Medical service redesign shares the load saving 6000 bed days and improving morale

Area of Science:

• Healthcare Management
• Hospital Operations
• Medical Services Redesign

Background:

• Auckland City Hospital's general medical service faced capacity issues and low staff morale in 2010.
• A critical review highlighted deficiencies in training for registered medical officers.

Purpose of the Study:

• To redesign the general medical service to address capacity constraints and improve staff morale.
• To implement a new model for managing patient flow and workload distribution.

Main Methods:

• A project was initiated to redesign the general medical service, involving workshops with all staff.
• A new model was developed, splitting patient workload into short-stay and long-stay ward-based care teams.
• Admissions were redistributed across 12 weekday teams and 4 weekend teams, with increased consultant staffing.

Main Results:

• Average patient length of stay decreased by 14% (from 3.7 to 3.2 days).
• Median length of stay reduced by 28%, yielding annual savings of 6000 bed days.
• Readmission, inpatient, and 30-day mortality rates remained unchanged.

Conclusions:

• The successful redesign was attributed to management support, staff engagement, data analysis, and increased senior medical officer staffing.
• The new model created more predictable and equitable work practices.
• Ongoing challenges include ensuring continuity of care between doctors and patients and within medical teams.