Surgical Services Group Allied Health Clinical Services 14 February 2017
Document control Version Date Prepared by Comments v0.1 09/01/2017 T. Hydes Initial draft v0.2 13/01/2017 K. McCleary Update Initial draft v0.3 16/01/2017 N. Powell Update Initial draft v0.4 20/01/2017 T. Hydes, J. Elsley Update draft v0.5 27/01/2017 T. Hydes, K. McCleary, G. Turato, N.Powell, T. Update draft Hickson-Jamieson v0.6 02/02/2017 K. McCleary, G. Turato Update draft v1.0 08/02/2017 T Hydes Final version Document Distribution Name Title Function Gemma Turato Clinical Director Allied Health Clinical Services Curtis Plate SCUH Commissioning / Program Manager Sunshine Coast University Hospital (SCUH) Jan Elsley Principal Project Officer Human Resources Tara Hickson- Jamieson Business Manager Finance Officer SSG Finance, Business and Operational Services Elaine Hausler A/ Nursing Service Director Surgical Service Group (SSG) Amanda Nolan Allied Health Manager Surgical Service Group (SSG) / Allied Health Kate McCleary Advanced Practitioner Physiotherapist ICU SSG / Allied Health Nola Powell Senior Social Worker SSG / Allied Health Approvals Approver Date Approved Lois Craig, Director HR Operations 8 February 2017 Gemma Turato, Clinical Director Allied Health 8 February 2017 Endorsed by Date Approved Kerrie Hayes, Executive Director Clinical Services 9 February 2017 Endorsed Business Case for Change confirms: The signatory s belief that the achievement of the identified business value and benefits justifies the investment of capital, recurrent funds and resources (including human, accommodation and equipment) as currently estimated and their support for progressing this initiative. The business case has undergone appropriate review Consultation with key stakeholders as outlined in Section 5 has occurred Related Documents Document name Author Model of Care - Intensive Care Services December 2015 Proposed Transition Plan Surgical Services March 2016 http://qirc.qld.gov.au/qirc/resources/pdf/awards/h/health_practitioners_and_dental_officers. Queensland Industrial pdf Relations Commission (QIRC), Qld Public Health Sector Certified Agreement ( Part 3 - consultation, Part 4 organisational QH and representative for QH change and restructuring employees District Health Services Employees' Award = State 2012 (Section 4.6) and other related Queensland Industrial sections, Relations Commission (QIRC), 2 P a g e
Contents 1. Purpose 4 2. Rationale for Change 4 3. Proposed Change 5 3.1 Scope 5 3.2 Details of the Changes 5 4. Timeframes 6 5. Communication and Consultation 6 5.1 Supporting employees through change 7 Attachment 1: Proposed Physiotherapy Surgical Services 2017 weekend roster 8 Attachment 2: Proposed Physiotherapy Surgical Services 2017 on call roster 10 Attachment 3: Proposed Social Work Roster 11 Attachment 4: Draft procedure Social Work on-call ICU 12 Attachment 5: Indicative timeframe and activities 15 3 P a g e
1. Purpose This Business Case for Change outlines the proposed roster changes to the Sunshine Coast Hospital and Health Service (SCHHS) Surgical Services Group - Allied Health (SSG AH) service to meet the change in service delivery at Nambour General Hospital (NGH) and the increase in service delivery at the new tertiary teaching hospital Sunshine Coast University Hospital (SCUH). This document is to assist consultation with employees and relevant unions, and facilitate communication and engagement to minimise the impacts on existing SCHHS employees. In accordance with the Queensland Health Framework Award State 2012 requirements, employees and unions are invited to provide feedback about the proposals outlined in this document. This Business Case for Change is approved for release for employee and stakeholder communication and feedback. 