Metro South Health
Metro South Health Service Plan 2017–2022 DRAFT FOR CONSULTATION
Metro South Health Service Plan | 2017–2022 1 Metro South Health Service Plan Published by the State of Queensland (Metro South Hospital and Health Service), January 2017
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For more information: metrosouth.health.qld.gov.au
2 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION Contents
List of Abbreviations 4
Executive Summary 6
Introduction 8
Context 6
Our Community 10
Our Health Services 11
Our Challenges and Opportunities 12
Service Directions and Strategies 22
1. Promoting wellbeing and health equity 24
2. Delivering healthcare to support population growth 26
3. Connecting healthcare and putting our patients first 28
4. Pursuing innovation for smarter healthcare 30
Our Service Enablers 32
Implementation and Review 35
References 36
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 3 List of Abbreviations
Abbreviation Definition
ABI Acquired Brain Injury AIM Acute Inpatient Modelling Tool BDHP Brisbane Diamantina Health Partners BIRU Brain Injury Rehabilitation Unit BSPHN Brisbane South Primary Health Network CHR Centres for Health Research ED Emergency Department EN Enrolled Nurse GP General Practitioner HHS Hospital and Health Service ICT Information and Communication Technology ICU Intensive Care Units IPAC Integrated Program for Ambulatory Care LPA Local Planning Area NDIS National Disability Insurance Scheme NSQHS National Safety and Quality Health Service Standards PHN Primary Health Network POST Patient Off Stretcher Time PPH Potentially Preventable Hospitalisation QAS Queensland Ambulance Service QEAT Queensland Emergency Access Target QUT Queensland University of Technology RN Registered Nurse SIU Spinal Injuries Unit TIC Transformation and Innovation Collaborative TRI Translational Research Institute UQ University of Queensland WHS Wynnum Health Service WMCHC Wynnum-Manly Community Health Centre
4 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 5 Executive Summary
The Metro South Health Service Plan 2017–2022 (MSHSP) provides a strategic perspective on health service delivery across all of our services. Robust health service planning—including multi-factorial needs analysis and stakeholder consultation—is essential to ensure our services continue to meet the needs of our community into the future.
6 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION By 2027, Metro South Health will serve a resident technology, quality and safety, research, and service population of almost 1.3 million—the largest of any partners. Detailed planning for each of these areas will Hospital and Health Service in Queensland—as well be completed via the Metro South Health Integrated as providing specialist services to people across the Planning Frameworkiii. State. Over the next 10 years, growing demand for our health services will be driven by overall population Measures of success have been identified for each growth as well as key population trends in Metro of our Service Directions in this Metro South Health South Health, including an ageing population, areas Service Plan. Our performance against these measures of significant socio-economic disadvantage, and will be monitored through the Metro South Health increasing populations of cultural and linguistically Integrated Planning Frameworkiii. diverse groups and Aboriginal and Torres Strait Islander peoples. Health service demand will also continue to Following endorsement of the Metro South Health be driven by the prevalence of modifiable risk factors in Service Plan by the Metro South Health Executive our community, which is reported to account for almost Committee and Board, the Planning, Engagement and one-third of the total burden of disease in Queenslandi. Reform Division will work with Metro South Health Modifiable risk factors include smoking, poor diet, facilities and services to enable implementation as overweight and obesity, risky alcohol consumption, and required. It is important to note that endorsement physical inactivity. of this Metro South Health Service Plan by the Metro South Health Executive Committee and Board does Despite the projections of growing health service not represent a commitment by Metro South Health demand, significant opportunities exist for us to to fund any additional capital and/or operating costs improve the health outcomes of our community that may be required for implementation. Following and mitigate the effects of demand on our services. endorsement, the Implementation Phase will include Advances in clinical technologies and research, incorporation into Service Annual Operational Plans, innovative models of care, and contemporary Service Enabling Plans and stream-level Health Service procurement, funding, quality and workforce Plans, and business case/s development for additional frameworks, all offer the potential to increase the required funding. efficiency and effectiveness of our health services.
We have identified four key Service Directions to provide a focus for Metro South Health to guide our service development and address the future health priorities of our community over the next 5 years:
1. Promoting wellbeing and health equity 2. Delivering healthcare to support population growth 3. Connecting healthcare and putting our patients first 4. Pursuing innovation for smarter healthcare.
Each of our Service Directions will be progressed through the delivery of 19 priority Strategies. These Strategies have been developed to align with the challenges and opportunities identified through our health service needs analysis. The successful delivery of these Strategies is dependent on complementary planning for the impact on key service enablers— workforce, infrastructure and assets, funding,
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 7 Introduction
The Metro South Health Service Plan identifies the key Creating a single, unified health service plan for Metro health service directions and strategies for the efficient South Health has several advantages in enabling us to: and effective alignment of our services to the needs of »» identify and respond to changing populations and our community over a 5-year planning horizon (2017– related health service needs 2022), with a long-term outlook to 2027. The Metro »» understand and respond to current and future South Health community includes not only those living demand for services within the boundaries of our HHS, but also people from »» assess the impact of advances in clinical evidence across Queensland who rely on the public sector health and technologies on the way future services need to services we provide.
