Waiting from the Hospital Perspective

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Todd Gordon
8 years ago
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1 Waiting from the Hospital Perspective A Successful Approach to Understanding and Addressing the Problem John Marshall John Lott

2 Waiting from the Hospital Perspective The Problem. from the Hospital s Perspective

3 Wait list Management Today Mostly paper based Single surgeon based Time consuming Duplicate data entry Cumbersome patient management processes Inconsistent Not shared in timely fashion Current Situation Lack of Hospital or System wide solutions

management processes Inconsistent Not shared in timely

4 Lack of concurrent information on waiting Results No consistent management of patients waiting No ability to set service or hospital priorities Classic Registries do not meet above needs

5 Assumption Basis for Solution Design Providers manage patients while they wait Conclusion Solutions must involve and support providers Therefore design principles of a solution must

6 Design Principles The solution must assist in the process of care be used by providers to manage patients waiting for services record all relevant wait times track patient preparation insure process and data integrity have simple real time/retrospective reporting capability

relevant wait times track patient preparation insure process and

7 The KGH Solution Axcess.Rx Combines data & processes to manage patients waiting for services Records and stores all relevant dates in care process Provides both real time and retrospective reporting on individual or aggregated waiting Drives resource allocation Web enabled enterprise software Provides a simple, intuitive user interface

stores all relevant dates in care process Provides both real time and retrospective

8 Remote access (e.g. VPN) Axcess.Rx (web-based application) Reg/ADT OR Sys PAS

9 Axcess.Rx Data Elements Full patient demographics Diagnostic and disease category details Procedure or service details Urgency category and associated target time Procedural resource requirements detail Required pre-procedural diagnostic resources Provider and provider service details

category details Procedure or service details Urgency category and

10 Axcess.Rx Data Elements Full Wait Time Details Pre-procedure investigation wait time Patient unavailable time Full procedure wait time Adjusted wait time Procedure Outcome Details Procedure completed Cancellations Done elsewhere Died before procedure No longer requires procedure etc.

wait time Patient unavailable time Full procedure wait time Adjusted

11 Axcess.Rx Functionality Manage lists of single or multiple providers Sort list by days to target, urgency, procedure, anaesthesia, name, ID# etc. Filter list by procedure(s), anaesthesia, site, availability etc Review full patient data Manage patient preparation Booking and scheduling

12 Axcess.Rx Reporting Capability Real time reporting of current list status by surgeon or groups of surgeons Predictive capability based on urgency Retrospective reporting by surgeon, service, procedure. Review of individual patient experience Administrative reports to ensure list integrity Limitless other reports available

groups of surgeons Predictive capability based on urgency Retrospective

13 Axcess.Rx

19 Axcess.Rx Summary Manages patients waiting for services Patient Preparation Patient Selection Patient Booking Provides data on patient waiting times Timely Accurate Valid Informs Healthcare Systems of patterns of unmet need Aggregated Waiting Patterns Provides a specifically designed tool for each provider group

Selection Patient Booking Provides data on patient waiting times Timely

20 Patient Advantage Immediate Early Achievements Surgeon more accurately predicts surgery date Increased efficiency - shorter waiting time Patient urgency visibility Patient Surgeon communication Longer Term Web published data can inform referral Data accepted because provider generated

Patient urgency visibility Patient Surgeon communication Longer Term

21 Early Achievements Provider Advantage Quantifies and defines the queue 12% increase in office efficiency This saves me one hour every day Decision support available Increased utilization of assigned OR time Up to 15% in OR utilisation Improved practice management Assured patient tracking

22 Early Achievements Service Advantage Quantifies and defines the queues Understand service performance Improves resource allocation Accountability and performance tool-peer to peer comparisons Addresses the balance between patient needs and physician needs Drives recruitment priorities

23 Hospital Advantage Quantifies and defines the queues Informs and directs planning Informs and directs staff planning and recruitment Improves OR utilisation Identifies process bottlenecks Early Achievements Informs and improves supply chain management

24 Early Achievements System Advantage Quantifies and defines the queues Source of accurate timely reliable data. Can feed registries whether general, disease or procedure specific. Focus efforts for development of disease specific urgency and eligibility tools. Aggregated data coupled with demographics and utilization can inform resource allocation. Highlight areas requiring improved system integration

25 Lessons Learned Accurate, valid, and timely data can be achieved directly from providers Such systems are readily adopted Priority setting and target times readily incorporated Real time data feeds to registries Process and utilization efficiencies achieved

26 Lessons Learned Resource allocation improved Process bottle necks can be identified Opportunities to understand the waiting continuum Increased throughput and reduced waiting achievable

27 Hospital Requirements to Tame the Queue Accurate data on all services competing for shared resources Reliable and comparable priority scoring Information on elements contributing to waiting Information on the entire waiting continuum Waiting linked to population service utilization Information driven resource allocation

28 Questions And Discussion

ebooking: electronic OR Booking...

ebooking: electronic OR Booking................... The Background: Patient Access Registry Tool (PART) WHAT IS PART? A custom-built IT system and standardized methodology to capture information on all