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Your bi-annual update from the Allied Health Advisory Group & Safe Staffing Healthy Workplaces Unit
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Electronic CCDM - Allied Health Newsletter


The Care Capacity Demand Management - Allied Health newsletter is now electronic. We would like to increase our membership, so please share and ask your network to sign up for our mailing list using the 'subscribe' button below.

For those who still prefer a paper copy, don't worry - this e-newsletter can be printed off and shared on notice boards or left in staff areas. Open the email in your browser and right click to print, or right click to save as a PDF. This works best in Google Chrome.
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In this issue
Welcome to new Allied Health Programme Consultants 


The Safe Staffing Healthy Workplaces Unit is delighted to announce the recruitment of two new Allied Health Programme Consultants. 

Stuart White and Lynda Wheeler 
have both joined the SSHW Unit on 0.6FTE, 12-month fixed term contracts. Huia Swanson is the existing Allied Health Programme Consultant, and the additional resource will enable each DHB to have a lead Allied Health Programme Consultant. These roles will support the inclusion of allied health, scientific and technical workforce's in CCDM implementation.

Stuart White is originally from England and now lives in Hawke’s Bay. With a background in Sport Science and Physiotherapy, Stuart has worked in the health industry for over 20 years, both in the UK and NZ.  Most recently he has worked with Habit Group as a Vocational Management and Rehabilitation Consultant, in addition to ongoing clinical physiotherapy work. 

Lynda Wheeler is also originally from England. She completed her physiotherapy undergraduate and post graduate studies in London, specialising in Neuro-physiotherapy. Lynda emigrated to New Zealand in 2002 and have called Tauranga home ever since. Lynda has worked for the local DHB as a community physiotherapist and within the hospital. More recently she has worked at BOP NASC and TAS as an educator and competency manager.

Update from the Allied Health Advisory Group

 

The Allied Health Advisory Group informs the Safe Staffing Healthy Workplaces Unit with regards to developing a Care Capacity Demand Management (CCDM) programme suitable for the allied health, scientific and technical workforce. The Advisory Group has membership from PSA and the following DHBs: Auckland, Waitemata, Whanganui, Midcentral, Hutt Valley and Nelson Marlborough.

The Advisory Group has this year met in February and May, and will meet a further two times.

As the 
DHB & PSA Terms of Settlement (2018-2020) references two components of CCDM, the Advisory Group's annual work plan is focused on progressing a workload methodology/tool and Variance Response Management. 

Read on to see the specific work happening with these two components. 

Staffing methodology

CCDM is about achieving an appropriate match of care capacity (staff and resources) to clinical demand, and then managing any variance that occurs each day. Determining the capacity required of the service to meet demand is a core feature of an allied health staffing model.
 
In January, a revised Activity Data Set and definitions document were released to the sector. Clinical staff from the pilot sites  (Auckland, Waitemata, Whanganui, Midcentral, Hutt Valley and Nelson Marlborough) all contributed to the data set review. As a result of their feedback, the revised data set now has two tiers, to accommodate the different needs and uses of data, and to promote data accuracy. Level 3 activities are high level activity descriptors, whilst level 4 activities are more detailed.
   


The current scope of the activity data set is inpatient attributable (IPA). Each DHB / allied health service should decide which level is most appropriate to their needs. The data set is intended to be vendor agnostic. 

The Activity Data Set and Dictionary documents can be found here: https://drive.google.com/drive/folders/11dAYUsLvUlqTCYxq_ntO5OSIEmQozlV1

Activity data is but one of the critical pieces of information which will contribute to a staffing methodology. In addition to activity data, allied health services should also work towards collecting:
  • Non clinical activity time
  • Unmet clinical need
  • Allied Health Data Standard (HISO)
  • Staffing capacity data 
TAS is currently progressing the development of a staffing methodology. When the methodology has been validated, a DHB will need 12 months worth of good quality data to generate a FTE calculation. There will be an update on progress later in the year. 
 
