The situation

•A large health system in Australia was experiencing poor Emergency Access performance at two of its main metropolitan hospital sites. Internal efforts to identify cause and strategies to improve performance had not achieved any material change, and cultural differences between the sites and between ED and inpatient teams had led to an impasse.  Tektology were engaged to provide an independent review to better understand the causes;  and to build clinical engagement and support for the recommended solutions.

Solution

•Tektology used a four staged approach to collect and assess the underlying causes for poorer Western Australia Emergency Access Target (WEAT) performance. These included: 

•Multi-disciplinary process mapping workshops  

•Independent data analysis of key information systems (i.e. EDIS, EBM) 

•70 hours of on-site independent observations in the ED 

•Solution co-design workshops with leading expert insights

outcome

•The client had visibility of the Emergency Access performance at its two major hospitals and insights into the causes of poor performance at each. Several commonly held views on performance were shown to be incorrect and the root causes were identified. Building on the work delivered during this project, the Health Service expanded AMU short-stay beds, refined mental health pathways and changed the admission criteria for many patient cohorts to remove artificial delays.