2 minute read
Parenting support access improvement
Katie Robinson Nurse Manager, Quality and Safety Child and Youth Community Health Service
Catherine Marron Nursing Director, Ellen Barron Family Centre Sonya Preston Director of Nursing, Specialised and Statewide Services Children’s Health Queensland
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Problem/Aim
Reporting for the Children’s Health Queensland Quality and Safety Board demonstrated that 26% of families were waiting longer than the recommended timeframes (long wait) to be seen at the tertiary parenting centre. The Children’s Health Queensland Board and executive leadership have zero tolerance for long waits across the organisation. Other early parenting centres in Australia report experiencing similar challenges with intake and admission processes and have implemented various solutions to address concerns.
Measures
A systematic analysis of organisational performance data provided initial information on the problem. Analysis of these data and using a tested quality improvement framework enabled better understanding of the key issues affecting waiting times and the instigation of proactive steps to address issues.
Design
This involved a process-mapping exercise, which defined the process components, explored barriers to access from referral to admission and prioritised the areas that could be actioned. In addition, an appreciative enquiry approach was used to gather qualitative data about the experience of staff, stakeholders and consumers, and to explore their ideas for improvement. Areas prioritised for improvement were identified across different aspects of the process or patient journey and categorised into three working areas: • referral and support • (concurrent) intake processes • administrative practices. A formalised implementation approach (Plan-Do-Study-Act [PDSA] cycles) was used as part of the quality improvement framework to allow tests of change during the process and rapidadjustment.
Results
The new administrative and communication processes have resulted in the number of families
being seen in time improve from 68% in 2016 and 71% in 2017 to 80% over the first 6 months of implementation (2018). This improvement means that there are fewer families waiting longer (n = 12) than recommended to be seen and that, of those waiting, 60% have a pre-organised admission date.
Next steps
The second phase of system improvements began in July with implementation of a single referral form and an electronic referral system to improve accessibility and transparency of referral progression. Next steps will involve a dashboard to monitor data and progress in real time, and redesign of the intake and categorisation process as well as the pre-admission interview. The final planned improvements relate to the Children’s Health Queensland digital health strategy and include a new scheduling system, contemporary patient-driven booking and confirmation systems, and centralisedreferral.
