Redesigning Acute Care for Older People: The Start of Sheffields Journey |
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Автор: Pre-installed;Tom Downes;Sheffield Teaching Hospitals NHS Foundation Trust;UK. Чтобы познакомиться с картинкой полного размера, нажмите на её эскиз. Чтобы можно было использовать все картинки для урока английского языка, скачайте бесплатно презентацию «Redesigning Acute Care for Older People: The Start of Sheffields Journey.ppt» со всеми картинками в zip-архиве размером 4329 КБ.
Redesigning Acute Care for Older People: The Start of Sheffields Journey
содержание презентации «Redesigning Acute Care for Older People: The Start of Sheffields Journey.ppt»| Сл | Текст | Сл | Текст |
| 1 | Redesigning Acute Care for Older | 19 | Batching patients for ‘Post-take ward |
| People: The Start of Sheffield’s Journey. | round’ Real-time senior specialist review | ||
| Tom Downes MB BS, MRCP, MBA, MPH (Harvard) | (7/7) Bedded medical assessment unit could | ||
| Clinical Lead for Quality Improvement | be unnecessary for most geriatric medicine | ||
| Sheffield Teaching Hospitals The Health | patients. | ||
| Foundation / IHI Quality Improvement | 20 | Twice weekly senior clinician ward | |
| Fellow 28th November 2012. | rounds Daily senior decision capability on | ||
| 2 | 4.3% per year over the last 30 years | every ward. | |
| Driven by technology and expectation Only | 21 | MDT planning meetings Assess needs at | |
| 0.4% attributable to ageing Need to | home once acute hospital environment no | ||
| deliver over 20% more care in 5 years’ | longer adding value. | ||
| time Need to deliver over 50% more care in | 22 | ||
| 10 years’ time UNSUSTAINABLE. Healthcare | 23 | Porter’s Value Based Design. VALUE. | |
| inflation. Rises in healthcare spending: | What Is Value in Health Care? Michael E. | ||
| where will it end? Jon Appleby, BMJ 1st | Porter, Ph.D. N Engl J Med 2010; 363: | ||
| November 2012. Rises in healthcare | 2477-2481December 23, 2010. | ||
| spending: where will it end? Jon Appleby, | 24 | Implementation headlines: April 2012 | |
| BMJ 1st November 2012. | New discharge process from assessment | ||
| 3 | ‘We must redesign services. Decisions | units Consultant geriatricians ‘on take’ 7 | |
| about service redesign must be clinically | days per week May 2012 Frailty Unit | ||
| led and clinicians must be prepared to | process initially virtually Frailty Unit | ||
| challenge the way services - including | opens mid-May July 2012 Ambulatory care | ||
| their own service – are organised.’. | area for work formerly considered to be | ||
| Hospitals on the Edge – The time for | outpatient. | ||
| action Royal College of Physicians, 13th | 25 | Outcome measure: 34% increase in | |
| September 2012. | discharge within 1 day. | ||
| 4 | Day 2127 as a consultant. | 26 | Outcome measure: Bed occupancy reduced |
| 5 | A ‘system’ problem. | by over 60 beds. | |
| 6 | A complex system problem. | 27 | Was reduction in bed usage due to |
| 7 | 2003 Toyota Corolla. | reduced admissions? No. | |
| 8 | How do others design complex systems? | 28 | Balance measure: Would it have |
| Toyota Oobeya Room. | happened regardless? | ||
| 9 | First find a room. | 29 | Balance measure: Decrease in |
| 10 | The Room. | readmissions. | |
| 11 | Board 1: The Business objectives: | 30 | Balance measure: Decreased mortality. |
| 12 | Board 2: What do these objectives mean | 31 | Value. Value = Outcome / Cost Return |
| for our patients? | on investment = Saving – Investment / | ||
| 13 | Board 3: How are we doing against the | Investment = (?3,000,000 - ?750,000) – | |
| GSM business and patients objectives? | 140,000 / ?140,000 = 2,110,000 / 140,000 = | ||
| 14 | Board 4: High Level GSM Process | 15. | |
| through the complex health and social care | 32 | Not hospital @ home. Resources have | |
| system & Board 5: Real time plan. | started to move to the community Designing | ||
| 15 | Tests. | hospital@hospital and home@home. | |
| 16 | Let me introduce ‘George’. 82 years | 33 | |
| old Lives independently and wants to | 34 | ‘Improvement in health care is 20% | |
| continue doing so Widowed 5 years ago Has | technical and 80% human’ Marjorie Godfrey | ||
| mild dementia Daughter lives locally | The Dartmouth Institute. | ||
| Losing weight and finding walking more | 35 | Conclusion. Modern health care is | |
| difficult. PDSA tests of moving from ‘post | complex Iterative testing and prototyping | ||
| take’ to ‘on take’. | is required Cooperation between and health | ||
| 17 | Challenge to UK geriatric medicine | and social care is essential Our journey | |
| traditions: Split of inpatient / | has only just started. | ||
| outpatient care Combined immediate | 36 | Thank you Tom.Downes@sth.nhs.uk | |
| delivery of specialist MDT care. | @sheffielddoc. | ||
| 18 | |||
| Redesigning Acute Care for Older People: The Start of Sheffields Journey.ppt | |||
Redesigning Acute Care for Older People: The Start of Sheffields Journey
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