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Paediatric Admissions

16

Appendix 2

PLC Admission from ACH ED FLOW Project

(included with permission from Dr JM Bailey)

Goals:  

1.

Improve use (% occupancy) of PLC beds from current baseline (May 07-April 08 : 53-82% per month, average 68.6%)

2.

Spread patient occupancy more evenly over the pediatric units (currently units 2, 3, and 4 at ACH average 85-95 % occupancy)

3.

Ensure the “right patient” is in the “right bed.  Monitor PLC to ACH transfers (current baseline 1-2 per month)

Methods:

1.

Identify patient characteristics that require ACH admission and direct all other admissions preferentially to PLC.

2.

Use diagnosis examples to highlight PLC-appropriate patients and distinctions between patients targeted for ACH and PLC care.

3.

Target daytime patients for PLC when available: likely small numbers but this is ideal time for PLC admissions.  Nighttime admissions are the major proportion of admissions so these must also be targeted in the project if the gaols are to be achieved.

4.

Broad education campaign for all staff and for patients and the broader public regarding regional pediatric care.  Messages see below for examples

Barriers:

1.

PLC housestaff coverage:  Use of PLC more frequently and consistently can only occur if there is consistent in-house coverage.  Currently, family medicine residents are providing less consistent coverage and other options such as extenders/IMG’s are being considered.  Project will be unsuccessful if there is inconsistency in the level of patient acuity that PLC can accommodate such that it changes from day to day based on coverage.

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