2. Rationale for Change In October 2015 (Decision paper Growth and Expansion: Our Future Opportunity) the SCHHS embarked on a significant transformation journey to the opening of the SCUH; by realigning and expanding functions and teams to effectively manage the services that will be provided across the Health Service and at the new SCUH facility. With the opening of SCUH the function of service includes a comprehensive elective surgery program plus a 24-hour a day, seven days a week emergency surgical response service. As a result of these decisions, the existing SCHHS model of care for intensive care services dated December 2015 will increase service requirements to a level 5 as defined in the Clinical Service Capability Framework (CSCF). The proposed transition plan Surgical Services Group (dated March 2016) outlines the service model and proposed workforce roster changes required for the delivery of services that the CSCF increase will result in: workforce requirements through the provision of allied health services within Intensive Care Unit (ICU) to support CSCF 5; include access to social work services on a 24-hour basis, and access to physiotherapist services on a 24-hour basis. The aim is to move, settle and grow. It will take time to ramp up to a 24-hour service, and therefore an increased evening service from social work and physiotherapy is proposed during the settle phase: with future aim of on-call to ensure 24-hour service. It is anticipated that the proposed changes to Surgical Services Group (SSG) - Allied Health will be finalised by mid-march 2017, to enable service model and workforce changes that will be required for day 1 SCUH. 4 P a g e
3. Proposed Change 3.1 Scope The proposed changes provide new and expanded services to be delivered under Surgical Services with the opening of SCUH. Within scope are: Workforce Roster Changes: The rostering arrangements for surgical stream physiotherapists supporting Intensive Care Unit (ICU) are proposed to change to include extended hours, weekend, public holiday and on call rostering arrangements to support the 24-hour a day, 7 day week operations of ICU. Social workers supporting Intensive Care Unit (ICU): an extension of hours is proposed; including the rostering of weekend, public holiday shifts. Changes to rosters of the other Surgical Services Group - Allied Health professions, inclusive of dietitians, occupational therapists and speech pathologists: rostering of public holiday shifts. 3.2 Details of the Changes Workforce Roster Changes Table 1 below outlines the current rosters for each of the professional groups. Table 1: Current and Proposed Rosters. Physiotherapy Surgical Services Social Work Surgical Services Dietitians, Occupational Therapists and Speech Pathologists Current Monday Friday 0730-1630 Saturday / Public Holiday 0800 1630 Sunday on call 0800 1630 Monday Friday 0730-1600 Monday Friday 0800-1630 Proposed Monday Friday 0700 2200 * On call 2200 0800 Saturday / Public Holiday 0800 1630 * On call 1630 0800 Sunday 0800 1630 * On call 1630 0800 Monday Friday 0800 2000 **On call 2000 0800 Saturday Sunday / Public Holiday 0800 2000 **On call 2000 0800 Monday Friday 0800-1630 Public Holiday 0800 1630 * On call roster covered on a rotational basis by surgical stream physiotherapists that have completed cardiorespiratory competencies. ** On call will be provided via the Allied Health In-Kind Service Agreement from Medical Service Group based on Clinical Prioritisation system. 5 P a g e
