Monday 2 March 2015: Doing the right thing every time – no wait, no harm, no waste Improving the health and wellbeing of our community is the fundamental reason our health system exists. The Canterbury health System has continued to focus on the delivery of a clear direction and vision for our health system that includes:
The development of services that support people/whanau to stay well and take greater responsibility for their own health and wellbeing.
The development of primary and community–based services that support people/whanau in the community and provide a point of ongoing continuity (which for most will be general practice teams).
The freeing up of hospital-based specialist resources to be responsive to episodic events, provide complex care and provide specialist advice to primary care.
Our goal is no wait, no harm and no wastage. With this in mind, I have highlighted below two wonderful examples where we are seeing the benefits play through for people in our community.
Our community-based falls prevention programme
The falls prevention programme has benefitted 3,519 patients, with associated flow on benefits tracked in Emergency Department and Hospital admission data
Based on pre-programme admission rates, an estimated 1083 falls-related presentations to ED have been prevented
There were 373 fewer neck of femur (hip) fractures than had been anticipated
Because we provide better post-discharge support following a hip fracture, 86 fewer people died within 180 days of discharge.
Giving priority to an integrated falls prevention programme was a decision based on anticipated clinical and social benefits. Doing the right thing also turns out to be the most efficient and effective use of resources. The community falls prevention programme has saved $18 million over the past three years.
Frail elderly Now to one of our 5+1 priorities: Improving the frail elderly persons’ pathway. Since February 2014 new processes within the frail older persons’ pathway have been introduced to provide more active care and planning with the patient and their family to facilitate early discharge. Clinical teams have redesigned ward processes to ensure daily active board rounds are held, that focus on what it will take to reduce the time a patient wastes waiting, and what needs to happen to get the patient safely home. The benefits are an effective restorative approach to the care of older people, and shorter hospital stays. When measured against expected trends for patients over 75 years old, the average length of stay for people in Assessment Treatment and Rehab (ATR) has decreased by six days. There has also been a reduction of 16 beds and neither of these gains has placed an additional cost on the system and in fact equate to over $4.2million saved. In combination with our ‘can do’ staff attitude and innovative approach the ability to form and build on productive and patient-focused cross health sector partnerships such as the Canterbury Clinical Network is our key point of difference. It is also the foundation for many of our best initiatives. Continues on the following page...