Figure 1: Metro South Health Integrated Planning Framework
Service Agreement with Department of Health
Metro South Health Strategic Plan 2015–2019
Metro South Health Annual Operational plan
Service Annual Operational Plans
Hospitals Health Services Support Services
Enabling Plans Health Service Plans
Strategic Finance Plan Addiction and Mental Health Clinical Governance Strategic Plan Aged Care & Rehabilitation Professional Stream Strategic Plans Consultation, Cancer Clinician Engagement Strategy collaboration, Emergency Consumer & Community Engagement Strategy integration Medicine and Chronic Disease Facility Master Plans Oral Health
Total Asset Management Plan Patient Flow Program
Strategic Workforce Plan Surgery
ICT Strategic Plan Women and Children External Service Monitoring our Individual and Partnership performance Performance Plans Agreements
Source: Metro South Health Integrated Planning Framework (2016 Update)III
8 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION be organised and delivered plans and service enabling plans across Metro South »» improve service efficiency through the exploration Health (as shown in Figure 1). The strategic directions of alternative service options that can optimise in the Metro South Health Service Plan have been service delivery arrangements to manage increasing influenced by the strategic state-wide health system demand priorities articulated in documents such as My health, »» prioritise the allocation of limited health service Queensland’s future: Advancing health 2026ii and resources various state-wide health service plans. »» continue to provide safe and sustainable services— high quality care that continues to meet and, where The Metro South Health Service Plan has been possible, exceed required minimum standards. developed following a desktop analysis of various data, plans and reports; as well as feedback from stakeholder The Metro South Health Service Plan provides a engagements with Metro South Health staff, service strategic perspective on health service delivery across partners, patients and our community over the last 12 to all of our services, providing guidance for service 18 months. delivery directions and strategies in other key planning documents, including our strategic plan, clinical stream-based health service plans, service operational
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 9 Context
Our Community hospitals, in addition to a number of health centres throughout the region. In addition, the Princess
Alexandra Hospital, as a major tertiary referral Metro South Health is the most populated health centre, provides state-wide specialty services in liver service in Queensland, with an estimated resident transplant, renal transplant, spinal injury management, population of 1,087,222 in 2014.iv It is expected to brain injury management and skull base surgery. remain the most populated of the 16 Hospital and We also play a key role in education and research, Health Services (HHS) in Queensland by 2027, with a with strong links to the University of Queensland, projected populated of almost 1.3 million people by that Queensland University of Technology, Griffith University time.v and several other academic institutions.
The health service’s catchment spans 3,856 square kilometres and covers the area from the Brisbane River in the north to Redland City in the east, south to Logan and the eastern portion of the Scenic Rim to the border of New South Wales.
Recent annual growth (2013 to 2016) in hospital admissions at Metro South Health facilities has outstripped population growth by more than 9:1, reflecting a number of population and health status trends, and placing ever-increasing demand on our health services. Between 2016 and 2026, an annual growth in admissions of 4.6 per cent is expected , compared to annual Metro South Health population growth of 1.5 per cent.
The highest projected additional population within Metro South Health is expected in the regions of Jimboomba-Logan Village and Brisbane South (west of the South East Freeway and south to the border with Logan City). Our Health Services
Metro South Health is the major provider of public health services, health education and research in the Brisbane south side, Logan, Redlands and Scenic Rim regions. We employ more than 14,000 staff and have an annual operating budget of $2.1 billion.
Metro South Health is comprised of five major
10 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION Metro South Health
Aboriginal and Torres Strait Islander Health
Addiction and Mental Health Services Our hospitals Our major health centres »» Beaudesert Hospital Aged Care Rehabilitation Services »» Beenleigh »» Logan Hospital Cancer Service »» Browns Plains »» Princess Alexandra Hospital »» Dunwich Emergency Services »» QEII Jubilee Hospital »» Eight Mile Plains »» Redland Hospital Medicine and Chronic Disease »» Inala Services »» Logan Central »» Redland Our specialty services Oral Health Services »» Addiction and Mental Health »» Wynnum »» Acute Medical Patient Flow Program »» Acute Surgical Surgical Services Our community-based »» Aged Care services Women’s and Children’s Services »» Cancer Services »» Aboriginal and Torres Strait »» Cardiology Islander Health »» Emergency Medicine »» Addiction and Mental Health »» Obstetrics and Gynaecology »» BreastScreen Queensland »» Paediatrics »» Chronic Disease Management »» Palliative Care »» Community Rehabilitation »» Rehabilitation »» Hospital Avoidance and »» Trauma Substitution »» Transplantation »» Offender Health »» Oral Health »» Palliative Care Our state-wide specialty Our staff services »» Refugee Health »» Liver and renal 14,000 staff members »» Residential Aged Care transplantation (headcount) across clinical and »» Spinal injury management non-clinical streams »» Brain injury management »» Skull base surgery
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 11 Challenges and Opportunities
12 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION Population
AGEING POPULATION Proportion of Metro South Health population aged 65 2027 years + 16% | 201,076 people | (QLD = 18%)
Older people are higher users of health services, and will be increasingly so, as younger age groups with higher burdens of “lifestyle-related” diseases enter the 65 year and over age group. viii, iv, v
SOCIO- 43% of Logan residents live in areas classed as being in the ECONOMIC top 20% of socio-economic disadvantaged areas in DISADVANTAGE Australia.
There are areas of significant socio-economic disadvantage in Metro South Health. People in these areas can have a 69 per cent higher rate of potentially preventable hospitalisations, and a higher profile of risk behaviours and chronic disease. ix, iv
2011 CULTURALLY 32% of Metro South Health residents reported being AND born overseas; half of those from non-English speaking background countries. LIGUISTICALLY DIVERSE 2015 562 humanitarian entrants settle in Metro South Health. POPULATION 44% of all humanitarian entrants to QLD.