Due to the increase in CSCF level 5 for the intensive care unit at SCUH, and the complexity of service provision, it is proposed that the increase hours of operation will support the extension of current hours, with an increased on-call service component that provides services across a 24- hour a day, 7 day a week model (inclusive of weekends and public holidays). (Refer to Table 1). Refer to Attachment 1 for details of the proposed Physiotherapy Surgical Services 2017 weekend roster. Refer to Attachment 2 for details of the proposed Physiotherapy Surgical Services 2017 on call roster. The proposed social work roster suggests an increase to a 10 hour shift arrangement with staggered start times. Informal consultation with staff and feedback to date has indicated that the extension in service coverage while increasing patient access to services may also provide a suitable work life balance to staff. Refer to Attachment 3 for details of the proposed Social Work roster. Refer to Attachment 4 for details of the draft procedure Social Work on-call ICU. The proposed roster change for dietitians, occupational therapists and speech pathologists includes increased rostering to include public holiday s shifts which will support the required service delivery model of surgical services. 4. Timeframes The proposed activities and timeframes for progressing the implementation of the SCHHS Surgical Services Group Allied Health are outlined below: Business Case for Change released Feedback period Feedback considered SSG AH Roster Submission SSG AH Roster commences 14 February 2017 14-28 February 2017 2-3 March 2017 22 March 2017 27 March 2017 Ongoing consultation As each activity is progressed, further communication, consultation and detail will be provided to employees. Refer to Attachment 5 for an indication of the activities and timeframes proposed for implementation of the SCHHS Surgical Service Group - Allied Health roster changes. 5. Communication and Consultation Employee engagement and consultation with relevant unions will occur in a timely manner to ensure employees are kept informed and up to date regarding the service model change for Surgical Services Group Allied Health. During the past six (6) months, informal consultation has occurred through discussion with individual staff, teams, and other clinical service groups in the development of proposed roster mapping. 6 P a g e
Throughout this consultation process Surgical Services Group Allied Health has identified proposed roster changes to meet service requirements; staff are encouraged to provide their individual feedback on the proposed roster changes. At the conclusion of the consultation period staff feedback will be considered to determine collective agreement to implement the proposed roster. Information will be provided to employees and other stakeholders within the scope of the change by the SSG Allied Health Discipline Advanced Practitioners and SSG Allied Health Manager. Stakeholders are invited to provide feedback in relation to the Business Case for Change by close of business 28 February 2017 via schhs_workforceconsultation@health.qld.gov.au. 5.1 Supporting employees through change During the implementation of the Surgical Services Group Allied Health the SCHHS commits to its obligations to employees as outlined in the Public Service Commission Chief Executive Directive 17/16: Supporting employees affected by workplace change, and Department of Premier and Cabinet Employment Security Policy. The SCHHS values and respects its employees, and the contribution they make in the delivery of health services. While the SCHHS is entering an exciting chapter with a unique expansionary journey over the next few years, the SCHHS recognises that change can be challenging for some employees. The SCHHS will offer employees the following support throughout this service model change: Ongoing communication to provide accurate, up-to-date information on organisational change and the likely impact of changes on the employees as soon as is possible via emails and team meetings. Encouragement to contact the Employee Assistance Program (EAP) on 1800 604 640 should employees require professional support through organisational change. Targeted and whole of Hospital Health Service change, engagement, organisational readiness programs provided by HR. 7 P a g e
