Number of contacts via single point of access Skye, Lochalsh and South West Ross s Realisation Workshop - 18 May 2016 v1 Page 1 of 8
Co-location of multi agency district teams in Hub and Spoke and opportunities for colocation with 3rd sector and partner organisations leads to less duplication, greater responsiveness to need; right person / time / place Quant & Qual Staff base / location (on same site), staff questionaire Redesign provides opportunities for flexible work patterns for community based staff, minimising travel Objective 2: Improve user experience Improved privacy and dignity for patients attending Hub and Spoke facilities Quant & Qual Mileage claims, staff questionnaire Quant & Qual Number of single rooms, Inpatient experience questionnaire, Day attender patient experience questionnaire (new), separation of waiting area from treatment area Monthly inpatient questionnaires - 20 per month 100% single rooms Improved experience of health and social care Qualitative User experience questionnaires, number of compliments, number of complaints Skye, Lochalsh and South West Ross s Realisation Workshop - 18 May 2016 v1 Page 2 of 8
Delivery of services closer to home Care at home users / hours (client group, town / postcode, type of provision) ANNUAL, Number of outpatient clinics provided locally Reduced number of inpatients travelling for x-ray services Number of patients transferred for x-ray services No inpatient transfers All inpatient care / treatment able to be delivered in one room; less disruption to service users, reduced infections and outbreaks Use of step up / step down beds provides more homely experience and increase patient choice End of life care; service users will have greater choice over where to die Infection control data e.g norovirus, C. difficile, SABs, number of times patients are moved between rooms, Suspension of services e.g. ward/bed closures Qualitative Patient experience questionnaire 2016/17 Death stats (place of death i.e. Home, hospital, care home), last 6 mths of life quality indicator, local audit, Use of Hospice by postcode, use of end of life funding packages 2015/16 Accessible WiFi for service users improving connection to the outside world and providing entertainment Presence / absence of accessible WiFi No accessible WiFi (2015/16) Skye, Lochalsh and South West Ross s Realisation Workshop - 18 May 2016 v1 Page 3 of 8
Objective 3: Improve access to services and care Improved environment and facilities allowing greater access to specialist outpatient clinics locally Number of patients seen in clinics in the locality, Number of specialist clinics held locally, Number of SLWR patients seen elsewhere (Raigmore/Belford etc), number of VC consultations. Link to transforming outpatients Increase Redesign of space to support increased use of telemedicine for patient consultations, reducing travel Redesign of space to support increased use of telemedicine for staff support & training Number of telemedicine consultations Number of telemedicine consultations, number and location of teleconf equipment Equality of access to services across all patient groups Quant & Qual Commmunity feedback, access audits Estates Skye, Lochalsh and South West Ross s Realisation Workshop - 18 May 2016 v1 Page 4 of 8
Objective 4: Maximise flexible, responsive preventative care Improved anticipatory care planning and collaboration, including maximising independence through support for self care Number of patients being cared for through virtual wards. Number of anticipatory care plans. Number of contacts through "lets get on with it together", Staff skill mix in community services, SPARRA readmission data /Integrated Teams Shift in balance of care from hospital to community Quant & Financial Hospital and community service budgets, occupied bed days, Care at home users / hours (client group, town / postcode, type of provision) More care in community, less in hospital /Integrated Teams Skye, Lochalsh and South West Ross s Realisation Workshop - 18 May 2016 v1 Page 5 of 8
Objective 5: Make best use of resources Reduction in estate and co-location of teams and services, incl third sector, will result in reduced operating costs (utilities bills, maintenance, rent, equipment costs etc) Financial Financial monitoring Expenditure on backlog maintenance Recurring costs (all buildings; hospitals, health centres, offices) Finance Lead Design of new hospital Hub will result in energy savings, reduced operating and maintenance costs A workforce skilled for the new model of service delivery Access to technology (e.g. WiFi) allows staff to work more effectively and efficiently Financial Financial monitoring Finance Lead Quant / Financial Staff skill mix (did we achieve what we set out to do in workforce plan), Number of staff with enhanced skills As per workforce plan Qualitative WiFi access Skye, Lochalsh and South West Ross s Realisation Workshop - 18 May 2016 v1 Page 6 of 8
Objective 6: Improve quality and safety of accommodation Improved quality of accommodation Quant & Qual NHS Scotland Design Process. Design Statement self assessment. Achieving Excellence Design Evaluation Toolkit (AEDET). AEDET April 2015 Fully compliant facility Quant & Qual Compliance with SHTMs and relevant legislation, HAIscribe, infection control report Improved physical environment for service users with sensory / cognitive impairment Quant & Qual Access panel audit, DATIX incidents (e.g. falls), OPAH audit, Dementia champions / staff training / audit, dementia audit tool Improvement in business continuity due to DATIX, Estates maximo work environment orders Facilities adaptable to new technology Allowance in design strategy for future adaptation e.g. spare duct space, capacity for additional plant, accessible service routes. Skye, Lochalsh and South West Ross s Realisation Workshop - 18 May 2016 v1 Page 7 of 8
Objective 7: Improve safety of service delivery Improved infection prevention and control due to fully compliant facilities Infection control data. HAI-SCRIBE (Healthcare Associated Infection Sysyem for Controlling Risk in the Built Environment) assessment, domestic monitoring, HAI audits Improved and more efficient cleaning regimes More sustainable and flexible hospital staff cover Modern new facility attracting new staff to the area, improving staff morale and retention, promoting economic development in SLWR area Qualitative National cleaning standards audit, domestic monitoring, HAI audit (walk round x1 per year, team of staff) DATIX incident reports, Recruitment, Vacancies, use of bank staff / locums, bed availability, sickness absence Staff retention / turnover, staff satisfaction, sickness absence, staff survey, imatter 100% Skye, Lochalsh and South West Ross s Realisation Workshop - 18 May 2016 v1 Page 8 of 8