Transforming Health Milestones for 2017 and Evaluation Framework Lynne Cowan, A/Deputy Chief Executive, Transforming Health LHN Consumer and Health Advisory Councils TH Forum 30 November 2016

What our patients are experiencing through Transforming Health changes Specific patient focussed outcomes

Transforming Health Traction

Transforming Health Traction LENGTH OF STAY RESULTS Average length of stay has reduced in our metropolitan hospitals by a whole day this year, when compared to performance in the previous two years The proportion of procedures undertaken on a same-day or 23 hour basis across metropolitan Adelaide have increased, e.g. at Noarlunga Hospital for same day by nearly 2% and for 23 hour basis by 37.3% This means patients who don’t need to be in hospital longer than clinically necessary are freeing up bed capacity

Transforming Health Traction SPECIFIC PATHWAYS RESULTS Improving Stroke management has contributed to reductions in the average LOS across our metropolitan hospitals. At July 2016, overall average LOS for Stroke conditions across CALHN, NALHN & SALHN was 7.8 days – a reduction of 3.2 days compared to July 2015. SALHN demonstrated the most improvement in LOS and additionally, more than 10% of patients spent time in a dedicated Stroke Unit compared to the same time in the previous year. These results demonstrate our increasing effectiveness and efficiency caring for patients needing highly specialised care

Transforming Health Traction SPECIFIC PATHWAYS RESULTS Neck of Femur Fracture patients who need emergency hip fracture surgery used to wait up to 150 hours for their surgery in NALHN – now many patients are waiting less than 15 hours for surgery   Across our metropolitan hospitals patients are staying an average of 2 days less in hospital for hip fracture surgery, compared to last year.  This shows our patients getting to theatre more quickly, recovering faster and getting home much sooner.

2017 Transforming Health Priorities Specific patient focussed outcomes

Key Priorities – RGH decommissioning

Key Priorities – Jamie Larcombe Centre Concept image – Jamie Larcombe Centre

Key Priorities – General Rehabilitation services transferring to TQEH and Modbury Hospital general rehabilitation services transferring to Modbury Hospital (preliminary planning in progress). Concept images

Key Priorities – Flinders Medical Centre New Rehabilitation Building

Key Priorities – FMC Older Persons’ Mental Health Unit

Key Priorities – Southern Adelaide Palliative Services Concept images

Key Priorities – Flinders Medical Centre Multi-storey carpark Seven levels 1,780 spaces – 1,220 more than current

Key Priorities Continuing productivity and efficiency improvements for length of stay, same day and 23 hours elective surgery and clinical pathways Embedding continuous improvement & the importance of considering the four principles in all that we do: Patient centred Clinician-led Quality focused Evidence based Continued engagement and consultation with staff, unions and industry partners about change processes occurring as a result of Transforming Health initiatives.

Transforming Health Evaluation Specific patient focussed outcomes

Transforming Health Evaluation Transforming Health is a complex reform agenda over several years. To understand, measure and promote the benefits of Transforming Health an Evaluation Framework is being developed, in partnership with the South Australian Academic Health Science and Translation Centre at SAHMRI. Through initial discussions themes emerged as the basis of the Evaluation Framework. These are: Clinical Improvement and Economic Benefits System Improvement Staff Experience and Capacity Consumer and Community Experience

What do we need to know in an evaluation of Transforming Health? Did we improve patient outcomes? Did we improve patient experience? Did we improve the way we deliver services? Did we improve our staff capabilities as clinical leaders and service providers? Did we improve the system as a whole? Did we do everything we set out to do in Transforming Health?

Progress so far …. SA Health currently collects a lot of data and monitors a lot of things As part of the evaluation we want to use what's appropriate and build on this Workshop held 3rd August to engage and start the conversation. Attended by: The TH Consumer and Community Engagement Committee Also attending Health Performance Council, Clinicians, SAHMRI, SA Health staff, Academics

Transforming Health Evaluation Working Group Committee established to provide advice and oversee the establishment of the TH Evaluation Framework, and implementation of the TH Evaluation and reporting process. Set up under the auspices of the SA Academic Health Science and Transition Centre (SA Centre). Reports directly to the SA Centre Implementation and Evaluation Sub-Committee with input and advice as required from the Ministers Clinical Advisory Group (MCAG)

Transforming Health Evaluation Working Group cont… Key Priorities Chaired by Professor Alison Kitson First met late October 2016, next meeting 1st Dec. Membership includes: - Health Consumers’ Alliance - Health Performance Council - Researchers/Academics - SA Health clinicians and administrative staff - SA Centre Implementation and Evaluation Sub-Committee members

Work to be done …. Refine the evaluation questions across the identified themes Agree how to answer these questions – methods, data requirements Some questions may require new evaluation activities be undertaken, e.g. focus groups Prepare evaluation reports Work to be undertaken by Principal Evaluation Coordinator (position being recruited) under the guidance of the Evaluation Working Group