Attachment 1: Proposed Physiotherapy Surgical Services 2017 weekend roster Rosters will be completed when the opening date for SCUH is announced. Roster combined with Medical Services Group PT staff in current format until streams split. Month Date Staff Member Rostered ON Saturday and On-Call Sunday Staff Member On-call Saturday April 1-2 8-9 Easter Friday Friday 14 15-16 Easter Monday Monday 17 22-23 HP5 ICU HP3 Surgical 2 Anzac Day Tuesday 25 HP3 ICU HP3 Surgical 1 29-30 HP4 ICU HP3 o/patients 1 May Labour Day Monday 1 Surgical IPU 1 HP3 Surgical 2 6-7 HP5 Surgical HP3 o/patients 2 13-14 (Perm w/end staff member) HP3 o/patients 3 20-21 HP4 Surgical 1 HP3 Surgical NGH 1 27-28 HP4 Surgical 2 HP4 Surgical NGH 1 June CHS show Day FRIDAY 2 Surgical IPU 2 HP3 ICU 3-4 HP4 Surgical 3 HP5 ICU 10-11 (Perm w/end staff member) HP5 Surgical 17-18 HP4 Surgical 4 HP4 Surgical 1 24-25 HP3 ICU HP4 Surgical 2 July 1-2 HP3 Surgical 1 HP4 Surgical 3 8-9 (Perm w/end staff member) HP4 Surgical 4 15-16 HP3 Surgical 2 HP4 ICU 22-23 HP3 o/patients 1 HP3 Surgical 1 29-30 HP3 o/patients 2 HP3 Surgical 2 August 5-6 (Perm w/end staff member) HP3 ICU 12-13 HP3 o/patients 3 HP3 o/patients 1 19-20 HP3 Surgical NGH 1 HP3 o/patients 2 26-27 HP4 Surgical NGH 1 HP3 o/patients 3 September 2-3 (Perm w/end staff member) HP3 Surgical NGH 1 9-10 Repeat roster 16-17 23-24 October 30-1 Queen s Birthday Monday 2 7-8 14-15 21-22 8 P a g e
Month November December 28-29 4-5 11-12 18-19 25-26 Date 2-3 9-10 16-17 23-24 Christmas Day Monday 25 Boxing Day Tuesday26 30-31 2018 January New Year s Day Monday 1 6-7 Staff Member Rostered ON Saturday and On-Call Sunday Staff Member On-call Saturday Proposed Frequency of Shifts in Physiotherapy Surgical Stream: Rostered Weekend: once every four months; Rostered Weekend On-Call: once every three months; Rostered Public Holiday: one per year; Rostered Public Holiday On-Call one per year; and Carrying overnight on-call pager: three (3) weeks per year (Approx. 1 week every four months). 9 P a g e
Attachment 2: Proposed Physiotherapy Surgical Services 2017 on call roster Staff are on-call 2100Hrs Monday until 0800Hrs Saturday of the week stated, minus normal business hours. Month Date (week beginning) Staff Member Rostered on-call for PT SSG March 27 th April 3 rd HP5 ICU 10 th HP5 Surgical IPU 17 th HP4 Surgical 1 24 th HP4 Surgical 2 May 1 st HP4 Surgical 3 8 th HP4 Surgical 4 15 th HP4 ICU 22 nd HP3 Surgical 1 29 th HP3 Surgical 2 June 5 th HP3 ICU 12 th HP3 o/patients 1 19 th HP3 o/patients 2 26 th HP3 Surgical NGH 1 July 3 rd HP3 o/patients 3 10 th HP4 Surgical NGH 1 17 th Surgical IPU 1 24 th Surgical IPU 2 31 st HP5 ICU August 7 th HP5 Surgical IPU 14 th HP4 Surgical 1 21 st HP4 Surgical 2 28 th HP4 Surgical 3 September 4 th HP4 Surgical 4 11 th HP4 ICU 18 th HP3 Surgical 1 25 th HP3 Surgical 2 October 2 nd HP3 ICU 9 th HP3 o/patients 1 16 th HP3 o/patients 2 23 rd HP3 Surgical NGH 1 30 th HP3 o/patients 3 November 6 th HP4 Surgical NGH 1 13 th Surgical IPU 1 20 th Surgical IPU 2 27 th HP5 ICU December 4 th HP5 Surgical 11 th HP4 Surgical 1 18 th HP4 Surgical 2 25 th HP4 Surgical 3 2018 January 1 st HP4 Surgical 4 8 th HP4 ICU It is anticipated each staff member is rostered on-call three (3) times every twelve (12) months for a five (5) day cycle. 10 P a g e
Attachment 3: Proposed Social Work Roster Week 1 Classification Ward Monday Tuesday Wednesday Thursday Friday Saturday Sunday HP5 ICU 10am - 8pm 10am 8pm HP3 ICU 10am 8pm 10am 8pm 10am 8pm 10am 8pm 10am 8pm HP4 Surgical 8am 6pm 8am 6pm 8am 6pm 8am 6pm 8am 6pm HP3 Surgical 8am 6pm 8am 6pm Week 2 Classification Ward Monday Tuesday Wednesday Thursday Friday Saturday Sunday HP5 ICU RDO 10am 8pm 10am 8pm 10am 8pm 10am 8pm 10am 8pm HP3 ICU 10am 8pm 10am 8pm 10am 8pm HP4 Surgical 8am 6pm 8am 6pm 8am 6pm HP3 Surgical 8am 6pm 8am 6pm 8am 6pm 8am 6pm 8am 6pm 8am 6pm Week 3 Classification Ward Monday Tuesday Wednesday Thursday Friday Saturday Sunday HP5 ICU 10am 8pm 10am 8pm HP3 ICU 10am 8pm 10am 8pm 10am 8pm 10am 8pm 10am 8pm HP4 Surgical 8am 6pm 8am 6pm 8-6 8-6 8-6 HP3 Surgical 8am 6pm 8am 6pm Week 4 Classification Ward Monday Tuesday Wednesday Thursday Friday Saturday Sunday HP5 ICU 10am 8pm 10am 8pm 10am 8pm 10am 8pm 10am 8pm 10am 8pm HP3 ICU 10am 8pm 10am 8pm RDO HP4 Surgical 8am 6pm 8am 6pm RDO HP3 Surgical RDO 8am 6pm 8am 6pm 8am 6pm 8am 6pm 8am 6pm Roster to be reviewed 6 months post commencement. 11 P a g e
