Lengthy, medically unnecessary Length of Stay (LOS) for patients awaiting hearings for the appointment of substitute decision makers by the Queensland Civil and Administrative Tribunal (QCAT) is constraining inpatient capacity and putting patients at increased risk of deconditioning and/or adverse events.
Buying Time - An innovative Approach To Stranded Patients
Initiative Type
Redesign
Status
Close
Added
Last updated
Summary
Key dates
May 2016
Sep 2017
Implementation sites
Metro North Hospital and Health Service
Partnerships
Queensland Civil and Administrative Tribunal (QCAT)
Aim
To reduce the barriers to discharge faced by Metro North Hospital and Health Service (MNHHS) inpatients who require access to the justice system for the determination of guardianship matters.
Benefits
- Patients receive timely access to appropriate care
- Increased willingness for destination facilities (subacute, RACF) to accept patients discharged pending a QCAT hearing rather than insisting on completion of a QCAT hearing as a precondition for admission.
Background
The proportion of the population whose matters met QCAT criteria for a hospital-based hearing is 140-160 per annum.
Solutions Implemented
The project partnered with QCAT and other justice services to;
- Purchase additional on-demand hospital hearing days
- Vertically integrate the supply of justice services to better meet patient needs
- Centralise, standardise and streamline application and scheduling processes, both within MNHHS and between MNHHS and QCAT and other justice services
- Co-design education materials and conduct information sessions
Evaluation and Results
- Reduction in the average wait from 66 days pre-project to 23 days for the March 2017 quarter.
- Reduction in inappropriate Interim Order applications from more than 50% of all applications to zero in March 2017.
Lessons Learnt
- A boarder mutual understanding of internal pressures and constraints each organisation created a foundation of collaboration between unlikely partners.
- Health dollars can be spent in creative non-health partnerships to provide patient-centred, cost-effective outcomes.