Migrants may face language barriers and cultural practices that make it difficult to access health services. x, xi, xii
ABORIGINAL Projected annual population growth AND TORRES 2011 to 2026 STRAIT Brisbane Indigenous Region 3.3% | (QLD = 2.9%) ISLANDER Total Metro South Population 1.6% | (QLD = 1.9%) POPULATION
There are higher rates of projected population growth amongst the Indigenous population compared to the total population in Metro South Health. Aboriginal and Torres Strait Islander people statistically bear a greater burden of ill- DRAFT FOR CONSULTATIONhealth and early death than non-Indigenous Queenslanders.ix Metro South Health Service Plan | 2017–2022 13 Health Status Leading causes of death and burden of disease The “burden of disease” can refer to premature death and/or living with a reduced quality of life due to xv, xvi Risk Behaviours illness. Metro South Health residents have higher rates of Death: Heart disease, stroke and dementia risky health behaviours than the Queensland average Burden of disease: Cancer, mental disorders and heart xiv across a number of indicators. disease
Better or worse than Qld average Potentially Preventable Hospitalisations (PPHs) PPHs are conditions where hospitalisation is believed Overweight and to be avoidable through provision of timely and obesity adequate non-hospital care. xvii
2016: 16% of all Metro South Hospital hospitalisations Smoking were potentially preventable Leading conditions: Diabetes complications, urinary Alcohol tract infections and cellulitis. consumption
Fruit and vegetable consumption DRAFT FOR CONSULTATION Physical activity
Adult Child
Service Demand
Increasing demand for Increasing demand for Metro South Health hospital admissions our health services our hospital beds for people aged over 70 2016 38,642 46% 61% 2027 81% 2016–2027 2016–2027 69,881
Private hospital use Patient outflows Patient inflows
total public bed days total Metro South Health total accessed by Metro South bed days provided to Health residents in non admissions 35% non Metro South Health 50% Metro South Health 19% residents Highest in Brisbane East LPA 1 - 62% facilities 1 Lowest in Logan LPA - 34% Highest outflows to West Moreton HHS, Highest inflows from West Moreton, Metro Mater Health Services and Children’s North and Darling Downs HHSs Health Queensland HHS
Notes: 1. LPA =Local Planning Area
Sources: Metro South Health Service Activity Projections, 2016 xviii Metro South Health Bed and Treatment Space Projections, 2016 xix 14 AcuteMetro Inpatient South Modelling Health (AIM) Tool Service13-14 Base Case Plan (for private | 2017 hospital–2022 use by Local Planning Area) xx DRAFT FOR CONSULTATION Projected required growth (2016-2022) with Recent growth (2013-2016) EXISTING patient flow patterns Our hospitals Hospital Outpatient ED Hospital Outpatient ED Beds admissions services services admissions services services
Beaudesert Hospital 1% 36% 18% 62% 24% 38% 14
Logan Hospital 34% 23% 15% 22% 10% 17% 166
Princess Alexandra 29% 10% 0% 44% 29% 45% 393 Hospital
QEII Jubilee Hospital 25% 40% 25% 25% 24% 36% 108
Redland Hospital 18% 22% 3% 50% 15% 21% 155
Metro South Health 27% 21% 9% 37% 22% 24% 836 Hospitals
Sources: Decision SUpport System (DSS) (Recent Growth)vi Metro South Service Activity Projections, 2016 (Project required growth)xvii Metro South Bed and Treatment Space Projections, 2016 (Projected required growth)xix
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 15 Service Demand
»» High growth areas | Significant recent growth at QEII Jubilee and Logan Hospitals (new and expanded ED capacity opened in 2014-15). »» Emergency treatment time | Decreasing Queensland Emergency Access Target (QEAT) EMERGENCY performance (percentage of patients who leave ED within 4 hours) in Metro South Health, CARE from 75.3% in July 2013 to 68.4% in June 2016. xxi »» GP-type presentations | Minor decrease (2.4%) in “GP-type” presentations to Metro South Health EDs in 2015–16. Rates vary considerably across MSH facilities.xxii »» Leading ED diagnoses | Possible cardiac chest pain, viral infection, abdominal pain, non cardiac chest pain, urinary tract infection.xxiii
»» Medical services—future high growth areas | Cardiology, qualified neonates, neurology, gastroenterology, maternity. »» Surgical services—future high growth areas | Maxillo-facial surgery, transplants, head and neck surgery, cardiac surgery, urology. »» Procedural services—future high growth areas | Chemotherapy, radiotherapy, INPATIENT gastrointestinal endoscopy. CARE »» Elective surgery wait lists | Increasing total wait list and number of long wait patients in 2015–16. Longest wait lists in orthopaedics, urology, and general surgery.xxi »» Sub and non acute services | Significant recent growth in rehabilitation activity at Logan (new Rehabilitation Unit opened 2014) and Beaudesert Hospitals. Identified need for expanded sub-acute models of geriatric and evaluation management services, as well as dementia services. »» Mental health services—future high growth areas | Community care units, child and adolescent acute services. »» Services near where people live | A significant proportion of Logan-Beaudesert and Redlands residents access inpatient services from hospitals out of their local area; for example from Princess Alexandra or QEII Jubilee Hospitals, instead of from their local health facilities.