Attachment 4: Draft procedure Social Work on-call ICU Intensive Care Unit On-Call Social Work Procedure Statement The purpose of this guideline is to detail the role of the Intensive Care Unit On-Call Social Work Service. This guideline relates to all staff of the Surgical Services Stream of the Sunshine Coast University Hospital to ensure referrals for Emergency On - Call Social Work are appropriate, timely and communicated. On-call Social Work services are provided outside of general Intensive Care Unit Social Work business hours and cover the time period between: 2000hrs 0800hrs, 7 days per week. Social Workers will be the first point of contact if services (as determined in referral criteria below) are required. Outside of these hours i.e. 2000hrs 0800hrs social work will be provided via the Allied Health In-Kind Service Agreement from Medical Services Group based on a Clinical Prioritisation system. The service will be available for cases only as detailed within specified referral criteria. Scope The content of this document applies to all employees of the Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service. Intent/Purpose To ensure that an Emergency Clinical On-Call Social Work Service is available to Surgical Services patients and their families under specified referral criteria. To ensure effective use of the Emergency Clinical On-Call Social Work Service. To meet the crisis needs of patients and families outside of normal working hours to enable improved psychosocial outcomes for them. To provide an effective and efficient service with available resources. This requires that the service be restricted to targeted referrals only. Intensive Care Unit staff identify the need for Emergency On-call Social Work support and determines that the situation meets the referral criteria. Ward staff then contact the Nurse Manager/Team Leader to confirm that the situation meets the referral criteria. Nurse Manager/Team Leader then contact the oncall Social Worker. Nurse Manager/Team Leader provides all relevant information to Social Worker via telephone contact. Social Worker utilises this information to triage the situation. Social Worker, in consultation with Nurse Manager/Team Leader, determines an action plan which may involve the Social Worker coming to the hospital to provide assessment and intervention as required. Upon arrival at the hospital Social Worker to inform Nurse Manager/Team Leader of their arrival. Referral Criteria ** Any matters that can wait until the next working day are not an appropriate use of this service Death or expected death by suicide where the patient is admitted to the Intensive Care Unit. Death or expected death by assault/homicide where the patient is admitted to the Intensive Care Unit or Theatre. Unexpected or traumatic death that occurs within theatre. Acute deterioration or death of a child within the Paediatric Intensive Care Unit. Complex psychosocial dynamics/needs that the nursing and medical team require Social Work support to manage. 12 P a g e
