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From the CEO Last month we launched the Saving 20,000 Bed Days campaign through two engagement events held in the community for clinicians from across the health sector who work in Counties Manukau. These events were a great opportunity for us, alongside primary and secondary care, to start thinking about a whole of systems approach. It really kickstarted the process of working collaboratively with people from across the health sector to identify the problems we face. Specifically, we’ve been looking at ways to begin to shift demand away from the hospital to primary care. The challenges ahead are twofold: • We have to develop a health system which sends the fewest number of patients to hospital while ensuring that those who are treated in hospital receive timely and high quality care. • At the same time, we have to build up primary and secondary care to deliver the right care at the right time, in the right place and in the right way, including keeping people at home where possible. In order to work towards these objectives, four workstreams have been developed, all of which are clinically led. They are: • Keeping Well in the Community • Rapid Response in the Community to Acute Events • The Right Response at the Front Door of the Hospital • Safe and Quick In-Hospital Care The clinical leader for the Saving 20,000 Bed Days campaign is David Grayson while Diana Dowdle has been appointed as campaign manager. Alison Hendry, our Manager of Service Improvement, has further information for those who are interested. The campaign will be based on the methodology used in the very successful Saving 100,000 Lives
campaign which was run by our partners at the Institute for Healthcare Improvement in Boston to systematically improve standards of healthcare in America. Through this methodology, an additional 100,000 people were alive who otherwise may have been harmed by America’s healthcare system. The methodology developed for this campaign is an effective way of helping organizations deliver seemingly impossible and complex change on a large scale. We’re very fortunate to be in a position to draw on that thanks to our Ko Awatea partners, IHI. In turn, our hope is that by shifting 20,000 bed days away from the hospital, we can develop a body of practice which can be shared with others to help redevelop the health system more widely. We have to do this because at present the people from our community spend more than 200,000 days each year in hospital for acute events. We currently spend $240million on acute hospital care. Our population is growing in Counties Manukau; a 20year forecasted increase of 41% by 2026 and growth in health service-related demand of over 5%. At this rate, we predict we will run out of hospital-based beds for our community by 2013. Many of these acute events could be prevented or managed better out of hospital. The 20,000 bed day Campaign is to ensure that over the next two years our people will spend the equivalent of 20,000 of these acute event hospital days – about 5% of our total – at home or in the community. Converting 20,000 hospital bed days into 20,000 days of wellness at home, requires substantial effort and engagement from all of us who are committed to improving the health outcomes and health status for our people. Could we make better use of this 20,000 days and $24 million in 2 years? “This is going to be really good for our patients ... it’s about sustainability for the next decade or so, not only the hospital but for the whole health sector. If we need to keep funding the hospital at the rate it’s predicted to consume there’ll be no money left for anything else”. Peter Didsbury, GP and Chairman of ProCare PHO.
Opening with a collaborative engagement event
series at Ko Awatea and the Telstra Clear Pacific Events centre last month, the campaign brought together many willing members of the community and the hospital to create energy and develop ideas on how such a goal might be achieved. “I think this challenge is positive ... if we get the relationship right with the patients and the clinicians, & the clinicians with the organisation with the clinicians out in community care, we’ll really make a difference. I think it’s about relationships, relationships and relationships, and I spell relationships T R U S T.” Paul Cressey – CMDHB Board member.
“We’re thinking this is much more like ‘Team Counties’ and recognise this is a whole system and we’ve got to work together, that changes in some part of the system will affect other parts of the system.” David Grayson, ENT Surgeon and Clinical Leader 20K Bed Day Campaign Ko Awatea
“How can we, most meaningfully, add value to our healthcare system?” Jonathon Gray – Director, Ko Awatea
The campaign work-streams follow the journey for a person from wellness in the community, through the points of opportunity for change, to the acute event and hospital stay. In focusing on the points of opportunity for change that precede the acute event we can release our resources to provide better care, sooner, to more of our people closer to their home. “This workshop has a bunch of people looking at how well we can keep people in the community ... we’re going to see if we can save some of these bed days” David Jansen, Clinical Director National HauOra Coalition.
“Our primary healthcare organisations are supportive of this campaign ... our organisations are fully behind this” Peter Didsbury, GP and Chairman of ProCare PHO.
“Once we’ve got the will and the ideas it’s about executing change ...” Jonathon Gray – Director, Ko Awatea
I would like to take this opportunity to thank everyone who is working so hard to ensure the success of this essential initiative. I would also like to take the opportunity to thank all of you for your hard work over the year and to wish you all a safe and happy holiday season. Regards Geraint Martin, CEO, CMDHB CONNECT I PAGE 1
Counties Manukau Health staff publication