125 A Quality Improvement Initiative of the Day Hospital Service

Abstract

Background The Day Hospital had the potential to assist the hospital in achieving its target of reducing length of stay and early supported discharge. However the service was not providing a timely, quality service. The Day Hospital was reviewed as part of a week-long Rapid Improvement Event (RIE) to optimise the service. Methods Lean methodologies were utilised, including process mapping, gap analysis and A3 thinking. Data collection and analysis was gathered on the initial state prior to the RIE. Patient interviews were conducted and visual management systems were used to clarify the therapy schedules and rapid experiments of clinic flow boards. The key areas for service development were identified and changes were implemented and audited at 90 days and one year. Results Results at one year review showed that wait time for patients to attend an appointment was reduced by 75% (average of 270 days to 70 days) from 2017 to 2018. There was a 184% increase in new patient referrals from 2017 to 2018 and 98% of feedback from the patient surveys was positive. Five new clinic pathways were developed and added to the three existing clinics. Slots were also made available at clinics for early supported discharge from the hospital. Communication between staff was greatly improved through monthly meetings and utilizing a visual management system. Patient feedback surveys were checked monthly and streamlining the administration process improved the capacity of the service. Conclusion The RIE produced positive outcomes for the hospital, patients and staff. It achieved the key targets of providing a quality and timely service. The data at key time points indicate positive sustainability in these key areas.