THE ON - CALL SERVICE DOES NOT RESPOND TO Accommodation Issues. Financial or Welfare Emergencies. Referrals for appointments that can be managed in normal business hours (Monday- Sunday 0800hrs 2000hrs) Discharge Planning Patients presenting with Mental Health Issues. Assistance with travel. Responsibilities The Allied Health Manager Surgical Services is responsible for the overall effectiveness and efficiency of the service, service reviews and the management of any issues as they arise. The After Hours Nurse Manager/Intensive Care Unit Team Leader screens the referrals to meet service policy as outlined. The After Hours Nurse Manager/Intensive Care Unit Team Leader is responsible for contacting the oncall Social Worker as/when required. On-Call Social Worker, post telephone contact with Nurse Manager/Team Leader ascertains the most appropriate course of action and provides Social Work services as appropriate. Upon arrival to the Sunshine Coast University Hospital the On-Call Social Worker to alert Nurse Manager/Team Leader to attendance. Upon leaving the Sunshine Coast University Hospital upon completion of work conducted the On-Call Social Worker to alert Nurse Manager/Team Leader. Nurse Manager/Team Leader to complete Social Work Call-In Intervention Log and email to the relevant Operational Manager Surgical Services. On-Call Social Worker to complete Social Work Call-In Intervention Log, in full, upon completion of oncall intervention and provide to the relevant Allied Health Operational Manager. Professional Lead/Advanced Practitioner/Allied Health Operational Manager - Surgical to be responsible for co-ordination of appropriate debriefing and supervision as required. AFTER HOURS CONTACT INSTRUCTIONS Ward staff ascertain On-Call Social Work service requirement (as per referral criteria). Ward staff to contact Nurse Manager/Team Leader regarding On-Call Social Work request. Nurse Manager/Team Leader contacts On-Call Social Worker and provides relevant information. On-Call Social Worker determines most appropriate course of action and provides relevant information to Nurse Manager/Team Leader (advice, need to come to Hospital etc.). If attending the Sunshine Coast University Hospital, the On-Call Social Worker alerts Nurse Manager/Team Leader of their arrival at Hospital. On-Call Social Worker to complete Social Work Call-In Intervention Log, in full, upon completion of oncall intervention and provide copy to the relevant Operational Manager of Allied Health Surgical Services office. Upon leaving the Hospital upon completion of work conducted On-Call Social Worker to alert Nurse Manager/Team Leader. 13 P a g e
Social Work Call-In Intervention Log Date: Time of Initial Social Work Contact: UR: Ward/Area Requesting: Referral Reason: Death or expected death by suicide where the patient is admitted to the Intensive Care Unit. Death or expected death by assault/homicide where the patient is admitted to the Intensive Care Unit or Theatre. Unexpected or traumatic death that occurs within theatre. Acute deterioration or death of a child within the Paediatric Intensive Care Unit. Complex psychosocial dynamics/needs that the nursing and medical team require Social Work support to manage. Did a Social Worker attend the Hospital: Yes No Time of arrival at the Hospital: Time of departure from Hospital: Other Relevant Information/Comments: Name of Person Completing Form: Signature: 14 P a g e
Attachment 5: Indicative timeframe and activities Surgical Services Group preparation timeframes Business Case for Change SSG Allied Health Rosters Indicative Date Activity 3 Feb 2017 Business Case for Change approved for release Responsibility Service Director 14 Feb 2017 Business Case for Change released Service Director/ HR workforce Change team 14-28 Feb 2017 2-3 Mar 2017 Communication and consultation (union and employees): 14 days Feedback reviewed and considered (EDCS, EDHR, Service Director) 6 Mar 2017 Feedback decision and approval to implement including roster agreement. From 8 Mar 2017 Employee letters: Roster changes confirmed Service Director & HR workforce Change team HR workforce Change team Executive Director Service/Service Director HR workforce Change team 22 Mar 2017 Rosters submissions due Service Director/ Managers 27 Mar 2017 Roster changes commence Service Director/ Managers 27 Mar 2017 Relocation to SCUH Service Director/ Managers/Commissioning managers 15 P a g e