Initiatives by Category

Efficiency

Endoscopy Information System (EIS)

Aim: To develop a high-quality endoscopy reporting system to ensure that an accurate assessment of NSW endoscopy services can be undertaken against accepted patient safety, quality and utility benchmarks.

Benefits: The implementation of a standard EIS across NSW Health will:Provide accurate statewide information on endoscopic procedures carried out in NSW public hospitals; Inform on issues of productivity, activity, costs, and access to services; Facilitate the comparison of services against critical safety and quality benchmarks; Facilitate electronic reporting to the National Bowel Cancer Screening Program’s Register; Enhance the efficiency and accuracy of clinician procedure-reporting through electronic image capture and customisable reporting templates; Allow endoscopic reports to be electronically stored and accessed...

ACI Ready to Implement Added: 5 November 2013|Last updated: 23 September 2014

Nurse Delegated Emergency Care (NDEC) Project

Aim: To provide timely, quality care for patients presenting to EDs in rural and remote areas with low risk, low acuity conditions, and to empower Registered Nurses to manage entire episodes of care through a delegated care model which promotes a more sustainable clinical workload for rural doctors.

Benefits: For patients - access to timely and quality care for less-urgent conditionsFor nurses - a validated and authorised framework to work within their scope of practice to manage entire episodes of careFor doctors - a robust model under which care can be delegated, leading to more sustainable clinical workload and work-life balanceFor rural health services - a collaborative framework for delivering quality patient care in small rural EDsFor rural communities – mitigation of some of the barriers to recruitment and...

ACI Ready to Implement Added: 7 November 2013|Last updated: 17 August 2016

Understanding the Role of Health Economics at ACI

Aim: Improved decision-making to support the delivery of sustainable, system-wide change proposals.

Benefits: Describes how health economics will be integrated into the work of the ACI; Articulates the objectives and principles of the ACI economics function and team; Demonstrates how health economics supports the development and implementation of ACI models of care; Provides high-level explanations of key economic techniques and documents.

ACI Ready to Implement Added: 8 November 2013|Last updated: 20 January 2014

Mapping of Services within NSW Health for People with an Intellectual Disability

Aim: Develop a web based service directory of available NSW Health service and resources for people with an Intellectual Disability. Identify existing specialist service and gaps in service for future planning.

Benefits: Information collected will be developed into a web based service directory for use by clinicians/health professionals, consumers and their families/carers. The information collected will also be used to support local and state-wide service delivery and to identify gaps in service for future planning.

ACI Pre-implementation Added: 30 May 2014|Last updated: 2 June 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

Clinical Variation in 30 Day Mortality for Acute Myocardial Infarction

Aim: To examine clinical variation in 30 Day mortality for patients presenting with Acute Myocardial Infarction to hospitals throughout NSW.

Benefits: Increased understanding of the factors that contribute to unwarranted clinical variation (UCV) in 30 day mortality for Acute Myocardial Infarction. If UCV is confirmed there may be opportunities to improve the quality of patient care and decrease length of stay, resulting in reduced costs.

ACI Pre-implementation Added: 6 November 2013|Last updated: 6 November 2013

Centre for Healthcare Redesign (CHR) Graduate Certificate Program

Aim: The Centre for Healthcare Redesign (CHR) Program aims to: Increase capability within the Health System to deliver, redesign and service improvement activities; Promote a patient-experience based approach to service improvement; Create a learning culture to support professional development and networking opportunities for healthcare workers; Implement recommendations from external review of the CHR Graduate Certificate Program.

Benefits: The CHR Graduate Certificate Program builds capability in Project Management, Change Management and Redesign through a combination of eLearning, face-to-face training, and workplace coaching applied in real-time to a workplace project.

ACI Ready to Implement Added: 8 November 2013|Last updated: 11 August 2016

Health Pathways Implementation and Evaluation

Aim: The ACI is supporting three sites to implement and four sites to evaluate Health Pathways. Local services review and clarify their patient pathways between primary and specialist care and share the information on a reference website for health professionals. This process is aimed at improving patient management, assessment and referral through streamlined links between primary and secondary care clinicians and providing clear information for referrers. The Local Health District/Medicare Local sites that the ACI are supporting are the Central Coast,...

