Ms Kath Feely1, Mr Robert Mehan1, Ms Georgina Jones1, Ms Belinda Cary1, Ms Jessica Knight1
1St Vincent’s Hopsital Melbourne, Fitzroy , Australia
Aim: To develop a standardised tool that enables provision of equitable physiotherapy services that respond to daily fluctuations in 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 acute teams 31% of the time. This reduced unmet physiotherapy contacts from 8% to 1% and increased contacts for acute patients waiting subacute care by 30%. This likely contributed to a reduction in average subacute length of stay from 18 to 14.5 days (June 2017 and January 2018). This reduction demonstrates a 24% improvement and saving of 84 subacute bed days. 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.
Significance of the findings to allied health: The DASH tool and model can be adapted for Allied Health to improve service provision in an 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.