Planning For Discharge On Admission Agency For Clinical Innovation - Medical Science Assignment Help

ACKNOWLEDGEMENTS

• The Agency for Clinical Innovation (ACI) is the lead agency in NSW for promoting innovation, engaging clinicians and designing and implementing new models of care. All ACI models of care are built on the needs of patients, and are underpinned by extensive research conducted in collaboration with leading researchers, universities and research institutions.
• The ACI acknowledges that we operate and function on the lands of the Cammeraigal people of the Eora Nation. We acknowledge and pay respect to the ancestors that walked and managed these lands for many generations. We pay respect to Elders past and present and extend that respect to other Aboriginal peoples present here today. We acknowledge elders who are the knowledge holders, teachers and pioneers. We acknowledge the youth who are the hope for a brighter future and who will be the future leaders.
• For further details on the ACI, visit: www.aci.health.nsw.gov.auThe ACI acknowledges the large number of people involved in the development of this resource for CLD, in particular:
• ACI Acute Care Taskforce
• ACI Criteria Led Discharge Working Group
• Auckland District Health Board
• Bega Hospital (Surgical Ward)
• Calvary Mater Hospital (Haematology Unit)
• Children’s Hospital Westmead, NSW
• Clinical Excellence Commission – initial draft of this document
• Department of Health / National Health Service, UK
• Queensland Health
• Royal Children’s Hospital Melbourne, Victoria
• The Nursing and Midwifery Office at the NSW Ministry of Health
• Wollongong Hospital (Cardiology Step Down Unit, Neurology Ward)
• CONTENTS
• GLOSSARY1ACRONYMS1Background2Increasing demand on our health facilities3Patient transfers of care3A Solution - Criteria Led Discharge5An Enabler: A Patient Flow Systems Approach9The Criteria Led Discharge Framework6Implementing Criteria Led Discharge7Supporting Documentation9References10APPENDIX A: FREQUENTLY ASKED QUESTIONS FOR IMPLEMENTING CLD11APPENDIX B: PATIENT INFORMATION SHEET FOR CLD12APPENDIX C: CRITERIA LED DISCHARGE TEMPLATE13APPENDIX D: GUIDANCE ON CRITERIA LED DISCHARGE FORM14APPENDIX E: TRANSFER OF CARE CHECKLIST15APPENDIX F: PATIENT AND STAFF EXPERIENCE - PATIENT EXPERIENCE TRACKERS (PETS) 16
• APPENDIX G: DRAFT PROTOCOL/POLICY FOR LOCAL ADAPTATION17APPENDIX H: A Competency Statement for Criteria Led Discharge18APPENDIX I: A Checklist for Implementing Criteria Led Discharge19APPENDIX J: A set of education/orientation slides for CLD20
• GLOSSARY
• MEANS
• Admission1 Admission to hospital is a formal process, and follows a decision made by a medical officer that a patient needs to be admitted for appropriate management or treatment of their condition, or for appropriate care or assessment of needs. Separation is the term used to refer to the episode of admitted patient care.
• Bed block A situation in which a patient stays in hospital because there is no other suitable place to which they can be transferred. This also means that other patients cannot enter the hospital when they need to, because there are no beds available for them.
• Discharge See transfer of care.
• Interdisciplinary2 This document uses the terms interdisciplinary and multidisciplinary to mean the same thing. Although this resource recognises that a multidisciplinary team utilises the skills and experience of individual team members from different disciplines, with each
• discipline approaching the patient from their own perspective. An interdisciplinary team
• approach attempts to integrate separate discipline approaches into a single method.
• Multidisciplinary See interdisciplinary.
• Separation1 Separation is the term used to refer to the episode of admitted patient care. A separation, which can be a total hospital stay (from admission to discharge, transfer or death) or a portion of a hospital stay beginning or ending in a change of type of care (for example, from acute care to rehabilitation).
• Transfer of Care This term is used interchangeably with discharge. It involves the transfer of professional responsibility and accountability for some or all aspects of care for a patient to another person or professional group on a temporary or permanent basis.
• ACRONYMS
• MEANS
• ACI NSW Agency for Clinical Innovation
• CEC Clinical Excellence Commission
• CLD Criteria Led Discharge
• CMP Clinical Management Plan
• EDD Estimated date of discharge
• HETI Health Education & Training Institute
• LHD Local Health District
• LOS Length of stay
• MOH Ministry of Health
• PET Patient Experience Tracker
• PFP Patient Flow Portal
• SHN Speciality Health Network
• Background
• The Acute Care Taskforce (ACT) has been involved in developing solutions for improving the medical
• patient journey since 2005. This includes work around safe clinical handover, avoidable admissions and the establishment of medical assessment units.
• In 201 the NSW Ministry of Health published a policy directive titled Care Coordination: Planning from Admission to Transfer of Care in NSW Public Hospitals. Acknowledging that patient involvement contributes to positive health outcomes, the policy mandated that hospital teams involve patients/carers in care planning. It highlights five important stages to a coordinated inpatient experience:
• Pre Admission/Admission
• Multidisciplinary team review
• Estimated date of discharge (EDD)
• Referrals and liaison for patient transfer of care
• Transfer of care (discharge) out of the hospital
• In 2012 the ACT transitioned to the NSW Agency for Clinical Innovation (ACI) and in order to build upon this important work the ACI brought together a group of clinicians, consumers and managers. Under the
• guidance of this group the ACT decided it would focus on improving the medical inpatient journey in 2013.
• Five important elements to improving the inpatient journey were identified with the system lead noted in brackets ():
• A patient flow systems approach to improving the inpatient experience focused on the estimated date of discharge (EDD) and Waiting for What? functions (NSW Ministry of Health – MOH and Health & Education Training Institute - HETI)
• Inpatient clinical management plans (ACI)
• Ward rounds (Clinical Excellence Commission - CEC)
• Criteria led discharge (ACI)
• Transfer of care / discharge (CEC)
• Under the guidance of the ACT Executive, two working groups were established: one for clinical management plans (CMP) and another concentrating on criteria led discharge (CLD). Following a comprehensive literature review and in consultation with the statewide ACT the clinician led working groups developed a set of tools to assist staff from Local Health Districts and Specialty Health Networks (LHD/SHNs) to:
• Improve documentation of the CMP in their wards and facilities, and/or
• Assess the requirements for implementing CLD. This resource is focused on CLD.
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