15 February 2012 - Auckland District Health Board

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Project: Primary Objective: That at least 95% of patients will be admitted, discharged or transferred from Auckland Emergency Departments within 6 hours Date of Delivery: 30 June 2012 100% 80% 60% 40% 20% 0% Jul-2010 Aug-2010 Acute Patient Flow , Actual vs Target, July 2010 - June 2012 Sep-2010 Oct-2010 42 Nov-2010 Dec-2010 Jan-2011 Feb-2011 Mar-2011 Apr-2011 May-2011 Jun-2011 Jul-2011 Aug-2011 Sep-2011 Oct-2011 Nov-2011 Dec-2011 Jan-2012 Feb-2012 Mar-2012 Apr-2012 May-2012 Jun-2012 Actual Goal MOH Target Project Risks / Comments: 95% of patients admitted, discharged or transferred from Emergency Department within six hours in December, giving 3 consecutive months of 95% performance. Quarterly result advised to MoH is 95%. Actions continue to be taken across Adult and Children’s service to respond to constraints impacting on flow and to sustain current level of performance.
Project: Adult Acute Patient Flow Primary Objective: That at least 95% of patients will be admitted, discharged or transferred from Auckland Adult Emergency Department within 6 hours Date of Delivery: 30 June 2012 Clinical Leads: Nurse Director Margaret Dotchin , Dr Tim Parke Project Sponsor: Nurse Director Margaret Dotchin Steering Group: Nurse Director Margaret Dotchin, General Manager Ngaire Buchanan, Dr Tim Parke, Dr Art Nahill, Dr Wayne Jones, Dr Andrew Old Adult Acute Patient Flow , Actual vs Target, July 2010 - June 2012 Improvements to date: Streamlined AED processes and measurement and manage the challenge of growing demand Reviewed Medical / Nursing requirements for AED and approved business case for resource increase to match increased workload. Charge nurse patient flow coordinator introduced Improved access to Radiology Streamlined documentation required for safe transfer Improved triage processes. Managing bed block with additional resources 58 Additional beds opened 2009‐2010 Winter Ward 31 General Medicine 10 additional beds August – October 2010 Managing bed block & reducing the time patients wait through improved processes and teamwork Daily Rapid Rounds introduced in General Medicine (Feb 2010) and Orthopaedics (July 2010) Nurse Facilitated Discharging in General Medicine (April 2010) Improved Bed Management Communication via Estimated Discharge Dates, CMS upgrades, improved visual management, more efficient bed management meetings, earlier time of day discharging. Daily breech review meetings to understand root causes and implement short term solutions. Immediate actions to improve performance: 1. Increased engagement of Senior Leadership Team to support improvement activities and reduce road blocks to improvement. Increase communication and engagement of Clinical Directors, SMO’s, RMO’s Increase communication and engagement of Charge Nurses and RN’s after hours to further reduce wait times for patient transfer from Emergency Department Engage with SMO’s, RMO’sand nurses one to one, by CD, Nurse Advisor or Level 2 clinical leader where resistance to required behaviour is demonstrated. Valuing patient time poster campaign 2. Establish ED short stay unit Implement APU flex beds Improve measurement of Ready to Go patients in ED Project Risks / Comments: Complete recruitment of remaining ED resource to improve weekend coverage Support General Medicine by diversion of patients to subspecialties 95% of patients admitted, discharged or transferred from Adult Emergency Department within six hours in December, Implement general surgery acute flow team initiatives to improve response time giving 3 consecutive months of 95% performance. CMO to attend Orthopaedic SMO meeting to increase engagement. Relocate bed manager to ED after hours Three areas for further focus include: reducing delays to ED sign on, reducing delays to inpatient specialty sign on post Implement ED discharge nurse on weekend referral from ED, reducing access block (no beds available). Hands on support of ED flow Charge Nurse to reduce roadblocks to Measures underway to address these concerns include: timely review and transfer of patients Finalising Adult ED escalation plan and incorporate into hospital wide plan. Commence physiotherapy facilitated discharge in Orthopaedics. Implement Gen med redesign with new rosters commenced 16 Establish discharge co‐ordination responsibility in Gen Med ward nursing team. Further increase timely overnight transfers from ED to inpatient wards once bed allocated. 