Ms Kath Feely1, Mr Robert Mehan1, Ms Georgina Jones1, Ms Belinda Cary1, Ms Jessica Knight1
1St Vincent’s Hospital, Melbourne, Fitzroy, Australia
Aim: To develop a standardised tool that enables provision of equitable physiotherapy services that respond to daily fluctuations in acute clinical demand.
Method: Acute physiotherapy services at St Vincent’s Hospital Melbourne (SVHM) were aligned to inpatient units with fixed staffing profiles. A root cause analysis with key stakeholders identified there was no accessible data measuring daily demand or capacity and that teams only managed demand internally. The Dynamic Allocation of Staff Hours (DASH) electronic tool was developed to capture and communicate daily clinical demand and capacity to inform the department and organisation’s Daily Management System. Physiotherapy workflow was redesigned to move staff from areas with capacity to those with high demand.
Results: Since September 2017 physiotherapists have moved between teams 31% of the time. This reduced unmet physiotherapy contacts from 8% pre implementation to 1% (Dec 2017) and 2% (April 2018). There have been increased contacts for acute patients waiting subacute care from 30% (Jan 2018) to 21% (June 2018). The increased functional training likely contributed to a reduction in average subacute length of stay from 18 days (June 2017) to 14.5 days (January 2018) and 16 days (June 2018). This reduction demonstrated a 7 – 19% improvement and saving of 33 – 84 subacute bed days (n=25). We now have a flexible and equitable physiotherapy service that can react on a daily basis to changes in hospital demand. In July 2018 DASH was rolled out to all Allied Health teams at SVHM. Allied Health can now report their daily “outlook” by 9.30am to inform the Daily Management System.
Significance of the findings to Allied Health: The DASH tool and model can be adapted for Allied Health to improve daily service provision by identifying staff capacity and moving it to areas of high demand in a public hospital setting.
Kath Feely has worked as a Physiotherapist in Public Health in Victoria for 20 years. She is passionate about using data to evaluate and improve service delivery.