11 Envelope Template by ymw83458

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									The Yellow Envelope
Category 4: Building Partnerships for
Health




Kerry Bartlett
The Yellow Envelope
North Coast Area Health Centre
Aim
 To measurably improve communication, documentation and safe
  medication management between Residential Aged Care
  Facilities (RACFs) and Coffs Harbour Health Campus within 12
  months.




                                                                 1
Nature and extent of the problem

 All three key stakeholders had expressed dissatisfaction with
  communication and documentation relating to transfer of
  patients to RACFs (i.e. clinical handover).

   Diagnostic phase included:

        Surveys

        Open forums

        Formation of a working party




                                                                  2
Strategic importance

 Effective engagement of GPs and the RACF managers has
  resulted in improved coordination of care to meet individual
  patient needs (Category 2B).

 Reduced risks in relation to medication management (Category
  2A).

 Improved how patient’s experience transfer between acute
  facilities and RACFs (Category 2C).




                                                                 3
Planning & implementing solutions

 The preliminary working group met monthly for a period of 6
  months to plan and implement changes

 The partners collaboratively planned the envelope template

 Staff education conducted by discharge planner (hospital) and
  Division of GPs Project Officer (RACFs)




                                                                  4
Outcomes & evaluation

 Satisfaction surveys demonstrated positive improvements with
  communication and documentation.

 62% of respondents rated use of the yellow envelope as
  excellent or very good.

 Reduction in telephone and written complaints.




                                                                 6
                  Satisfaction with Documentation
                      Between RACF & CHHC

             60
             50                                 Excellent
Percentage




             40                                 Very Good
             30                                 Good
             20                                 Fair
             10                                 Poor
              0
                    2004              2008



                                                            7
                  Satisfaction with Communication
                     Between RACF and CHHC

             60                                   60
                                                  50
                                                       Satisfaction with Communication
                                                          Between RACF and CHHC


                                                                                     Excellent




                                     Percentage
                                                  40                                 Very Good
                                                  30                                 Good
                                                  20                                 Fair
                                                  10                                 Poor
                                                  0                                  N/A
                                                           2004          2008




             50                                                                                  Excellent
Percentage




             40                                                                                  Very Good
             30                                                                                  Good
             20                                                                                  Fair
             10                                                                                  Poor
             0                                                                                   N/A
                      2004          2008



                                                                                                             8
  Satisfaction with Usefulness of the
          'Yellow Envelope'.



       10%
                              Excellent
  7%
                              Very Good
                              Good
                       48%    Fair
21%                           Poor



       14%




                                          9
Sustaining change

 Integration into nursing pathways and education.

 Clinical champions- discharge planning resource group.

 Bi monthly aged care professionals group meetings.




                                                           10
Lessons learned



 Initial gains were gradual

 Yellow envelope proved to be the most effective strategy

 Multi pronged “attack”: GP Aged Care Panels education sessions
  and support worked very well




                                                                   11
Future scope

 Easily transferrable to other clinical settings as concept is simple
  with minimal cost.

 Has been adopted by 5 other hospitals in network and plans for it
  to be introduced to 3 NCAHS networks.




                                                                         12

								
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