3. Five day rapid improvement event planned for April to focus on improvement of process from decision to admit to patient transfer complete. Improve elective scheduling. th 100% 80% 2 3 60% 1 40% 20% 0% Act ual Goal MOH Target December. Develop acute and elective bed capacity forecasting to integrate with elective surgery POP. Jul-2010 Aug-2010 Sep-2010 Oct-2010 Nov-2010 Dec-2010 Jan-2011 Feb-2011 Mar-2011 Apr-2011 May-2011 Jun-2011 Jul-2011 Aug-2011 Sep-2011 Oct-2011 Nov-2011 Dec-2011 Jan-2012 43 Feb-2012 Mar-2012 Apr-2012 May-2012 Jun-2012
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Auckland District Health Board Boar
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Karakia E te Kaihanga e te Wahingar
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7 3 CONFLICTS OF INTEREST
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ADHB BOARD INTERESTS REGISTER NAME
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NAME OF BOARD MEMBER Rob COOPER Lee
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15 4 CONFIRMATION OF MINUTES - WEDN
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5 Action Points 2 November 2011 All
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8.1 Committee Recommendations Commu
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Next Meeting The meeting closed at
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25 Board Action Points from the mee
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6.1 Report - Verbal 29
Page 35: COMMUNITY AND PUBLIC HEALTH ADVISOR
Page 39: 37 7.1 Chief Executive’s Summary
Page 42 and 43: Introduction This report covers the
Page 44 and 45: � Director of Surgery Ian Civil h
Page 46 and 47: Therapy) while working part time as
Page 48 and 49: Strong performance against the othe
Page 50 and 51: Annual Review Total Maori Pacific I
Page 52 and 53: The overall goal being: Both WDHB a
Page 54 and 55: Māori Provider Development Scheme
Page 56 and 57: establishing links with Primary car
Page 58 and 59: The information set out on the foll
Page 60 and 61: Projects Phase On Time 978 - Increa
Page 62 and 63: participation 1099 - Develop and im
Page 64 and 65: 1067 - Continue regional lung tumou
Page 66 and 67: 1120 - Waitemata and Auckland DHBs
Page 68 and 69: INTRODUCTION With over 10,000 (head
Page 70 and 71: CONTENTS ADHB Workforce Composition
Page 72 and 73: ADHB WORKFORCE BY AGE As displayed
Page 74 and 75: ADHB MAORI & PACIFIC WORKFORCE As d
Page 76 and 77: GENDER BY OCCUPATIONAL GROUP Althou
Page 78 and 79: ADHB HEALTHCARE SERVICE GROUP PROFI
Page 80 and 81: JOB STATUS BY HEALTHCARE SERVICE GR
Page 83: 7.2 Health Targets 39
Page 88 and 89: Project: Children’s Acute Patient
Page 90 and 91: Project: Shorter waits for Radiatio
Page 92 and 93: Project: Cardiac Bypass Surgery 48
Page 94 and 95: Project: Diabetes Primary Objective
Page 96 and 97: Project: Increased Immunisation Pri
Page 99: 55 8.1 Committee Recommendations Co
Page 103: 9.1 DAP Projects Report 59
Page 107 and 108: Group Pack Report Group/Committee:
Page 109: 10 LIVE WITHIN OUR MEANS 10.1.1 Fin
Page 113 and 114: ADHB Board Author: Ian Bell (8077)
Page 115 and 116: 1. Establishm ent AUCKLAND DISTRICT
Page 117 and 118: � treasury Consumable & Capital P
Page 119 and 120: ADHB Board Author: Ian Bell 8077) S
Page 121: ADHB Board Author: Ian Bell 8077) S
Page 125 and 126: Date Wednesday 15 February 2012 To
Page 127 and 128: 83 Auckland DHB is unable to meet t
Page 129 and 130: 9 'V9 ~-::uatii I £9l0 ~!J OJOYS Y
Page 131: 87 BUILDING 15 - LEVEL LG G R E E N
Page 135 and 136: 91 Auckland District Health Board B
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93 Statement of Financial Performan
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95 Statement of Cashflows for the Y
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Year to Date � The result for the
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100
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MEETING DETAILS Time and Date 2:00p
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15 February 2012 - Auckland District Health Board

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