16 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION Service Demand
»» Future highest growth areas: - Sub-acute—rehabilitation, hospital avoidance programs, geriatric medicine - Medical—cardiology, epilepsy, spinal, neurology, gastroenterology OUTPATIENT - Other outpatient treatments—minor medical and surgical procedures CARE - Primary health care. »» Specialist outpatient wait lists | 33% decrease in total wait list in 2015-16. Longest current wait lists in orthopaedics, neurology, gastroenterology, general medicine, and opthalmology.xxi
»» Infrastructure that meets the needs of modern health care delivery in a community setting | Wynnum Health Service and Inala Community Health Centre are established centres that have been prioritised by stakeholders for service redesign and infrastructure improvement. Community-based oral health services and addiction and mental health services have also been prioritised for improved service access and infrastructure solutions. COMMUNITY »» Connecting healthcare | Need for better integration of care across funding, policy and BASED delivery barriers, improved chronic disease management, and better hospital avoidance CARE programs and post-discharge care. »» BreastScreen services | An increasing number of BreastScreen Queensland Brisbane Southside (BSQ BSS) clients are being screened outside of catchment. The number of new clients accessing the service has been steadily declining, while the number of clients retained by the service (rescreen rate) has been steadily increasing.
»» Improved residential aged care for people with dementia | The existing secure dementia unit at Redland Residential Care (RRC) does not meet best practice dementia RESIDENTIAL friendly design principles to provide optimum care for residents displaying behavioural AGED and psychological symptoms of dementia (BPSD). CARE »» Expanded psychogeriatric residential services | RRC currently provides 16 designated psychogeriatric residential beds. Mental health service activity projections indicate that by 2027, an additional 25 beds will be required to meet demand.
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 17 Service Directions — Such expansion brings opportunities to work together to address known infrastructure and workforce capacity Queensland health system challenges for public sector services. In recent years, Metro South Health has developed partnerships with Mater Health Services, St Vincent’s Private Hospital My health, Queensland’s future: Advancing health Brisbane and Canossa Private Hospital, to help 2026ii. meet the growing public health service needs of our community. The key service directions for the Queensland health system are:
1. Promoting wellbeing Service Directions — 2. Delivering healthcare 3. Connecting healthcare Australian Government policy 4. Pursing innovation National Disability Insurance Schemexxvi Metro South Health remains a key referral service for The National Disability Insurance Scheme (NDIS) will statewide specialist services; however, regional health begin in the Metro South Health catchment in the 2018– services are planned to grow in capacity and capability 19 financial year. We will need to plan how Metro South over the next 10 years to support better access to Health services will be involved with the NDIS and work health care for all Queenslanders. Metro South Health closely with the Queensland Government to ensure a will have a key clinical leadership role in mentoring smooth and effective transition. the development of regional specialist services, while also gaining opportunities to capitalise on capacity Aged Care Reformxxvii efficiencies resulting from reverse patient flows. A 10-year program of aged care reform is being implemented by the Australian Government. These HHS Service Agreement with the Department of changes are aimed at making Australia’s aged care Healthxxv system: The Service Agreement between the Department of »» Sustainable and affordable Health and Metro South Health covers a three-year »» Provide greater choice and flexibility for consumers period and identifies the health services that Metro »» Support people to stay at home, and part of their South Health will provide, funding arrangements communities for as long as possible for those services, and the targets and performance »» Encourage aged care businesses to invest and grow indicators to ensure outputs and outcomes are »» Provide diverse and rewarding career options. achieved. It outlines program-specific funding commitments as well as purchasing incentives, which Primary Healthcare Networksxxviii direct investment and service development towards Primary Healthcare Networks (PHNs) were established areas of high priority for the Queensland Government. by the Australian Government in 2015 to increase the efficient and effective delivery of primary health care. Private health services Metro South Health will need to work in partnership The opening of the Mater Private Hospital Springfield with the Brisbane South PHN to achieve improvements in October 2015 represents the largest expansion of in primary health care and care coordination within the private health care services available to Metro South Metro South Health catchment. Health residents in recent times. However, a number of other private health care providers (e.g. primary care, diagnostics, allied health, medical specialists, hospitals and aged care services) have recently expanded or have plans to expand their services across our region over the medium term.
18 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION Funding »» Significant oversupply of Enrolled Nurses (ENs) graduates over next 10 years »» Legislated nurse-to-patient ratios in Qld—further The tension between limited funding growth and increase RN shortages. an increasing requirement to do more without compromising quality and safety is driving change. Oral Health To deliver on these requirements, an increased »» Supply of all oral health workforces is expected to focus is needed on innovation, outcomes-based exceed demand. resource allocation models, and hospital avoidance and prevention programs. However, current funding Allied Health mechanisms for HHSs are heavily focussed on acute »» Expanded scope of practice strategies have hospital-based activity, with limited opportunity for demonstrated success in managing increasing funding of community-based primary care and early service demand intervention services. »» Risk of shortages—orthotics and prosthetics, medical physics, psychology—due to prolonged training pathways and/or limited training supply. Infrastructure
The projected increases in demand for health care services in Metro South Health are greater than the existing infrastructure and asset capacity can Quality and Safety accommodate. Meeting future health service demand through the delivery of high quality services will require NSQHS Standardsxxxi an investment in new facilities and better use of Our health services must be accredited to the National existing facilities. If left unchanged, the current asset Safety and Quality Health Service (NSQHS) Standards. portfolio will develop significant capability gaps by There are 10 Standards which focus on areas essential 2027xxix. to improving the safety and quality of care for patients:
Workforce
The following future clinician workforce implications have been identified, arising from workforce, population, health status and health service utilisation trendsxxx:
Medical Practitioners »» Shortfall of over 3,000 medical practitioners across Qld by 2023 »» Increasing feminisation of the workforce— participation and attrition impacts in future years. Flow-on effects to workforce management and human resource policies »» Shortfalls in ophthalmology, general practice, psychiatry and radiology.
