Every day as I drive to work, I reflect on how privileged I am to work in healthcare. My work life has been a rich experience where I have been able to positively influence patient, family and community experiences. As you know, healthcare is a balance between the best and worst times from sitting, listening and holding the hand of a patient at 2.00am after they have received bad news, relaying sad news to a family member, celebrating the joy of a new baby or talking to community groups about how they can access care. Every experience has been an honour.

On day 19 in my role at CKW, I am very focused on how we can improve the care we provide to our community and in particular, how patients flow through our health system.

As an example, Emergency Departments (ED) are great places when you need immediate care to stabilise your condition and gain a provisional diagnosis. However, we also know that EDs are not places where people want to spend a long time. The environment can be overwhelming for patients, not to mention, that it is always daytime! The lights are always on, people are always noisy and there is little opportunity to rest and recuperate.

Taking these things into account, and also observing the areas where we can make improvements, the executive team have decided to re-energise priorities around ensuring we move our patients to the best place at the right time to receive the best care possible.

This week I will focus on areas that impact acute patient flow such as:

• presentations to the ED – managing the ambulance flow in unison with the patients in the waiting room
• patients staying for extended periods in our inpatient wards and ED
• our capacity and processes in outpatient areas
• the need for early discharge to ensure early bed availability
• our alternative care opportunities such as hospital in the home and Virtual Ward.

There are any ways that we can improve patient flow including:

• Ambulance offload

We are expected to take over care from the Queensland Ambulance Service (QAS) within 25 minutes to ensure that the QAS can leave to attend to community calls. None of us would want to have one of our family members needing help and unable to receive it as a result of avoidable delays. Occasionally, there will be challenges in achieving the 25 minute goal, however we have an absolute commitment to never hold an ambulance longer than two hours (with the goal to release them as early as possible).

• Long stays

When patients stay for prolonged periods in ED, it prevents other patients being seen. It is also recognised that patients who stay for extended periods, also have delays to treatment and recovery. This can then lead to longer, unnecessary hospital stays. Our focus is to ensure patients move out of the ED efficiently. This is to ensure they receive treatment in the most therapeutic environment. It is expected that patients never stay in ED longer than 24 hours.

To improve flow and the safety for our patients it takes a whole-of-hospital approach. There are very simple actions that you can take to assist:

• understanding that the discharge of patients is a priority
• considering other areas of care or support for early discharge such as HITH and Virtual Ward
• using the Transit Lounge for all clinically suitable patients, including while waiting for prescriptions and discharge letters (discharge scripts and processes can be effectively completed in Transit Lounge)
• notifying Patient Flow of empty beds as soon as possible
• organising discharges the day prior and prioritising discharge reviews early
• ensuring Kyra / HBCIS is kept up to date
• maintaining effective communication with key team members.

Welcome to our 2024 UQ medical students

This week UQ Clinical Site Coordinator Dr Lisa Kane and Student Coordinator Gay Meikle were busy inducting our 3^rd and 4^th year medical students. Nearly 30 students will complete their placements at CKW this year, a highly regarded placement recognised for its excellent clinical training and peer support! Importantly, students are also engaged in discussions about ‘respectful and compassionate care’, and how to develop and hone communication skills with patients and the multidisciplinary team.

This is a fantastic approach that helps students to understand and appreciate that being a good doctor is also about having empathetic and compassionate interactions with their patients and colleagues.

Welcome to CKW!

A patient’s perspective

To keep us focused on the great work done at CKW, I thought I would share a recent compliment:

I would just like to submit my feedback regarding my recent pregnancy and birth experience at Caboolture Hospital. I was also in the midwives and me program and Ria was my midwife. I could not speak more highly of the service and support I received throughout. 

The team provided me with such great care and ensured my concerns were addressed when I attended to be monitored. All the reception staff whenever I attended hospital were always helpful and friendly. I am so thankful that I was able to participate in the midwives and me program.

Ria provided such wonderful support and guidance. Her knowledge and caring nature make her such an asset to your team. As a first-time mum I could not have felt more supported. I was also very grateful for the post birth home visits. I also had the pleasure of meeting with Teresa, Em and Leisa and they were all just as wonderful, supportive, knowledgeable. They truly are a great team.

I got to attend the new midwives and me clinic in Morayfield. It made attending appointments so easy, great location and convenient. I hope this space will still be around in the future when I hopefully have another baby. You have a wonderful maternity service and I will happily provide this feedback to those around me. I hope this can be passed onto the team.

To the people mentioned in this compliment, well done! What fantastic recognition of your professionalism and compassion.

Bribie Island Satellite Hospital

This week Acting Director of Operations David Thompson and I visited the Bribie Island Satellite Hospital. It is still very much a construction zone, as the new Chemotherapy Unit and other key functional spaces take shape. I am always impressed how these large infrastructure projects take life, as many different teams such as onsite construction teams, tradespeople, project team members, architects and clinicians all work together, quickly learning the new  ‘language’ of infrastructure.

As David said, “On a project like this, it is important to have clear communication and adopt an approach where you take time to understand the needs of each team and the impacts they have on each other as well as the project goals”.

Balancing competing needs can be a challenge for all CKW teams. What skills and values help you manage projects and situations like this?

Refurbishment update – Caboolture Hospital

Refurbishment works commence across Levels 1 and 2 in the main hospital building on Monday 15 January 2024. If you identify a construction issue affecting clinical services or the comfort and safety of patients, visitors or staff, please contact the CHRP team.

• During business hours email Caboolture_Projects@health.qld.gov.au or phone 5316 5464.
• Outside business hours, weekends and public holidays, please contact the on-call engineer.

CKW Grant submission

Just a reminder that the CKW Research Grant round closes in March 2024. CKW has a thriving research culture which contributes significantly in advancing healthcare and improving outcomes. I encourage staff to consider applying.

CKW Health Research Grants

• Open 11 December 2023
• Close 8 March 2024

Novice Researcher up to $10,000; Experienced Researcher up to $20,000. CKW and UniSC Collaborative Grant

• Open 11 December 2023
• Close 8 March 2024

Refer to our Researcher Hub for Advice to Applicant documents, and TPCHF Smarty Grants portal to apply.

Reflection of the week

Healthcare has changed so much over my time working and sometimes the goals set seem so large. As I spoke about our focus on improving patient flow and removing ‘never events’ as never means never – not sometimes, I realise that some people might be sceptical, but think about this…

‘Nothing is impossible, anything can happen’
‘Whatever we can conceive and believe, we can achieve’
Napolean Hill

Regards,

Karlene.