Initiatives by Category

Surgical Services

Pre Procedure Preparation / Perioperative Toolkit

Aim: To review the NSW Health Guideline: Pre-Procedure Preparation Toolkit.

Benefits: To review the existing toolkit to ensure it supports best practice for pre procedure care for patients undergoing surgery or a procedure.The existing toolkit was developed in 2007 by a working group of the Surgical Services Taskforce. The Anaesthesia Perioperative Care Network, in collaboration with the Surgical Services Taskforce, is currently reviewing the document. As part of the review process, work has also being undertaken to include information specific to Aboriginal/Torres Strait Islander people in the toolkit.

ACI Pre-implementation Added: 11 November 2013|Last updated: 11 August 2015

Surgery Redesign School

Aim: The School is aimed at project leaders who are responsible for implementation of surgical models of care, or improving operating theatre efficiency.

Benefits: Increased awareness and skills in project management, change management and Accelerated Implementation Methodology (AIM).

ACI Ready to Implement Added: 6 November 2013|Last updated: 30 May 2014

NSW Pain Clinic Referral Form and Process

Aim: To provide a consistent method when making a referral from primary care to a tertiary pain service, irrespective of where the service is located.

Benefits: All services will have the same triage criteria and process for accepting patients from primary care.

ACI Ready to Implement Added: 7 November 2013|Last updated: 17 November 2014

Healthcare Associated Infections (HAI)

Aim: Healthcare Associated Infections (HAIs) are infections acquired in healthcare facilities and infections that occur as a result of healthcare interventions and which may manifest after people leave the healthcare facility. Prevention of HAIs and the transmission of multi-resistant organisms (MROs) are key patient safety and clinical quality initiatives for NSW Health. The HAI program at the CEC aims to reduce the risk of acquiring a HAI during care delivery in NSW health facilities. The program enables NSW Local Health Districts...

Benefits: Improved health outcomes for patients (reduced morbidity and mortality); Reduced risk of HAI transmission to patients, visitors and staff; Standardised approach to HAI prevention and control.

CEC Ready to Implement Added: 2 June 2014|Last updated: 9 April 2015

SEPSIS KILLS Program

Aim: To improve the recognition and treatment of sepsis and septic shock in NSW healthcare facilities and to reduce their impact, mortality and financial costs.

Benefits: Successful implementation of the SEPSIS KILLS program is providing significant benefits at both clinical and system levels, including: more timely, standardised and effective detection and management of sepsis; reduced mortality, morbidity and bed-stays from sepsis-related conditions; enhanced clinician skills in sepsis recognition and management; enhanced networking opportunities across the system for clinicians and service teams; improved quality and safety of care; a better and safer patient experience.

CEC Ready to Implement Added: 6 November 2013|Last updated: 5 February 2015

Special Committee Investigating Deaths Under Anaesthesia

Aim: To improve the quality and safety of anaesthetic administration in NSW. To reduce anaesthesia-related mortality in NSW.

Benefits: SCIDUA looks for errors of management in the administration of anaesthesia and/or sedation. The committee also monitors anaesthetic outcomes and identify emerging trends that are associated with changes in anaesthetic, surgical and medical interventions over time. Lessons are identified and shared to facilitate improvements.

CEC Ready to Implement Added: 30 October 2013|Last updated: 30 May 2014

NSW Standardised Pain Charts (adult)

Aim: Development and implementation of statewide charts to be used at the bedside when delivering Patient Controlled Analgesia (PCA), ketamine infusions and neuraxial opioid administration. To standardise practice and reduce error relating to documentation, monitoring and prescription across NSW.

Benefits: Benefits include improved safety and quality of care for patients.

ACI Ready to Implement Added: 7 November 2013|Last updated: 15 December 2014

Quality Systems Assessment (QSA)

Aim: The Quality Systems Assessment (QSA) is a clinical risk management program designed to provide clinicians and managers at all levels with information relevant to their local systems for clinical quality and patient safety.

Benefits: The QSA is one vehicle that contributes to resilience in our health system. Working directly with local teams and local priorities, the QSA supports continuous learning and improvement to prevent and reduce patient harm. Through the multi-level self-assessment, reporting and site visits the QSA is able to identify risks and support improvements: Locally – through detailed local data returned directly to local teams Systemically – through aggregation of local data to identify high priority themes for action All effort that...

CEC Ready to Implement Added: 24 January 2014|Last updated: 14 October 2014

Pleural Drains in Adults - Consensus Guidelines

Aim: Improve the standard of clinical practice in the insertion, management, trouble shooting and removal of pleural drains in adults within NSW hospitals.

Benefits: Improve patient experience and outcomes. Increase awareness of ‘good’ practice in relation to pleural drains. Support managers and clinicians to implement processes that will reduce the risks associated with pleural drains.

ACI Ready to Implement Added: 8 November 2013|Last updated: 15 January 2016

Care of Adult Patients in Acute Care Facilities with a Tracheostomy

Aim: To improve the safety and quality of care provided to adult patients with a tracheostomy in NSW hospitals.