Nurses and Midwives »» Impact of age-related retirement of Registered Nurses (RNs)—41% of RNs and RN midwives to retire by 2022 DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 19 DRAFT FOR CONSULTATION
20 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION EQUIPNational Standardsxxxii Research and Innovation EQuIPNational provides a further five Standards that focus on the performance of non-clinical systems as a part of comprehensive organisation-wide assessment— Metro South Health is an internationally recognised Service Delivery, Provision of Care, Workforce Planning leader in biomedical and clinical research, with a strong and Management, Information Management, and history of collaboration between clinicians, scientists, Corporate Systems and Safety. university partners and industry. Translating research into real benefits for patients and innovations in the Other Standards way we deliver services must remain a priority for the »» Nursing Excellence—The Magnet Recognition future. Program ® and Pathway to Excellence Program ®, developed by the American Nurses Credentialing Center, are globally recognised designations for excellence in nursing care (www. nursecredentialing.org).xxxiii »» Patient-Centred Care—Planetree Person-Centred Care Designation is a globally-recognised external accreditation in patient-centred care based on evidence and standards (www.planetree.org).xxxiv
Technologyxxxv
There are both opportunities and challenges for healthcare services in using technology to enable the shift from episodic, provider-centric service delivery to patient-centric, accountable health management. There is growing demand for online services, alternative models of care, evolving clinical practice and advances in biomedical equipment.
Some of the relevant global innovation opportunities include:
»» Electronic medical records »» Portals »» Information interoperability »» Mobile health »» Mobile telecommunications technologies »» Integrated scheduling and eReferrals.
While technological and clinical innovation has the potential to contribute to remarkable advances in health care, it can also contribute considerably to increases in health care expenditure. In an environment of limited resources, it is essential to evaluate and identify technologies and programs that improve patient outcomes and offer value for money from those that offer no value or low value.
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 21 Service directions and strategies
Our Service Directions build on the directions future health priorities of our community over the established in My health, Queensland’s future: next 5 to 10 years, as identified through analysis of Advancing health 2026ii. They represent the key the service challenges and opportunities identified focus areas for Metro South Health to address the in the previous section.
22 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION The service directions are:
Measuring our success... | Promoting wellbeing and health equity | »» reduced child obesity rates We will promote wellbeing for all in our community »» reduced smoking rates by promoting healthy behaviours and increasing »» increased fruit and vegetable illness prevention and early intervention services. consumption »» reduced suicide rates We will improve health equity amongst our »» increased childhood immunisation rates community by targeting services to meet the needs of »» increased cancer screening those at highest risk of poor health outcomes due to participation rates social determinants, biomedical risk factors and »» reduced hopsitalisation rates for behavioural risk factors. Aboriginal and Torres Strait Islander 1 peoples Measuring our success... | Delivering healthcare to support population growth | »» improved performance against QEAT We will prioritise increases in service capacity to best »» improved performance against Patient Off Stretcher Time (POST) targets meet the projected increases in health service demand »» Reduced wait times for specialist arising from current service challenges, population outpatients growth and key health status trends. »» Reduced wait times for elective surgery
2 Measuring our success... »» reduced PPH rates | Connecting healthcare and putting our patients first | »» reduced GP-type presentations to ED »» reduced readmission rates We will support our patients on their healthcare journey »» increased telehealth utilisation rates by better integrating care between primary care, »» implementation of Metro South Health hospitals and other community-based healthcare actions from Statewide Health Service providers. Plans »» Implementation of Integrated Health Plan/s 3 »» Complete NDIS service transition Measuring our success... »» Implementation of redesigned Metro | Pursuing innovation for smarter healthcare | South Health Patient Flow Program »» Implementation of digital healthcare- We will translate evidence-based service innovations enabled service delivery improvements into better practice and healthcare for our community. »» Implementation of evidence-based 4 service innovations DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 23 1 Promoting wellbeing and health equity
24 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION What we will do
Implement strategies to improve childhood immunisation rates to 95 per cent at 1 year, 2 years and 5 1.1 years of age.
Improve coverage of annual staff influenza vaccination program throughout Metro South Health to 1.2 reduce the risk of staff contracting flu and transmitting it to patients who may be at risk of serious illness.
Improve the efficiency of cancer screening programs (breast, bowel and cervical) in Metro South Health 1.3 through partnership with the Department of Health to: »» Improve coordination of health promotion activities to develop health awareness and increase the participation rate of Metro South Health residents »» Improve population based modelling of cancer screening demand and the development of location- based activity targets.
Expand the implementation of the Smoking Cessation Clinical Pathway throughout Metro South Health 1.4 facilities and to Metro South Health Oral Health patients, to contribute to reduced smoking rates in the Metro South Health population.
Implement the Metro South Health Oral Health Service Planxxxvi (2016) to deliver a suite of service 1.5 efficiency initiatives and improve oral health services for the Metro South Health population.
