Fast Track Process Map by linzhengnd


									                        Where are you now?                What do you need to do                   What do you need to
                                                                  next?                           implement Fast track?

                    What does the current system          Develop an implementation plan.       Develop business rules for the
                    look like?                                                                  management of Fast Track
                                                          Map the ideal journey for low         Identify.
                    How do the clinical areas of the      acuity ambulatory patients with           Where it will work, whether
  Purpose:          ED currently function?                key stakeholders.                          space and staff are

 Understand         What are your present timelines       Identify how you would like Fast          The limitations of fast track
 the present        of care for?                          track to work. Answer the                 Breach management
 system and             Performance against Triage
                                                          following questions:
                                                               Where would you like it to
 what needs              category?
 to be done to                                                 happen?                          Identify how will you measure the
 improve                Total treatment time?                 Will the area be                effectiveness of Fast track and
 access to                                                     quarantined?                     the key performance indicators
 care.              Are there times of peak activity           What time of day would you      used. Suggested kpi’s are:
                    for lower acuity/ambulatory                like it to be operational?            Triage benchmarks, total
                    presentations or are the                   What are the timelines of             treatment time,
                    presentation rates consistent              care? (2 hours total                  % Of patients treated in fast
                    24/7?                                      treatment time)                        track
                                                                                                     Patient and staff
                                                          Ensure that all key stakeholders            satisfaction.
                                                          understand what Fast Track is
                                                          and the elements of success.

                                                          Visit sites that have implemented
                                                          a Fast Track Model

                    Is there a separate process for       Identify what current processes       Identify what type of patients you
                    the management of low acuity          can be simplified, eliminated,        wish to manage in fast track and
                    ambulatory patients?                  combined or reordered?                develop the selection criteria.

                    Are patients streamed to defined      Understand what adds value to         Identify who will be responsible
                    clinical areas of the ED based on     the patient journey and what          for managing the flow of patients

                    their clinical presentation? Who is   doesn’t                               through fast track.
                    looked after and where?
                                                          Identify what process do you          Identify how results will flow back
  Process:          When does clinical care               need to change in order to            to Fast Track.
                    commence and by what process?         implement fast track.
 How do
 patients flow      How do patients move through          Decide on the operational             Develop a process to manage the
 through the        the system?                           characteristics i.e. what is the      transfer of patients who need
 ED and how                                               ideal time of operation, how          ongoing care in to other clinical
 will Fast          Who drives the flow of patients       patients will flow is to the area     areas of the ED.
 Track              through the ED?                       and identify the scope of practice
 access to          What are the effective elements       Identify the implications of other
 care               of the current process?               parts of the ED will be affected as
                                                          a result of the implementation of
                    What are the barriers to patient      Fast Track (e.g. Acute/
                    flow?                                 Radiology/ Pathology)

                    Understand the current                Identify the clinical and             Develop clinical order protocols
                    ambulatory case mix Minor injury,     operational policies needed to        for the management of patients in
                    minor illness or both.                drive patient flow and support        fast track
                    Are there clinical order protocols
                    available to assist in the
                    implementation of care?

                    Who are the key stakeholders          Identify who you will need to staff   Develop position descriptions
                    and how do you engage them?           Fast Track and whether the roles      available for staff allocated to
                                                          are new or existing.                  Fast Track.
                    How do all roles currently
   People:          function?                             Analyse the current roles and         Develop competencies and an
 Understand                                               responsibility of key positions and   educational program for nursing
 who the staff      Are there any staff quarantined to    how they fit with the Fast Track      staff
 are, how           care for low acuity ambulatory        model of care
 they function      patients?
 and what                                                 Identify what skills do staff need
 role they play     What skills nursing staff use to      to have to have to work in Fast
 in the patient     manage the patient journey?           Track.
                    Is nurse time seen captured           Identify what are the educational
                    when is implemented?                  requirements needed prior to the

Emergency Department Models of Care: Fast Track Implementation:

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