Benefits: Creates clear referral pathways between services Provides comprehensive service information for referring clinicians Links clinicians to the appropriate best practice information Increases the appropriateness, quality and timeliness of referrals to specialist services Highlights opportunities for service improvement and redesign Creates links between primary and secondary care clinicians

ACI Ready to Implement Added: 4 December 2013|Last updated: 5 December 2013

The Patient Based Care Challenge and Associated Guide

Aim: The Patient Based Care Challenge and associated provides practical strategies for transforming hospitals and health services for a patient based care focus.

Benefits: Local Health Districts sign up to The Challenge as a long term strategic commitment. The Guide provides practical advice on strategies within The Patient Based Care Challenge. Improving patient care experience is linked to improved clinical and business outcomes, including cost savings.

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

State Cardiac Reperfusion Strategy (SCRS)

Aim: To improve care for all patients in NSW with a suspected Acute Coronary Syndrome (ACS) and reduce the time from symptom onset to reperfusion for patients with ST Elevation Myocardial Infarction (STEMI).

Benefits: Care is tailored to specific settings so that all patients, regardless of their geographical location or presentation pathway can benefit from early access to specialist medical advice and appropriate treatment. Timely reperfusion rapidly restores blood flow to the heart, which means patients with STEMI may have better outcomes and fewer days in hospital.

ACI Ready to Implement Added: 11 July 2013|Last updated: 21 May 2015

Electronic Persistent Pain Outcome Collaboration - routine patient outcomes reporting of pain management intervention

Aim: The NSW pain plan provided funding and an outline of a system of collecting and analyzing data from NSW pain clinics which quantified patient outcomes.

Benefits: The routine collection and analysis of data regarding patient outcomes is an important aspect of service delivery and improvement. The data enables benchmarking across NSW services as well as nationally enabling us to build on the service aspects that deliver the best outcomes.

ACI Ready to Implement Added: 25 February 2015|Last updated: 25 February 2015

NSW Subcutaneous Insulin Prescribing Chart

Aim: To standardise an adult subcutaneous insulin chart and minimise risks in insulin prescription, administration and documentation.

Benefits: The chart combines prescription and administration with blood glucose, ketone monitoring and glycaemic management. It links all the necessary information for glycaemic management in one document.The chart is designed to minimise delays in management decisions and provide clinicians with clear guidelines for:Insulin prescription and administrationGlycaemic managementSafe supplemental insulin use.The chart includes:Regular, supplemental, once only, and telephone ordersMonitoring for blood glucose levels (BGLs) and ketonesGlycaemic management guidelines to support clinicians that may not have access to local guidelines, policies or specialist...

ACI Ready to Implement Added: 8 November 2013|Last updated: 16 July 2015

Acute Myeloid Leukaemia (AML) Model of Care

Aim: To optimise the quality of care for patients with AML and enable a consistent approach to the provision of care. It provides a set of principles and outlines the key requirements at each stage of the patient’s journey based on evidence of best practice. It incorporates guidelines related to various components of the model.

Benefits: Key points included in this model are:Mechanisms to ensure early identification and referral to an AML treatment centreA multidisciplinary team (MDT) approach to treatment planning and the provision of care in an appropriate settingThe use of ambulatory care services to enable early discharge programs in a safe and efficient wayEffective follow-up and supportive care for all patients with AML

ACI Pre-implementation Added: 5 November 2013|Last updated: 10 July 2015

Clinical Leadership Program

Aim: The ultimate aim of the program is to build a cohort of clinical leaders with the skills and commitment to shape a sustainable culture of patient safety, professionalism and positivity within the NSW health system.It aims to enhance:the understanding of clinicians about the workings of NSW Health; knowledge of contemporary approaches to patient safety and clinical quality systems; the skills of clinicians in relation to communication, conflict resolution and team leadership within an environment of health care resource limitation; the...

