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The 2007 New Zealand Health Innovation Award Ceremony was held on the 10th October 2007 in Wellington. Of the 22 finalists, four projects were from the Canterbury DHB.
Finalists from the Canterbury DHB
A Group Circuit Rehabilitation Programme Improves Accessibility to Physiotherapy
Services (Physiotherapy Department, Burwood Hospital)
Limited resources and an increasing waiting list provided an opportunity to
review the service delivery of physiotherapy outpatients at the Brain Injury
Rehabilitation Service (BIRS) at Burwood Hospital. A group circuit training
programme was implemented (once a week for eight consecutive weeks) to determine
if it would improve lower limb functional outcome measures (balance, speed,
endurance and strength) and improve patient’s quality of life scores.
The results demonstrate highly positive findings for clinical outcomes, quality
of life and value of the programme (to patients, BIRS and Physiotherapy staff
and service delivery). The results in the Burwood programme reflected those
documented in literature. Unexpectedly, this programme also decreased
participants’ risk of falling and 50% of participants became ‘community
walkers’. From these findings, it can be concluded that a group circuit training
programme has a definite positive effect on patient outcomes and is a cost
effective method of reducing physiotherapy outpatient waiting times. With these
impacts the programme is improving service delivery for this patient population.
This project also won the ‘Hospital and Specialist Services’ category in the
2006 Canterbury DHB Quality and Innovation Awards.
Contact: Allyson Calder
Front Door Physio – A New Physiotherapy Service in the Emergency Department
(Emergency Department, Christchurch Hospital)
This project was designed to address the group of patients who waited in
Emergency Department (ED) / Emergency Observation Area (EOA) for Physiotherapy
assessment. In an already congested environment this group of patients further
contributed to the congestion and overcrowding in ED and the Emergency
Observation Area (EOA).
Audits of weekend and weekday patient activity indicated that 30 – 40 patients
per 8-hour period (peak time) would have been referred to a Physiotherapist, had
one been available.
In the, then, current process the majority of these patients remained in the EOA
for an extended period of time and were then discharged without having a
physiotherapy assessment and with no community care referral for physiotherapy.
Of this group, some patients were admitted to Christchurch Hospital.
The initiative was targeted at peak-time patient numbers in ED / EOA and aimed
to provide efficient attention to patients’ clinical needs in an
interdisciplinary team environment. The project involved implementation of a
full time physiotherapy service within the ED/EOA/OOPD areas of Christchurch
Hospital. This service was 7-day a week with time of delivery matched to patient
demand.
A full-time physiotherapy service was piloted from July to December 2005. During
which several success indicators were recorded, these included; a reduced length
of stay in ED/EOA, increased discharge rates (from ED/EOA), decreased numbers of
patients leaving ED without been seen by a Physiotherapist and high level of
staff satisfaction with the physiotherapy service provided. Following these
successful results, approval was given in January 2006 to implement a permanent
full time physiotherapy service in the ED/EOA and the Orthopaedic Outpatient
Department (OOPD) area with a 1.4FTE allocation. This project also won the
‘Supreme Award’ and ‘Systems Improvement’ category at the
2006 Canterbury DHB Quality and Innovation Awards.
Contact: John Kenny
Improving the Patient Journey
Programme
This project is facilitated by the Business Development Unit (BDU) whose vision
it is to support operational staff within the Hospital and Specialist Service
group to achieve key service objectives, by providing specialist project and
operations management resources. The unit operates in both a project management
and advisory role, ensuring projects are completed on time, within budget and
integrated into the daily management activity of the Divisions.
The 'Improving the Patient Journey' programme was formally launched in October
2004. It is a single, uniting banner for quality and performance improvement
within the clinical and patient processes of Canterbury DHB. While the
'Improving the Patient Journey' programme encompasses all clinical areas of the
Canterbury DHB, initial focus has been on the health services provided at
Christchurch Hospital (medical and surgical divisions).
Since its launch the ‘Improving the Patient Journey’ programme has: improved the
flow of patients by reducing ‘bottlenecks’ in the processes and increased the
capacity of the services to more efficiently match capacity to demand. Other key
results to date have been the reduction in patient wait times in ED, the
introduction of 3 additional acute theatre sessions and the implementation of a
night team coordinator to support clinical staff. Contact:
Yvonne Williams
Improving the care of children with gastroenteritis and dehydration (Paediatric
Department, Christchurch Hospital)
The initial aim of the project was to audit the clinical practice of children
with gastroenteritis against international guidelines. This audit within the
Paediatric Department at Christchurch Hospital highlighted significant
deficiencies in current practice.
Gastroenteritis is a common seasonal illness with dehydration being the most
significant complication. International consensus statements recommend oral
rehydration (ORT) as the most appropriate treatment for mild to moderate
dehydrated children. It is safe, effective and cost efficient. However despite
these recommendations ORT is underutilised in the developed world.
A local guideline was developed in an attempt to increase the use of ORT and
reduce painful interventions such as intravenous (IV) or nasogastric (NG)
methods. A proforma was also developed which aimed to overcome a number of
barriers to successful use of ORT including; excessive vomiting, unclear
instructions, nursing input and parental beliefs/disempowerment.
The combination of a guideline and proforma has significantly increased the use
of ORT, reduced the numbers of children receiving invasive procedures and
allowed patients to be safely discharged after shorter periods of observation.
Shorter patients stays and lower equipment costs has economic benefits too.
This project also won the ‘Runner-up Award' in the 'Hospital and Specialist
Service' category at the 2007 Canterbury DHB Quality and Innovation Awards. Contact: James Hector-Taylor