Variance response management

 
Managing the variance between capacity and demand is something allied health services do every day. However, the CCDM programme supports a DHB to develop infrastructure, processes and systems to achieve consistency, transparency and visibility.

Variance Response Management systems and processes 
include:
- Integrated operations center
- Daily operational meetings
- 'Capacity at a Glance' dashboards - See example from Waitemata DHB
- Variance indicator scoring
- Standard operating procedures 

Variance Response Management or VRM is all about visibility across the organisation. In order for an allied health service to achieve visibility they need to assess 'capacity' and 'demand', every shift, every day. 

Capacity includes:
- Hours available for clinical care
- Hours available for non-clinical activities
- Vacancy and leave (planned and unplanned)
- Staff mix & skill mix

Demand includes:
- Volume of patients across all wards 
- Status of all referrals (new and in progress)
- What priority level has been assigned to each 


A Variance Indicator Scoring tool is then used, which produces an over-all traffic light colour in response to the indicators selected. The traffic light colours range from Mauve - Red, dependent on the status of the service. 

Traffic light colour and descriptor 
If a service is in Yellow, Orange or Red, they will use their Standard Operating Procedure to systematically manage the impact of variance, and alert the wider organisation to their situation.

Next steps:
The SSHW Unit is currently reviewing the VRM documents. It is anticipated that they will be available for sector release in July 2019. A SSHW Unit Allied Health Programme Consultant will be available to support DHB allied health services customise the resources for their own context.  
 
Allied Health CCDM spot light - Waitemata DHB


At Waitemata DHB allied health clinicians are based in their own departments, and are not allocated to specific wards or units.

Staffing levels across the wards can very daily due to vacancies and leave. There was no visibility of allied health staffing capacity each day across both the North Shore and Waitakere Hospital sites.

The allied health team also had no single communication strategy to communicate capacity across each inpatient wards. Team leaders would email charge nurse managers with any significant capacity concerns as they occurred.

Allied health clinicians would then communicate workload requirements via meetings and cells phones to reallocate resources according to clinical need and priority of each patient.

Capacity at a glance (CAAG)

Capacity at a glance (CAAG) is an electronic board displaying information about bed availability on our inpatient wards, Elective Surgery Centre, Emergency Departments and Assessment & Diagnostic Units. CAAG boards give an overall view of bed availability however there is minimal patient information.

Using this technology as a base, the allied health team wanted visibility on the CAAG boards so that each day they can see allied health staffing capacity, and where allied health staff are needed within the hospital. This will help the allied health team prioritise their workload, and ensure patient care and assessments are completed. 

The tool uses a traffic light system with green showing standard staffing  through to red indicating a critical care capacity deficit. Variance indicators guide a consistent and transparent approach to defining capacity and will help us streamline and integrate the service provided to our patients.

What have we done

The allied health capacity at a glance tool has been developed through two separate "pen and paper" trials to determine the appropriate variance colour indicators.

This was achieved manually using spreadsheets and creating the view and emailing out the information to the allied health teams on a daily basis.

Extensive consultation was undertaking with key stakeholders including all allied health disciplines and nursing groups.

Where to from here

The Allied Health CAAG tool has been successfully trialled with an immediate improvement in the communication and management of allied health capacity on a daily basis across both hospital sites. Staff have also found the tool to be very informative and clear.

The electronic Allied Health CAAG tool is now under development and will be live in due course.

Would you like to feature something in the next edition of CCDM - Allied Health or do you have some feedback?  

Please contact: ccdminfo@tas.health.nz
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Copyright © 2018 TAS, All rights reserved.
 


Phone 04 801 2430  Address: TAS, 69 Tory Street, Te Aro Wellington 6011
Email: ccdminfo@tas.health.nz  Web address: https://tas.health.nz

Care Capacity Demand Management is managed by the Safe Staffing, Healthy Workplaces Unit at TAS.

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