Benefits: The Clinical Excellence Commission (CEC) believes that the power of clinical leadership is an essential component of the CEC’s commitment to improving patient safety and clinical quality in our healthcare system. Clinical leaders play a pivotal role in the patient safety and clinical quality environment and need to have their full potential harnessed to ensure the health system works better and more safely for staff, patients and their families. In this, the program supports clinicians to develop extraordinary leadership practice....

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

Training in Patient Based Care

Aim: The Directorate of Patient Based Care facilitates training and education in Patient Based Care to: Board, Executive, Leaders, Senior Managers and Clinicians; Junior Clinicians; and the workforce (through Train-the-Trainer).

Benefits: Through training the Directorate assists services to provide patient based care and meet new performance goals and the Australian Commission on Safety and Quality in Health Care National Safety and Quality Health Service Standards (Standard 2.6 Implementing training for clinical leaders, senior management and the workforce on the value of and ways to facilitate consumer engagement and how to create and sustain partnerships).

CEC Ready to Implement Added: 7 November 2013|Last updated: 5 March 2015

AMBER Care Bundle

Aim: The AMBER care bundle provides clinical teams a framework to develop a management plan that may include end of life decisions in collaboration with the patient and family for patients whose recovery is uncertain while continuing with treatment in the hope of a recovery.

Benefits: Early identification of people who may have end of life care needs is the foundation of excellent end of life care. If early identification does not occur then appropriate planning, transfer, interventions and communication with the person and their family cannot take place The AMBER care bundle: Provides a tool to help clinicians identify people for whom recovery is uncertain and who may have end of life care needs Simplifies key interventions to support best practice Supports staff to start...

CEC Ready to Implement Added: 25 June 2013|Last updated: 9 November 2015

Community Update on Patient Safety and Quality

Aim: The Community Update is designed to provide consumers with information on the progress of NSW public hospitals across key areas including: handover, hand hygiene, medication safety, falls, healthcare associated infections, sepsis and incident management. A template of the Community Update is available for Local Health Districts who would like to report on their safety and quality data locally.

Benefits: By engaging the community and partnering with patients, family and carers as team members we can improve quality in health care. The Community Update supports the Australian Commission for Safety and Quality in Health Care National Safety and Quality Health Service Standard 2.7.

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

Develop and Implement an ACI Knowledge Management (KM) Approach

Aim: To partner with Health Services to develop and implement an approach that supports collaboration, learning capability and sharing knowledge about innovation and improvement projects in health services.

Benefits: A robust KM approach will serve NSW Health by ensuring: Both small and large-scale innovations and improvements generated across health services are recognised and shared to benefit the broader health system The work of the ACI is shared across the NSW Health system to encourage effective partnerships and assist in delivering better health outcomes, improved patient experience and efficient service delivery.

ACI Ready to Implement Added: 8 November 2013|Last updated: 30 May 2014

In Safe Hands Program

Aim: The In Safe Hands program aims to build and sustain effective health care teams. It is intended to give these teams the structure and tools to redesign their units into strong, interdisciplinary teams, working together to deliver highly reliable, planned care to all patients.

Benefits: Teams that have implemented In Safe Hands have identified the following benefits: Reduced patient length of stay; Reduced unexpected deaths; Reduced adverse events; More satisfied staff; Improved patient experience; Improved safety culture.

CEC Ready to Implement Added: 6 November 2013|Last updated: 12 January 2015

Clinical Analytics Initiative

Aim: To extract data from the electronic medical record and work with clinicians in using information to deliver quality and efficiency initiatives, and research the future needs for clinical analytics.

Benefits: Enable clinician led improved quality, safety and efficiency initiatives using data from the electronic medical record; Increase clinician engagement with information from the electronic medical record.

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

Understanding Program Evaluation: An ACI framework

Aim: To provide a framework for undertaking evaluations of programs and projects. Programs include projects, models of care, clinical pathways and guidelines, and other innovations and interventions aimed at improving health outcomes.The frameworkis divided into three sections, covering:Purpose and principles of evaluation; Types of program evaluation and the key steps in undertaking an evaluation; An overview of the suggested governance process for undertaking evaluations in ACI.