Expand addiction and mental health prevention and early intervention services across identified at- 1.6 risk populations, such as youth, perinatal, and various socially vulnerable groups.
Develop and implement Metro South Health service plans for: 1.7 »» Aboriginal and Torres Strait Islander populations »» Multicultural populations.
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 25 2 Delivering healthcare to support population growth
26 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION What we will do
Facilitate increases in total bed and treatment space capacity for MSH facilities to safely and sustainably meet projected future demand, including enabling residents to access services as close as possible to where they live:
Current bed Projected required 2.1 capacity (2016) bed capacity (2022) Gap
Beaudesert Hospital 39 44 -5 Logan Hospital 427 712 -285 Princess Alexandra 1,024 1,267 -243 Hospital QEII Jubilee Hospital 217 291 -74 Redland Hospital 205 466 -261 Redland Residential Care 128 149 -21
Total at major Metro South 2,040 2,929 -889 Health facilites (as listed)
Priority areas for service development in each facility are: Priority areas for service development
Beaudesert Hospital Emergency, Rehabilitation Logan Hospital »» Increase capability and capacity to provide services to local residents »» Emergency, Medical (respiratory, general medicine, neurology), Surgical (orthopaedics, general surgery, endoscopy), Maternity, Neonatal, Mental Health acute, Sub and non-acute Princess Alexandra Emergency, Medical (ICU/CCU, neurology, general medicine), Surgical Hospital (orthopaedics, plastics, endoscopy), Mental health (acute, ABI, community care units), Sub and non-acute (including SIU, BIRU) QEII Jubilee Hospital Emergency, Medical (including ICU) Surgical (orthopaedics, urology, endoscopy)
Redland Hospital »» Increase capability and capacity to provide services to local residents »» Emergency, Medical (general medicine, renal dialysis, ICU), Surgical (general surgery, endoscopy), Maternity, Neonatal, Mental health (acute, community care units), Sub and non-acute Redland Residential Complex aged care, Transition care, Psychogeriatric care, Dementia care Care
Provide expanded integrated community health services for the Wynnum-Manly community from the 2.2 new Wynnum-Manly Community Health Centre (Gundu Pa) (WMCHC) (to replace existing Wynnum Health Service (WHS) facility).
Facilitate increases in specialist outpatients capacity for Metro South Health facilities to meet projected future demand, especially for the following services: 2.3 »» Cardiac rehabilitation, Diagnostic support services, Geriatric medicine, Hospital avoidance, Minor surgical and medical procedures, Neurology.
Maximise partnerships with private health service providers—e.g. Mater Health Services—to meet 2.4 growing service demand.
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 27 3 Connecting healthcare and putting our patients first
28 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION What we will do
Implement an Integrated Program for Ambulatory Care (IPAC) in Metro South Health, aimed at reducing 3.1 ambulatory care sensitive hospital presentations and outpatient referrals. Key deliverables include:
»» Expand chronic disease “beacon” »» Support GPs to establish Health Care partnerships between specialists and GPs Home services »» Community-based chronic disease »» Urgent care service model management, including Nurse Navigators »» ED Live online tool for case management »» Expand SpotonHealth online tool »» “Pathways to Home” service—improved »» E-Consult Call Centre for GPs and QAS discharge processes paramedics
Expand the use of telehealth to deliver inpatient and outpatient services—to improve service access 3.2 for patients and support other service providers to deliver quality care.
Implement the recommendations of the Statewide adult brain injury rehabilitation health service plan 3.3 2016–2026xxxvii and Statewide adult spinal cord injury health service plan 2016–2026xxxviii , as relevant to Princess Alexandra Hospital services.
Develop and implement a Logan Health Plan—recognising the specific and urgent health needs in this 3.4 region—in collaboration with various government agencies, health service providers, non-government organisations, and the Logan community.
Complete service planning and implementation to ensure a smooth transition of Metro South Health 3.5 services to the National Disability Insurance Scheme.
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 29 4 Pursuing innovation for smarter healthcare
30 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION What we will do
Implement redesign of the Metro South Health Patient Flow Program to enhance strategic patient 4.1 flow management across MSH through engagement, communication and evidence-based integrated service delivery.
Leverage the benefits of the Digital Hospital Implementation Project through redesigning health 4.2 service delivery models to improve service efficiency and health outcomes for patients.
Advance service innovation ideas through the Metro South Health Transformation and Innovation 4.3 Collaborative (TIC), to enhance the culture of innovation within Metro South Health and ensure innovative ideas are supported through robust project management and evaluation frameworks. The following service innovation projects are currently in the TIC Concept, Planning and Early Implementation phases:
»» Acute Stroke Care Improvement Project »» Peritoneal Dialysis App »» Dementia Service Strategy »» Post-ICU Follow Up Clinic »» End of Life Strategy »» Safer and Kinder Care for Patients »» Exercise Equipment in Early Psychosis »» Structured Interdisciplinary Bedside Clinic Rounding »» Gestational Diabetes App »» Gastrointestinal Endoscopy Strategy
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 31 Service Enablers
The successful delivery of our health service directions and strategies is dependent on complementary planning for the impact on key service enablers. An overview of the key strategic directions for our service enablers is provided below, with detailed planning completed via our Integrated Planning Framework (Figure 1).
