The Improving Emergency Access Collaborative (the Collaborative) is working with 11 Victorian health services to take a whole-of-health service approach to addressing constraints in patient flow impacting on four hour length of stay in emergency departments. This important work leverages on existing initiatives and activity in patient flow at health services, and provides resources to expand capacity. The work undertaken by the Collaborative is not limited to emergency departments, and it is expected that improvements will be targeted across the patient journey. This video provides some further information about the Collaborative, highlighting the integral role of Better Care Victoria’s Industry Coaches and the positive experience of St Vincent’s Hospital since joining the Collaborative in October 2016.

Belinda Cary, Collaborative Project Lead, St Vincent’s Hospital

The Better Care Collaborative is an initiative that has involved a number of organisations throughout the state that are all working collectively to achieve the same outcome, which is an improved patient experience through the Emergency Department and improved access and flow for those patients.

Simon Craig, Industry Coach, Better Care Victoria

We know there is a lot of research that says that the wait in the Emergency Department has a very real impact on the outcome of patients. If we can speed that up, we are going to increase access capacity of our health services and also the patient experience and patient outcome. A big part of the Collaborative is supporting problem-solving within our health services. Improvement isn’t just about coming up with a solution. It is about firstly understanding the problem.

Bree Nation, Industry Coach, Better Care Victoria

It started with the organisations getting their data and then using that data, we began to, what we call ‘Process Map’.  So, step-by-step look at how their processes work and then identifying with them what the points are where there’s problems and then gathering data around those problems and also we encourage peer-to-peer learning, through some workshops that we hold. Also, collaboration through networking people together and we have hands-on industry coaches, myself and my colleague, Simon, and they’re really the key components of the collaborative.

Dr Jonathon Karro, Physician/Toxicologist, St Vincent’s Hospital

So, at 830 every morning, we meet in this room. There’s members of the Executive, general medicine, emergency medicine, the Chief Medical Officer and the demand and access team and we all work together to plan the day. We review the previous day’s performance – what things went well, what didn’t go so well and we plan for the day ahead. Every health service that we visited, we’ve brought things back. Going to Frankston and hearing from their general physicians, in particular, in how the emergency medicine interface was crucial in us then engaging our general physicians in the process.

Belinda Cary, Collaborative Project Lead, St Vincent’s Hospital

There’s definitely been some great learnings from the other organisations. So, in particular, the workshops that have being held at each of the different sites have been fantastic to attend. At Eastern Health, for us at St Vincent’s, that was quite a useful visit. We got to witness, or see first-hand, their operating system and we have certainly used some of the information from what they’ve developed at Eastern Health to feed into what we’re working on developing here at St Vincent’s.

Clinton Cummins, Executive Director, Performance Improvement

The improvements have led to significant changes in our access to the hospital. We’ve reduced that time. So, if you came into ED today, you now get seen quicker, you get your treatment quicker, you get your diagnosis quicker. You then, if you’re admitted, you get into your ward and bed quicker.

Dr Jonathon Karro, Physician/Toxicologist, St Vincent’s Hospital

One thing that is apparent is how important data is. We’re very much in a data-driven healthcare system. It’s been really important. I’ve had a lot assistance from the redesign team in collaborating and collecting all the data and I have got to see the value and the data has really helped in what’s the biggest bang for our buck.

Belinda Cary, Collaborative Project Lead, St Vincent’s Hospital

Our experience here at St Vincent’s, I think we’ve been lucky to have strong buy-in from our Executive. It really meant that we were allowed the time to really try and delve deep and really understand the problems without jumping to solutions too early.

Dr Jonathon Karro, Physician/Toxicologist, St Vincent’s Hospital

We’re now running at a current need performance well above any need performance in the past but the most important thing is that our care has remained patient-focused. It’s all been directed at getting the right care to the patient at the right time.

Clinton Cummins, Executive Director, Performance Improvement

So, it’s about investing upfront in your people, the people on the frontline. If you do that in the right way, you build that capability in the frontline, you’ll find the problems, you’ll drive the improvement and it will be sustainable long-term.