Review of acute hospital services in the Mid - Health Service Executive

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Review of acute hospital services in HSE Mid-West An action plan for acute and community services Understanding the new clinical model of care In this section, we describe: the global drivers for change; the consistent international response to these pressures; the resulting new clinical model of acute care, benchmarked to recognised best practice standards; and how this acute model relates to, and integrates with, the new model for local primary and community care. The global nature of the drivers for change Globally, many different countries and health care systems have recognised the need for fundamental change in the way health services are presently delivered in order to respond to a number of common severe pressures and drivers for clinical change 6 7 8 9 , including: • The need to incorporate the rapidly increasing expansion in healthcare knowledge and expertise into normal clinical practice; • The need to keep pace with demographic changes, in particular, the rapid growth in the health and social needs of the elderly; • The impact of patient knowledge, demands and their rising expectations; • The need to incorporate tough new infection control strategies to drive down the risks of exposure to healthcare associated infections through clinical service changes and updates in hospital design; and • The enabling technologies to rapidly expand access to diagnostics and extend the boundaries of telemedicine. 6 National Framework for Service Change in the NHS in Scotland. ‘Drivers for change in Healthcare in Scotland’. National Planning Team, July 2005. 7 Common vision for the Canadian Health system, 2004. 8 Implementing the New Zealand Health Strategy, 2005. 9 Siegel, J.D. et al, 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, CDC Centers for Disease Control and Prevention, June 2007 (http://www.cdc.gov/ncidod/dhqp/pdf/Isolation2007.pdf). 11
What is ‘International Best Practice’? Review of acute hospital services in HSE Mid-West An action plan for acute and community services Teamwork maintains a dynamic database of international developments in acute and community health services, updated on a regular basis. This information enables us to compare current health services against international standards. Our latest update at the time of this review is included in Appendix 5. For the purposes of this review, we focused our attention on countries and health systems that have similar characteristics to Ireland in terms of health, economic status, urban and rural mix of services, population growth, environment, etc., namely Australia, New Zealand, Canada, USA, Scotland, Wales, Northern Ireland and England. In practice, we found a strong consensus about how countries, including Ireland, are responding to the global drivers for change. We identified consistent strategies and core themes in routine use to bring about safe, sustainable clinical service improvement, changes that are commonly referred to and recognised as ‘International Best Practice’ standards of care. The future clinical model of acute and community care described in this section is therefore a composite picture, derived from all the various individual elements of strategic service change that we know are happening today, somewhere, of changes in healthcare that are accepted as recognised international best practice and enable the delivery of an assured quality of care. The emerging clinical model of care in Ireland The common response, internationally and in Ireland as well 10 11 12 , to the global drivers for change in healthcare, has been to develop a new clinical model that puts the patient at the centre of service planning and delivery, with the primary objective of delivering care ‘at home, or as close to home as is clinically safe and appropriate’, as illustrated in Figure 1. 10 Health Service Executive Service Plan, 2005-2008. 11 Improving Safety and Achieving Better Standards: An Action Plan for Health Services in the North East. Report to the Health Service Executive, July 2006. 12 A New Direction for Healthcare in the North East, Health Service Executive, July 2006. 12
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