Workforce
Develop a Metro South Health Strategic Workforce Plan which identifies priority actions over the next five years to ensure an appropriately skilled and sustainable workforce to successfully support: »» future demand for health services; and »» future service delivery models, including consideration of demand shifts, new models of care, new technology, policy and legislative directions, and industry trends.
Infrastructure and Assets H
Master Planning (15 year horizon) completed for Logan, Princess Alexandra, QEII Jubilee and Redland Hospitals. Initiatives have been prioritised to align with the areas of greatest service delivery need and business continuity risk.
Key opportunities include: 1. strategic alignment of infrastructure with service needs and the appropriate allocation of funds through a prioritisation framework to support enhanced and sustainable service delivery 2. better use of existing infrastructure through extending life by appropriate maintenance, re-utilisation and refurbishment of both building and equipment assets 3. establishment of public-private partnerships 4. government investment 5. implementation of delivery frameworks, methodologies and governance to support project management, leasing, equipment management and planning.
32 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION Funding
Collaborate with the Department of Health to design funding and investment models that incentivise health service delivery that is: »» patient-centred »» health outcome-focussed »» integrated across sectors »» resource efficient.
Adopt a strategic approach to prioritising services and interventions in order to maximise health gain for our community: »» incorporating concepts of efficiency, low-value care and investment in growth services in a fixed budget environment.
Technology
1. Delivery of Digital Hospital and other eHealth initiatives to Metro South Health facilities – e.g. Electronic Medical Record, McKesson Capacity Planner, Imprest Medication Management Program, Patient Flow Manager Program, Telehealth capacity 2. Support clinical excellence through innovation, mobility and access to data 3. Investment in Health ICT actively and effectively supports Metro South Health in addressing its major priorities 4. Continue to build on our excellence in ICT governance, planning and innovation 5. Continue to build our internal capability to deliver and support ICT 6. Focus on improving customer experience with ICT services 7. Support the enablement of information to be easily exchanged between Government departments, business and the community.
Quality and Safety
»» Maintain National Safety and Quality Health Service (NSQHS) Standards accreditation across all Metro South Health facilities - mandatory patient safety and quality care accreditation »» Achieve EQUIPNational Standards accreditation across all MSH facilities – additional five standards to the NSQHS standards, that focus on non-clinical systems performance »» Achieve Magnet Recognition Program ® re-designation at the Princess Alexandra Hospital – recognised excellence and leadership in nursing practice and research »» Achieve Pathway to Excellence Program ® designation across Metro South Health facilities – recognised excellence in nursing and midwifery services »» Achieve Planetree Person-Centred Care designation across Metro South Health facilities – recognised excellence in person-centred care.
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 33 Research
The Centres for Health Research (CHR) is the coordinating body for research at the Princess Alexandra Hospital. The CHR provides: »» advice and support to researchers and clinicians »» promotion of funding opportunities and assistance with developing grant applications »» pre- and post-award administration of research grants »» assistance with intellectual property and contractual agreements »» administration of research governance and ethics processes, including hosting the MSH Human Research Ethics Committee.
The Translation Research Institute (TRI) is located on the Princess Alexandra Hospital campus, and is a partnership of four medical research institutions: Queensland Health; Princess Alexandra Hospital; The University of Queensland (UQ); Queensland University of Technology (QUT); and Mater Research, and its health partner, DSM Biologics. TRI combines clinical and translational research to advance progress from laboratory discovery to application in the community.
Metro South Health is proud to be one of the Brisbane Diamantina Health Partners (BDHP) – an Academic Health Science System, bringing together eight of Queensland’s leading hospitals, universities and research institutes. The BDHP mission is to integrate innovative research with education, training and clinical care to deliver the highest quality healthcare for our local and extended communities.
Service Partners
»» Maintain a strong partnership with the Brisbane South Primary Health Network (BSPHN) to move towards a more integrated and coordinated health care system »» Evaluate public-private partnerships to meet infrastructure and asset requirements »» Maintain relationships - including effective service agreement performance management - with public and private sector service delivery partners to ensure sustainable publicly-funded health service delivery for our community (eg. Mater Health Services) »» Increase value-based contracting and outsourcing to improve the effectiveness and efficiency of support services and procurement.
34 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION Implementation and review
Following endorsement of the Metro South Health »» Performance monitoring via regular reviews as Service Plan by the Metro South Health Executive detailed in the Metro South Health Integrated Committee and Board, the Planning, Engagement and Planning Framework. Reform Division will work with Metro South Health facilities and services to enable implementation as required.
It is important to note that endorsement of this Plan by the Metro South Health Executive Committee and Board does not represent a commitment by Metro South Health to fund any additional capital and/or operating costs that may be required for implementation.
