QI In Action: Same-day rehabilitation reform
V-QIL Program participant, Mrs Kera Fulurjia undertook a project to improve the data captured from outpatients to enhance service delivery at their rehabilitation facility.
This week we showcase a fantastic project undertaken by Virtual Quality Improvement Lead (QIL) program participant, Mrs Kera Fulurjia, Project manager- Rehabilitation Strategy from St John of God Health Care.
Project Background
St John of God Health Care (SJGHC) is a not-for-profit organisation that operates 19 hospitals across Australia. Six SJGHC hospitals in Victoria provide outpatient rehabilitation services; all six hospitals were in scope for this project. Our hospitals have limited optics on their outpatient rehabilitation service patient experience, activity, workforce and financial performance. Therefore, they are unable to make evidence-based decisions about quality improvement, service development, workforce requirements and service offering to remain fit for purpose for the communities they serve.
Project Summary
By August 2023, our goal was to send outpatient reported experience measures (PREMS) to 100% of patients who complete outpatient rehabilitation programs and to provide these hospitals with a live dashboard displaying meaningful data to support them to provide a fit for purpose health service.
We investigated the drivers for poor optics through workshops with end-users and documented their response in affinity diagrams. We observed and mapped each hospital’s administration processes and held interviews with senior leadership to understand how the lack of data affected decision-making. These findings were documented using a fishbone diagram. We found 100% of hospitals used arduous paper-based activities. The driver for poor optics was that no hospital collected PREMS and 100% of the hospitals cited inaccurate data in the patient administration system (WebPAS).
We brainstormed solutions with end-users and focused on three solutions: 1. A gold standard administration process that supported operational requirements. 2. Standard configuration of webPAS to collect the data required for business optics and PREMS. 3. An online education and training program for caregivers.
The above three solutions took over 12 months to iteratively develop with Plan, Do, Study, Act (PDSA) cycles (Figure 2). There was significant engagement with multiple key stakeholders to ensure the solutions met our caregiver expectations. In March 2023, we rolled out these products iteratively across each hospital and used the PDSA system between each implementation. We found caregiver anxiety and lack of team communication was the biggest risk for ‘go-live’ success. To combat this, we built a checklist that outlined everyone and everything that they needed to do; we held regular sessions to reduce anxiety; and the change manager flew to Victoria to support the go-live. We found this support improved the caregiver’s confidence and limited issues with the go-live. Now all sites are live, we have monthly meetings between all sites to provide ongoing support.
Results
In June 2023, we reached our stretch goal of 100% PREMS surveys being sent to patients who completed their rehabilitation programs.
Drive improvement at your organisation – Join our V-QIL Info Session Now
Participants of the V-QIL program have the opportunity to undertake a work-based improvement project while being guided by our expert faculty of clinicians. V-QIL is a 9-month program broken up into 6 modules that delivers methods, tools and coaching to equip participants with the skills to become an improvement leader.
We are running a free information session for those interested in the 2024 V-QIL Program. Register now to learn more about the program structure, pricing and benefits for your career development.
