SITUATION: 

•Our client established their Expansion Plan to deliver a broad range of interrelated and interdependent strategies to improve the capacity and capability of Emergency Department (ED) services across their two sites, as well as increasing their overall clinical capability and capacity.

•Presentations to the FMC ED over recent years had increased rapidly. In the 2019 financial year, FMC had over 90,000 presentations making it the busiest ED in South Australia, delivered from an ED facility designed for 70,000 presentations. The FMC ED was in code white (>125% capacity) more than 30% of the time requiring clinical prioritisation of lower acuity cases. In this context Resuscitation and Emergency Care was regularly prioritised over less urgent categories. Elective Arthroplasty was delivered across three sites and use of theatres at Flinders Private Hospital was not guaranteed beyond mid-2020. SHEP provided an opportunity to relocate elective Orthopaedic Surgery including Arthroplasty and general surgery to NH, allowing comprehensive service delivery from a single site.

SOLUTION:

•Tektology, in partnership with EY, was engaged by SALHN to undertake an evaluation of the SHEP and to identify the extent to which the proposed benefits were achieved, a baseline view of the current performance of the impacted divisions, establish the key areas that were successful to the plan and, to provide recommendations for achieving the benefits where they had not yet been achieved. 

•We applied a quantitative and qualitative approach, using data analysis alongside engagement with key stakeholders to obtain a comprehensive overview of the benefits realised with SHEP. This involved a first round of virtual and face-to-face interviews with executive and clinical stakeholders to obtain qualitative evidence for the achievement of the changes and intended benefits, as well as a second round of stakeholder engagement that consisted mostly in data validation. A series of interactive analytic dashboards were produced in PowerBI, based on all the patient level data provided, to query the dataset and answer a range of questions and hypothesis underlying each of the SHEP benefits to assess the extent to which they had been achieved.

CLIENT OUTCOME / BENEFITS DELIVERED:

•We successfully identified the proposed outcomes that had been achieved:

•Increase capacity and capability at Noarlunga Hospital – New medical and Surgical inpatient capacity is enabling higher admission rates and fewer transfers to FMC. Transferred elective orthopaedic activity is fully operational.

•Continuity of care for patients at Repat Health Precinct – The new Special Acute Dementia Unit (SADU) is operational and offers an improved environment in line with contemporary practice.