Improving and designing innovative HITH services to foster care in the community

Ingrid Ridler, Manager of Mercy@Home, Patient Access and Workforce Coordinator at Mercy Hospital for Women joined us recently to discuss her futuristic goals and how to get strategic direction for HITH services in Australia.

Ingrid will be presenting at the upcoming Hospital in the Home Conference 2014, which will take place on 26th and 27th May 2014 at the Rydges in Melbourne.

At the upcoming HITH Conference, you are speaking about a unique model of care that combines two separate streams of funding to service mother and baby, with care provided by an individual midwife. Can you provide us with a brief insight into the journey of this family centred model of care and why it is unique?

Ingrid: It is unique because the very model reflects how we can change our approach to how we service the patient and her family efficiently and be economically streamlined.

The mother and baby are not visited by two separate nurses or midwives from two separate programmes.  We link the midwife to the two programmes to keep the family unit together with planned care that is discussed with the mother and the family.

Watch this space.

The Hospital in the Home Conference will provide attendees with case studies that offer innovative and practical solutions for the challenges and issues associated with HITH services. What do you see as the futuristic goals and getting strategic direction for HITH services in Australia?

Ingrid: The challenge is to balance good health outcomes for patient/family centred care. With decreased length of stay, an increased demand for hospital beds, and increased cost of health services, we need to be progressive in our approach to balance health outcomes that involve the patient and her family.

Mercy Health (MH) has an innovative model of care that has streamlined programmes to meet clinical care efficiently, economically and supporting the national health care standards.

We use one senior clinician who is credentialed to meet the needs of both mother and baby.  This has a positive effect on a patient/families’ journey when she is discharged or transferred to our services.  The journey that the mother and baby take through the health system is interrelated as one unit, one plan and one goal – promoting quality efficient economical health care outcomes.

At MH our quality plan along with strategic directions supports both programmes.  We need to be more active and involve consumer participation to set health industry standards to meet a family/patient focused care.

I look at HITH, as a floating ward that is variable, and should be able to expand and contract depending on demand.  MH has this ability; we rotate staff from other areas to support high demand.

The challenge to support most HITH programmes is to get the right match for good quality plans, resources and workforce to meet consumer needs.

The economic challenge and question is how can we sustain growth and demand?  I hope I can listen and learn from the speakers who are presenting their individualised HITH units, and the challenges that they face and the outcomes that they have achieved.

Earlier in the research stages, you mentioned that other countries welcome the progression of telemedicine to enhance hospital in the home services, by using I Pads for example. How do you envisage telemedicine changing the delivery of HITH in Australia and what tools would assist you and others working in this area of healthcare?

Ingrid: There are some countries that have mobile medical units that are dispatched to the point of care.  We have not reached this level of expertise.  That would be the ultimate form of telemedicine at point of care.  My vision is to have a mobile unit with medical support, radiology, pathology results, drugs, and health plans being implemented at the point of care.

Mercy Health is working on programmes to support staff in the community giving them access to clinical health care information.  We are trialling an application that has access to clinical pathways, the data is on a tablet, clinical care is entered and saved  on the programme and is easily accessed by health workers.   Information sharing is available to staff to meet clinical needs for the patient.

Via Citrix access to results can be viewed and discussed with relevant key internal and external stakeholders such as doctors, social workers, allied health paediatricians, obstetricians, Maternal and Child Health care workers, enhanced care, for all patient needs.

We also have a live tracking security system for staff in the community.  The programme is activated by the midwife, who leaves the hospital, and we are able to view her visits, the address and an SOS is also available for them to activate if required.

My futuristic goal is to plan health care around a family centred model of care that adds value to the environment and is sustainable.  A paperless user friendly system that is easy to us, resourceful, and is accessible for internal stakeholders to meet optimum clinical needs.

You are very passionate about collecting your own data. Can you provide some further details about this and incorporate the challenges and benefits of doing so?

Ingrid: Our care is hard to capture because it is not tangible. The biggest hurdle I have is how to qualify and quantify our activity and care.

We have a robust data programme called Donel that captures every episode of care, the clinical care we have given, the variances, and the outcomes.  We summarise the data that reflects this care, on Donel, and then look at all the variables that have been documented.  We then focus on how best to achieve best practise outcomes,  using the  data that we have collected  and then modify the care to suit the patient and achieve safe quality health care outcomes.

The questions that I pose in order to be an efficient and effective unit:  Where do we go with data collection?

The data that I have collected over 3 years reflects our increased demand.  It reflects optimal delivery, and customer satisfaction.

Where to next? How do I leverage our unique model of care to meet consumer needs?

With finite resources stretching how can I be innovative in improving clinical outcomes to meet increasing health care demands? 

In addition to contributing as a speaker, you’re also chairing the 14th Annual Hospital in the Home Conference. What aspects of the conference are you most looking forward to?

Ingrid: We are all challenged with leading complex organisations in a changing health care system.

The HITH Conference will bring together like minded people who are aware of the shift of care to the community which is consumer focussed.

Over the 2 day conference the same theme will arise to meet the challenge of quality health care outcomes that deals with design, lean thinking, and learning new and innovative ways to meet health care needs and at the same time meeting the strategic direction of quality safety performance, and innovation.

As managers we are all trying to explore our leadership styles, how can we manage through health care design, and be effective leaders in the organisation to drive change and streamline innovative services.

All the speakers have the same outlook, we need to lead a health care system that improves the use of our health care $$$s. Each speaker will be discussing the principles of how best to manage a HITH unit.

Speakers will be talking about what we have, how we are challenged, how we can improve and design a HITH service to foster care in the community and at the same time be innovative in the way we deliver our service.

I am excited about being part of this national conference that brings together passionate people who focus on sharing their experience in their HITH units, how they have been successful in meeting health industry change, the challenging  demands placed on their units, and being innovative in their approach to quality standards of one of the world’s best health care facilities. 

To find out more about the event program and to register, please visit the 14th Annual Hospital in the Home Conference website.