Positive signs for Tasmanian health system

Tasmania's health system is showing positive signs of improvement according to the latest statistics.

Shorter waiting lists and improved bed availability in key treatment areas at the Royal Hobart Hospital (RHH) are just some of the improvements recorded by Health Services Innovation Tasmania (HSI Tas), the University of Tasmania based clinical redesign program.

HSI Tas Co-Director Associate Professor Craig Quarmby said one of the most significant improvements had been seen in the RHH's general medicine wards.

"General medicine has decreased the average length of stay of patients in their wards by nearly a day, freeing up eight beds a day in those wards. That's an additional 3000 bed days every year," Associate Professor Quarmby said.

"The staff have achieved these results by making changes that focus on better patient care, things like daily multidisciplinary ward rounds, completing rounds in the morning not the afternoon, and getting patients actively involved in their own care.

"General Medicine patients are getting better care, but crucially it's also a more efficient use of health resources and it's helping reduce access block and emergency department overcrowding. This ensures that other patients benefit too."

Supported by Commonwealth funding, HSI Tas was launched in 2014, first undertaking a thorough diagnostic process to capture solid base data in the State's hospitals.

The clinical redesign process then began in a staggered start last year, and has focused on improving the patient journey in the key areas of emergency department access, elective surgery, bed demand and capacity, specialist outpatient clinics, and mental health.

More than 1700 healthcare staff have undertaken HSI Tas developed and facilitated health service improvement courses and activities under the program, and many others have been involved in clinical redesign workgroup activities across the State.

"The magnitude of this health service improvement program, incorporating both large scale education and training and on-the-ground clinical redesign initiatives is unprecedented in Tasmania," Associate Professor Quarmby said.

"Such solid foundations are now achieving, as anticipated, significant changes in the areas where clinical redesign has begun in earnest."

Improvements include:

• In General Medicine the average length of stay of patients in wards have decreased significantly, resulting in the freeing up of around eight beds a day, or 2993 bed days annually.
• Waiting lists for patients of RHH specialist outpatient clinics have reduced dramatically in the areas of urgent ear nose and throat surgery (a drop from 389 to 61 adult patients, and from 208 to 0 paediatric patients); Plastic Surgery (from 1000 to 675 patients) and Ophthalmology (from 750 to 468 adult patients).
• Clinical redesign initiatives in Surgery and Mental Health, which started recently, are progressing well.
• Statewide and multidisciplinary engagement is producing "one system" outcomes, an example being a recent workshop in Launceston attended by 40 clinicians to look at ways of improving the experience of patients requiring hip and knee replacements.

Associate Professor Quarmby said the clinical redesign improvements would continue to have ongoing benefits for patients, staff and the Tasmanian health system.

"Tasmania's health system has begun the journey, on a previously unexperienced scale, to reach the consistent, high-quality care of every patient that all clinicians wish to deliver.

"And patients and our community are beginning to experience the benefits."

 University of Tasmania

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Positive signs for Tasmanian health system