Benefits: High-quality evaluation supports accountability and provides a rigorous evidence base toinform health-service development and program design.Program evaluation will provide the information needed to guide better resource allocationand improved services.

ACI Ready to Implement Added: 8 November 2013|Last updated: 18 November 2013

Accelerating Implementation Methodology (AIM)

Aim: To increase Implementation capability across NSW Health; To embed AIM principles in large-scale program and model of care implementation; To apply AIM principles in Local Health District project implementation.

Benefits: Given the scale and pace of change-initiatives there is an ongoing demand for increased capability in applying AIM principles across the NSW Health system. The AIM strategy moves beyond training, to build capability through application of the principles in practice.

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

The Health Literacy Guide

Aim: The Health Literacy Guide has been developed to assist health services by providing practical strategies to address health literacy barriers for patients. The Guide also assists health services to meet new performance goals and the Australian Commission for Safety and Quality in Health Care (ACSQHC) National Safety and Quality Health Service Standards.

Benefits: By considering approaches to health literacy, health care organisations can benefit by improving safety and quality in health care. Consumers can benefit by accessing health information that is meaningful and relevant to their individual medical needs and navigating the system more easily.

CEC Pre-implementation Added: 6 November 2013|Last updated: 15 July 2014

Support Network for the Local Health District Redesign and Innovation Leaders Group

Aim: To enable, support and challenge group members to achieve their mission of driving healthcare quality and efficiency through shared knowledge, collaborative communication and professional peer support.

Benefits: This network can generate significant momentum for local and system change by optimising relationships within and across clinical and geographical boundary lines.

ACI Ready to Implement Added: 25 October 2013|Last updated: 5 August 2016

Implementation of the Statewide Pain Plan

Aim: To document and implement a statewide pain strategy to reduce the burden of chronic pain in the community.

Benefits: Following the implementation of the NSW Pain Plan, there will be greater access to expert services, and improved support for primary care, for people living in regional NSW.

ACI Ready to Implement Added: 8 November 2013|Last updated: 20 January 2014

Specialist Outpatient Services Improvement Project

Aim: This collaboration is designed to support the achievement of providing equitable access to timely, quality care, efficiently and sustainably, in the outpatient setting.

Benefits: It is intended that this initiative will provide the system leadership and direction required to achieve the following service outcomes:Services that are responsive to community need, appropriate, effective and sustainableThe provision of outpatient services enhances the system as a whole to better integrate services across the continuumPatient care pathways are underpinned by evidenced-based standards of care that are contemporary, efficient and offer a consistently high quality of carePerformance targets are transparent, continually monitored and informed by timely and reliable information...

ACI Future Initiative Added: 17 September 2014|Last updated: 10 October 2014

Clinical Innovation Program – Spread of Innovation

Aim: The aim of the ACI Clinical Innovation Program is to:Accelerate implementation of ACI Models of Care and Guidelines; Assist in the sharing and spread of local innovations.

Benefits: Improved implementation and system uptake of models, with demonstrated patient and health system benefit; Reduction in time and effort for LHDs to replicate contemporary evidence based models; Opportunities for LHDs to receive funding to implement the model.

ACI Ready to Implement Added: 4 August 2014|Last updated: 7 August 2014

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

Improving the Medical Inpatient Journey with Criteria Led Discharge

Aim: To reduce delays when a patient is medically ready to return home from hospital.

Benefits: A formalised criteria-led discharge process has the potential to: Improve patient experience: patients are able to get home sooner; Enhance patient safety: criteria led transfers of care through a checklist; Reduce unnecessary length of stay: not being in hospital when patients can actually return home; Reduce bed days: elimination of unnecessary days in hospital; Minimise waste: reduction of costs as a result of eliminating unnecessary lengths of stay in hospital; Improve staff satisfaction: staff are not pressured to transfer patients...

ACI Ready to Implement Added: 8 November 2013|Last updated: 30 May 2014

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