Presentation fianl copy
- 1. The Royal National Throat, Nose and Ear Hospital
- 2. The Royal National Throat, Nose and Ear Hospital Challenges of managing a newly merged clinical service Presented by : Neeta Lakhani
- 3. The Royal National Throat, Nose and Ear Hospital Introduction The merging of a clinical services is to increase Growth, Efficiency and Capital and most of all to provide a world class service to the patients
- 4. The Royal National Throat, Nose and Ear Hospital Case Study : Ophthalmology Managing the delivery of streamlined pathways Achieving targets Information Management Centralisation of Relationship
- 5. The Royal National Throat, Nose and Ear Hospital Managing the delivery of streamline pathways and Information Management Challenges • What may work on one site may not work on another - Different work methods - Break down in communication and information not reaching the right people • Changes in time tables for clinicians, nurses, the MDT as well as support staff • Mismatched Infrastructure – medical records, data protection, IT. • Resistance/ Adverse reaction to change Possible solutions Allowing flexibility and autonomy - Sharing best practice across site - Clear communication lines regular meetings/ Video conferencing . • Planning and having clear direction. • Having an Electronic system that is accessible to all – consolidating data to a central point • Providing training and support to help manage change
- 6. The Royal National Throat, Nose and Ear Hospital Centralisation of relationship and achieving targets Challenges • 48-hr triage • 18-week pathways • Same level vs subordinate • Decision making Possible solutions • Electronic triaging • Efficient co-ordination across sites • Clear job roles and reviews • To involve the spoke leaders
- 7. The Royal National Throat, Nose and Ear Hospital Summary Clear pathways Communication Co-ordination Sharing Best practices / Resources Flexibility
- 8. The Royal National Throat, Nose and Ear Hospital Framework for Integration (model by Noblis center for health and Innovation) Competitiveness Growth Efficiency Capital Is a function of ↓ ↓ ↓ Institutional Volume and - Expenses + Return on assets performance Service level (cost/unit x units) (Human +Capital) ↑ ↑ ↑ Performance -Geographic penetration -Labour productivity - Incentive alignment Drivers -Community linkages -Process Efficiency - Compensation & -Reputation -Service levels benefits -Programs and service mix - Capacity management - Information & -New product & development - Supply chain infrastructure -Physicians - Care and clinical resource – Plant & Equipment -Quality and service initiatives management - Real Estate - Organisational structure
Editor's Notes
- #4: Merging of clinical services has its challenges
- #5: Having worked at both Hub and spoke the main challenges face included the above The main downfall of the Hub and spoke model is communication Communication with one key point of contact may no necessarily be the right person to make the decision and From Experience decision made at the Hub , may look fine on paper but may not nesarlily work at the spoke sites due to limitations at the sites For example : Surgery setting – At RFH – changing doctors lists to cover another may work as the equipment, trained nursing staff where as at outreach this is not possible thus making any changes may need input from the local sites and see if it is feasble to have make these changes
- #6: The main downfall of the Hub and spoke model is communication Communication with one key point of contact may no necessarily be the right person to make the decision Example of theatres in Barnet : not same function as RFH Clinic mixing : work due to space and shortage of staff : RFH – not at barnet – streamline process such as macular clinics at Barnet For example : Surgery setting – At RFH – changing doctors lists to cover another may work as the equipment, trained nursing staff where as at outreach this is not possible thus making any changes may need input from the local sites and see if it is feasble to have make these changes Teams working with a single managerial structure – prioritising and organisation will be to patients benefit Same terms and conditions for development for staff across all sites Removal of cross organisational boundaries – more clarity for patients The main downfall of the Hub and spoke model is communication Communication with one key point of contact may no necessarily be the right person to make the decision and From Experience decision made at the Hub , may look fine on paper but may not nesarlily work at the spoke sites due to limitations at the sites For example : Surgery setting – At RFH – changing doctors lists to cover another may work as the equipment, trained nursing staff where as at outreach this is not possible thus making any changes may need input from the local sites and see if it is feasble to have make these changes This is an opportunity to have a greater skill pool in work place More resilience in times of operational pressure , sickness and absence Team work can be distributed to other sites to meet targets and demand
- #7: Use example of Edgware community - works and has a high success rates as it can be done via email and works 18 week pathway – using Edgware or Whittington with more capacity – patient choice and efficient utilisation Manager at Barnet – making and running the sites automosly , RFH do the same This is an opportunity to have a greater skill pool in work place More resilience in times of operational pressure , sickness and absence Team work can be distributed to other sites to meet targets and demand Teams working with a single managerial structure – prioritising and organisation will be to patients benefit Same terms and conditions for development for staff across all sites Removal of cross organisational boundaries – more clarity for patients
- #8: Co-ordination –who/ What where Clear pathways – process across all sites clear Communication – with the right people with in the right time frame Flexibility - to allow elasticity when need arises - to ensure care is not affected Sharing - best practice in way of work and sharing resources to reduce costs
- #9: A model on frame work on integration by Noblis center for Health and innovation - this cover the vast number of challenges on faces when any clinical service is merged and need to be managed in order for the merger to be sucessful