Barwon Health Outpatients

1. Barwon Health Outpatients

2. Barwon Health Outpatient Catchment Area

3. Barwon Health Geelong Hospital Barwon Health serves a geographically dispersed population through 2 major sites with a total of 1016 beds and a total of 21 sites. The primary catchment area has a population of 350,000 and for some tertiary services the catchment is 500,000 extending to the South Australian border. The area has some seven million visitors each year that impact on service demand. Health services available through Barwon Health cover the full spectrum  (with the exception of spinal injuries, neurosurgery and transplantation) from emergency and acute to mental heath, primary care, community services, aged care and sub acute/rehabilitation.

4. Barwon Health Outpatients Sites

5. Barwon Health Outpatients Department • The Geelong Hospital Outpatients Specialist clinics run over multiple sites • The Outpatient NUM manages the Specialist clinics run in the Outpatient Department and Outpatient Annexe. (The Outpatient Annexe opened in January 2013 and is located across the road from the hospital main entrance) The following clinics are conducted in these two sites:- General Surgery including Colo-rectal, Upper GIT, Breast Cancer, Plastics, Gynaecology, Chronic Pain Management, Urology, Paediatric Ortho, Ortho, Vascular, Sexual Health, Infectious Diseases, Refugee Health, Respiratory Discharge, General Medical Discharge, Diabetes, Liver, Ophthalmology, ENT, Gastroenterology and Pregnancy care • The number of patient events for the above clinics is 70,000+ per annum • The number of referrals for the above clinics is 30,000+ per annum • DNA rate 10 -15% PFB was commenced 4 years ago and SMS appointment reminders implemented in March 2014.

6. Barwon Health Target Processes - 10.3 and 11.2 The baseline How the health service was previously operating in regards to the target processes 10.3 Communication with referrer about initial findings and assessment • Expectation within 5 working days – not achieved • Variable amongst specialties. • Due to the use of a variety of communication methods (including electronic notes, phone call to referrer, mailed copy of progress notes and dictation) there is currently no effective audit tool to determine compliance 11.2 Discharge summary sent to referrer • Expectation within 5 working days – not achieved • Variable amongst specialties. • Due to the use of a variety of communication methods (including electronic notes, phone call to referrer, mailed copy of progress notes and dictation) there is currently no effective audit tool to determine compliance

7. Barwon Health Outpatients Department Data to illustrate baseline • Data reports are currently unavailable to demonstrate this, due to variability of communication methods used. • The lack of correspondence to GPs is highlighted by anecdotal evidence – including calls to the GP hotline, feedback from the GPLU and discussions at Medicare Local meetings between consultant medical staff, GPs and OPD NUM Challenges identified in changing the way things were done within the health service • Engaging stakeholders, communicating Department of Health expectations to all care providers within the Outpatient setting and subsequent adherence to these guidelines • Provision of efficient and sustainable methods of communication by Outpatient clinicians, to primary care givers to ensure efficient delivery, automated audit process and presentation of audit results to specialty clinics

8. Barwon Health Outpatients - Action plan Description of initiatives that have been undertaken and supported by the Specialist clinics access policy implementation funding initiative • Presentation of Specialist Clinics Access Policy to Specialty Clinical Directors • Identification of deficits within current processes that prevent achievement of current DoH timeframes. • Agreement on an efficient communication process – introduction of specialty specific enotes to facilitate communication with referrer about initial findings and assessment and discharge summary sent to referrer within 5 working days. • Completion of patient summary page in DMR to facilitate faster access into DMR, with direct access to patient episodes, pathology results and all activity feeds to the DMR - accessed on one “page” within DMR. • Introduction of dual screens in each consulting room to facilitate navigation between DMR and Enotes to enhance uptake and reduce clinical risk. • Development of audit tool to ensure capture of dictated and electronic correspondence on initial assessment and discharge.

9. Barwon Health Outpatients - Progress to date What you have achieved so far, if you have met your evaluation milestones • 50% of specialty clinics now have specialty specific enotes available. • Testing of patient summary page underway • OPD NUM has met with some Specialty Directors to promote Access Policy and discuss further rollout of enotes, patient summary page and introduction of dual screens to remaining clinics. • Development of an efficient audit tool for outgoing correspondence via enote • Enhancement of current audit tool for dictated correspondence Any challenges you have encountered • Prioritisation by IT department for creation and testing of accurate data reports required to align with access policy • Limitations of current IT programs and state of flux regarding updating of computers • Ongoing testing of updated IT system, delaying implementation of patient summary page • Setting, implementing and sustaining expectations for all medical staff especially rotating junior

10. Barwon Health Outpatients Department Are you on track to aligning with the Access Policy by 1 July 2015? Aiming for alignment with the Access Policy