Key activities in the implementation of the Metro South Health Service Plan will include:
»» Facility and service-level analysis of the Service Directions and Strategies and incorporation into Service Annual Operational Plans, Service Enabling Plans and stream-level Health Service Plans »» Business case/s development for additional required funding (both capital and operational), and submission through appropriate funding approval committees »» Support implementation »» Transition to “business as usual”
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 35 References iQueensland Health. The health of Queenslanders 2016. Report of the Chief Health Officer Queensland. Brisbane: 2016. iiQueensland Health. My health, Queensland‘s future: Advancing health 2026. Brisbane: 2016 iiiMetro South Health. Metro South Health Integrated Planning Framework (2016 Update). Brisbane: 2016 ivAustralian Bureau of Statistics. Catalogue No. 3235.0—Population by Age and Sex, Regions of Australia; Consultancy for QGSO. Prepared by: Statistical Analysis Linkage Team, Department of Health. Brisbane: 12 September 2016. vAustralian Bureau of Statistics. Queensland Government Population Projections, 2015 edition (Cat No. 3235.0). Prepared by Statistical Reporting and Coordination Unit, Department of Health. Brisbane: 4 May 2016. viQueensland Health. Decision Support System (DSS)—ABF Analysis Module. Accessed: 28 July 2016. viiQueensland Health. Acute Inpatient Modelling (AIM) Tool 13-14 Base Year—Purchasing Scenario. Brisbane: 2016. viiiAustralian Institute of Health and Welfare. Australia’s health 2014. Australia’s health series no. 14. Cat. no. AUS 178. Canberra: 2014. ixQueensland Health. The health of Queenslanders 2014. Fifth report of the Chief Health Officer Queensland. Brisbane: 2014 xRoyal Australian College of General Practitioners. Multicultural health: The RACGP Curriculum for Australian General Practice 2011. Melbourne: 2011. xiAustralian Bureau of Statistics. 2011 Census of Population and Housing. Accessed via ABS Table Builder: 9 August 2016. xiiAustralian Government (Department of Social Services). Settlement Reporting Facility. Accessed: 15 September 2016. xiiiAustralian Bureau of Statistics. Aboriginal and Torres Strait Islander Population Projections. Accessed via ABS.Stat: 9 August 2016. xivQueensland Health. Queensland Survey Analytic System—Queensland Preventative Health Survey 2015–16. Accessed via SPR Insights: 1 November 2016.
xvAustralian Institute of Health and Welfare. MORT books: Primary Health Network (PHN), 2009–2013. Canberra: AIHW 2016. xviQueensland Health: S Begg, M Bright, C Harper. Burden of disease and health-adjusted life expectancy in Health Service Districts of Queensland Health, 2006. Brisbane:2009. xviiQueensland Health: Potentially Preventable Hospitalisations, Metro South Hospital and Health Service, Queensland Hospital Admitted Patient Data Collection. Prepared by Statistical Analysis and Linkage Team, Department of Health. Brisbane: Accessed 25 August 2016. xviiiMetro South Health. Metro South Health Service Activity Projections, 2016. Based on Estimate of Future Activity 2015 Version 4.1 and Acute Inpatient Modelling (AIM) Tool 13–14 Base Year—Purchasing Scenario. Brisbane: 2016. xixMetro South Health. Metro South Health Bed and Treatment Space Projections, 2016. Prepared using Queensland Health-endorsed Health Service Planning Guidelines and the Department of Health 2016 Nominal Bed Projections
36 Metro South Health Service Plan | 2017–2022 DRAFT FOR CONSULTATION Methodology (Fact Sheet). Brisbane: 2016.
xxQueensland Health. Acute Inpatient Modelling (AIM) Tool 13-14 Base Year—Base Case. Brisbane: 2016.
xxiQueensland Health. System Performance Reporting (SPR). Accessed: 25 August 2016.
xxiiMetro South Health. Emergency Department Type of Presentations Report. Prepared by Metro South Decision Support, July 2016.
xxiiiMetro South Health. Performance Explorer Management System. Accessed: 14 July 2016.
xxivMetro South Health. Metro South Health Residential Aged Care Places Projections, 2016. Based on Commonwealth Government Aged Care Places commitments, Aged Care Planning Regions and current places therein, and Population Projections. Brisbane: 2016.
xxvQueensland Health. Metro South Hospital and Health Service, Service Agreement 2016/17–2018/19. Brisbane: 2016.
xxviMetro South Health. NDIS intranet page. http://qheps.health.qld.gov.au/metrosouth/ndis/home.htm. Accessed 5 September 2016.
xxviiAustralian Government (Department of Health). Aged Care Reform internet page. https://agedcare.health.gov.au/ ageing-and-aged-care-aged-care-reform/why-is-aged-care-changing. Accessed 5 September 2016.
xxviiiAustralian Government (Department of Health). Primary Health Networks internet page. http://www.health.gov.au/ internet/main/publishing.nsf/Content/PHN-Background. Accessed 5 September 2016.
xxixMetro South Health. Total Asset Management Plan 2016/17–2030/31. Brisbane: 2016.
xxxQueensland Health. Health of the health workforce. Brisbane: 2015.
xxxiAustralian Commission on Safety and Quality in Health Care. National Safety and Quality Health Service Standards (September 2012). Sydney: 2012.
xxxiiAustralian Commission on Safety and Quality in Health Care. Introducing EQUIPNational—Australia’s Premier Accreditation Program. Sydney: 2013.
xxxiiiAmerican Nurses Credentialing Center. ANCC internet page. http://www.nursecredentialing.org/. Accessed 6 September 2016.
xxxivPlanetree. Planetree internet page. http://planetree.org/. Accessed 6 September 2016.
xxxvQueensland Health. eHealth Investment Strategy. Brisbane: 2015.
xxxviMetro South Health. Metro South Health Oral Health Services—Health Service Plan. Brisbane: 2016.
xxxviiQueensland Health. Statewide adult brain injury rehabilitation health service plan 2016–2026. Brisbane: 2016.
xxxviiiQueensland Health. Statewide adult spinal cord injury health service plan 2016–2026. Brisbane: 2016
DRAFT FOR CONSULTATION Metro South Health Service Plan | 2017–2022 37 www.metrosouth.health.qld.gov.au
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