Recognising and enabling clinician-led quality improvement initiatives

the Spinal Pressure Care Clinic (SPCC)

Bonsan Bonne Lee, Rick Iedema, Sonia Jones, Obaydullah Mariel, Jeffrey Braithwaite, Debbi Long

Research output: Contribution to journalArticle

Abstract

Objective: This paper describes efforts to manage spinal cord injured patients with pressure areas through a complex multidisciplinary outpatient intervention that was implemented at two different hospital sites. The paper presents the achievements of this clinic-level organisational change project, which showed improved levels of efficiency and effectiveness at both sites.
Approach: The study measured staff activity, severity of condition, surgical intervention and in-hospital length of stay pertaining to two patient cohorts presenting at spinal units in two different Australian hospitals. Data were collected by the clinical team with the assistance of a database manager who reviewed the data collection process periodically and compared across sites. Data were stored within a computerised database.
Results: The intervention led to an 11% reduction in patient length of stay when first trialed and a 68% reduction in length of stay (off a lower baseline) when trialed in a second location. This type of pre-emptive outpatient therapy is now standard care for tertiary spinal services in New South Wales.
Conclusions: Despite clear evidence of practice improvement and clinician-initiated organisational improvements, local managers and funders/purchasers are constrained in providing resources to consolidate documented improvements. This case study highlights the need for building management and funder/ purchaser capacity to respond to the organisational and resource implications of successful clinician-led quality improvement initiatives. If quality improvement is an imperative within the current Australian health care system, it needs to become possible for clinic-level achievements to be subsequently made sustainable.
Original languageEnglish
Pages (from-to)26-33
JournalAsia Pacific Journal of Health Management
Volume2
Issue number2
Publication statusPublished - 2007
Externally publishedYes

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