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Legislative Assembly for the ACT: 2005 Week 06 Hansard (Friday, 6 May 2005 2005) . . Page.. 1963 ..

work practices and business processes. Public hospital and health care is a complex business, involving the coordination of large numbers of highly qualified professional, technical and support staff on a 24/7 basis to deliver a package of essential care to people with life-threatening or chronic conditions.

Within a single episode of hospital care—sometimes referred to as the patient journey—a patient potentially may directly interact with more than 100 health care workers, working across a large number of specialised departments both within and outside the hospital on a 24/7 basis. A patient may start a care episode in the emergency department, go to the operating theatre, require a short stay in intensive care, transfer to the general ward and then may need a period of rehab and progress to a subacute environment prior to being finally discharged home. At home, they may require ongoing support provided by multiple health and support workers. In fact, this community support may also be provided by multiple agencies.

All up, this is a complex journey to better health. Managing the interfaces of each step in the patient’s journey is similarly complex. As the demands placed on the public hospital system have increased, coupled with the progressive introduction of new treatment methods and technologies, likewise the task of coordinating care has become more challenging. And with this added complexity comes added risk—added risk to the safety and quality of care, the timeliness of and access to that care and the efficiency of that care.

Because of this, the 2005-06 ACT budget delivers a comprehensive investment in system capacity. It is therefore timely also to invest in the redesign and overhaul of a number of management and business practices underpinning health care delivery in the ACT public hospital and health care system. Other jurisdictions, both internationally and within Australia, have embarked on a process of modernisation of management and business systems as they introduce extra capacity. The ACT is well placed to do the same, given the substantial investment in health capacity in the latest budget.

ACT Health has already identified a number of key care processes that could benefit from such an approach. Firstly, we will improve the interface between the emergency department, critical care and hospital wards, reducing the time that people have to wait before getting a hospital bed. We all know that the more timely the access to appropriate care the better the long-term outcome.

Secondly, we will not only focus on improvements in access across the board but also redesign the patient journey between emergency departments, critical care and wards for older people and people with acute mental illness. Waiting times for access to beds are longer for these groups than for the general population, and long-term health outcomes are maximised when necessary care is provided in a timely fashion.

Too many people have their elective surgery booking deferred. Most of the time this is due to the arrival of more urgent emergency patients or bed pressures. However, I can advise members that I have instructed ACT Health to overhaul the management, booking, scheduling and allocation of operating theatres and theatre resources at the Canberra Hospital to ensure we meet our emergency responsibilities while minimising the impact on those waiting for elective surgery.

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