"Six Hours It Matters!" is the catch-cry for Dunedin Hospital's revamped approach to finding ways to shorten the time patients spend in the emergency department.
The intention is that improvements will follow an organisation-wide focus on the issue, based on improving patients' care from the time they arrive to the time they leave.
The hospital's poor performance in meeting the six-hour-stay target has been under the spotlight recently, with former clinical leader of the department Dr John Chambers claiming real improvements would not be possible without significant investment.
While the national health target requires 95% of patients to be discharged or transferred from an emergency department within six hours of admission, Dunedin's performance has rarely exceeded 75%.
In December, it was 69.44%.
The new approach builds on the work of a 2008 programme that aimed to identify waste in the department and ways to eliminate it.
Clinical leader of intensive care Mike Hunter is the clinical sponsor of 6 Hours It Matters!, which is expected to link all projects related to the issue.
In a report to go to the first 2011 meeting of the Southern District Health Board this week, corporate sponsor of the latest approach Vivian Blake said achieving this linkage would require a new way of working, one that viewed what the hospital did from the perspectives of the patient and the organisation as a whole.
"This approach is dependent on good communication and ownership of issues."
Mrs Blake said the length of stay in an ED could not be viewed in isolation from community services or other hospital services, as "both the push and pull" from these services would affect ED performance.
Among the projects planned is computer modelling this month to test how different scenarios could work, using data already gathered.
Other projects include changing specialists' and nursing rosters to improve efficiency, putting in extra nursing staff, trialling an admitting medical registrar, improving transition from hospital to home, speeding up triaging and fast-tracking access to CT scanning for some patients.
One of the linked projects is a six-month pilot to follow the journey of orthopaedic patients from presentation at ED to discharge to see where improvements could be made.
The board agreed last year to spend $160,000 on this first stage of the project, in the hope the Ministry of Health would meet the rest of the cost.
GPs to have their say
Otago general practitioners will get a chance to have their say about any shortcomings they see in the system of admitting patients to Dunedin Hospital .
A special meeting has been organised for next Tuesday as part of the programme to decrease the amount of time patients spend in the hospital's emergency department.
The sponsors of the hospital's "6 Hours It Matters!" programme, Vivian Blake and Mike Hunter, want to hear first-hand what experiences GPs have had communicating with inpatient services about patients they feel need to be admitted.
GP liaison officer Dr Anne Worsnop, in her newsletter to GPs, said doctors should also describe what strategies or behaviour they adopted if they were frustrated in getting patients admitted.
"Do they fare any better speaking directly to ED staff?"Mrs Blake and Mr Hunter wanted to hear whether they considered barriers or delays to gaining urgent outpatient appointments affected their decision to refer a patient to the ED.
GPs are also being asked to say how well they consider the assessment and management of rest-home residents is handled, particularly after hours, and whether there are barriers to a more rapid return of those residents.