Benefits: Reduce number of, and severity of adverse events in adults with tracheostomy Improve patient experience and outcomes Improve staff experience in caring for patients with a tracheostomy Reduce length of stay

ACI Ready to Implement Added: 28 October 2013|Last updated: 26 June 2015

High Volume Short Stay Surgical Units (HVSSS)

Aim: The HVSSS Unit Model emerged as a model of care from the Surgery Futures – A Plan for Greater Sydney project (released January 2011). This toolkit provides Local Health Districts with information about the key features of the model, processes for service delivery, staff roles, diagnosis-related groups suitable for HVSSS, key success factors, benefits, and steps for implementation of this model.

Benefits: Improved access to planned surgical services; Improved service efficiency, regarding both operating theatre and bed utilisation; Extended range of procedures suitable for the short-stay environment; Release of additional clinical capacity (including beds, staff and other resources) within tertiary/quaternary surgery centres; Reinvestment of this additional capacity into emergency and complex service needs.

ACI Ready to Implement Added: 7 November 2013|Last updated: 30 May 2014

Emergency Surgery Redesign

Aim: To provide a reference tool for Local Health Districts when initiating the redesign of emergency surgery practices.

Benefits: There are multiple benefits, including:Improved patient outcomesEnhanced patient and surgical team satisfactionIncreased trainee supervision in emergency surgeryHigher rates of emergency operating-theatre utilisationReduced patient cancellationsReduction in after-hours costs.

ACI Ready to Implement Added: 5 November 2013|Last updated: 30 May 2014

Operating Theatre Efficiency Strategies

Aim: Following the Auditor-General’s report, Performance Audit: Managing operating theatre efficiency for elective surgery, the ACI will work with the Ministry of Health (MoH) to support Local Health Districts (LHDs) in meeting three of seven recommendations outlined in the report and assigned to ACI.

Benefits: Increased collaboration and support for operating theatre efficiencies.

ACI Pre-implementation Added: 7 November 2013|Last updated: 20 January 2014

Supervision for Safety

Aim: It is proposed that the Supervision for Safety project address NSW Health system deficiencies related to supervision at the point of clinical care. Specifically related to ensuring patient care plans are appropriate and deterioration in patient condition is escalated to the most appropriate level.

Benefits: The Supervision project aims to ensure the appropriate support is provided to less experienced clinicians.The expected project outcomes include:Supervision of the clinical workforce is built into core work practices; Supervision is structured to allow clinicians to be trained without compromising patient care; Supervision provided by clinicians at the point of care is appropriate for the level of expertise of the clinicians involved; Practices are in place to establish the level of expertise of less experienced staff; Supervision is treated as...

CEC Pre-implementation Added: 2 June 2014|Last updated: 2 June 2014

Improving Patient Outcomes from Cataract Surgery Study

Aim: The primary aim of the research is to explore patient-centred outcomes of cataract surgery in Australia and the effectiveness of currently available tools to assist Australian Ophthalmologists to appropriately plan surgery for people with cataract.

Benefits: While there is a large body of knowledge describing visual improvement following cataract surgery, we currently know little about the expectations that Australian cataract patients have of their impending surgery, or their satisfaction with post-surgical outcomes. This research will provide important information on which to shape patient-focused criteria for cataract surgery referral, including measures of driving confidence and quality of life.Up to 500 bilateral cataract patients in NSW will be assessed for vision function and quality of life prior to...

ACI Pre-implementation Added: 8 December 2014|Last updated: 8 December 2014

Minimum Standards for the Management of Hip Fracture in the Older Person

Aim: To improve the outcomes of patients with fractured hips requiring surgery and management in NSW.

Benefits: Reduced medical complications, reduced hospital stays and improved patient outcomes.

ACI Ready to Implement Added: 5 November 2013|Last updated: 7 April 2015

Reducing Unwarranted Clinical Variation (UCV) Taskforce

Aim: To oversee the development and implementation of a system-wide approachto identify, address and reduce Unwarranted Clinical Variation (UCV).

Benefits: To refine care processes and implement evidence-based models of care tosupport improved patient outcomes.

ACI Ready to Implement Added: 8 November 2013|Last updated: 17 November 2013

Collaborating Hospitals’ Audit of Surgical Mortality (CHASM)

Aim: To improve the quality and safety of surgical care in NSW hospitals. To reduce the number of preventable surgical deaths in NSW hospitals.

Benefits: All surgeons who are in operative practice are required to report the clinical management of their patients who die while under their care to CHASM for peer review. CHASM provides feedback on the peer review findings to surgeons to facilitate reflective learning and improvement in surgical care.

CEC Ready to Implement Added: 30 October 2013|Last updated: 30 May 2014

Other initiatives related to Surgical Services:

NSW Health Coaching Panel (pilot phase) NSW Health Coaching Panel (pilot phase)
Agency for Clinical Innovation

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