integrated care: the ultimate outcome of healthcare change mr. leo kearns national lead for...
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Integrated Care: The Ultimate Outcome of Healthcare Change
Mr. Leo KearnsN a t i o n a l L e a d F o r T r a n s f o r m a t i o n a n d C h a n g e
ABF
Free GP Care
Healthy Ireland
Hospital Groups & Community Healthcare Organisations
Universal Health
Insurance
Universal Healthcare
Commissioning
REFORM
A healthier Ireland with a high quality
health service for all
Medical TeamSpecialist Autoimmune TeamRenal TeamRadiology Team
In ward with very elderly patients; 3 nights without
sleep
Renal scan requested on Monday, carried out on Thursday; discharged on Friday with OPD appointment to review renal progress
25 year-old girl, diagnosed at 21 with rare autoimmune condition; triggered acute attacks – infusion treatment
Contraindicated Medication
Prescribed
Acute attack triggered, advised by
consultant to attend ED
After some time, infusion (1 of 2) given, and admitted Sunday night; concern about possible
renal damage
Good outcome; 5 nights in hospital but should have been three; for patient complete confusion as to what was happening between teams; no-one noticed that she hadn’t slept for three days and was becoming highly
distressed; why medication prescribed in first place that triggered attack; why through ED?
25 year-old girl, diagnosed at 21 with rare autoimmune condition; triggered acute attacks – infusion treatment
25 year-old girl, diagnosed at 21 with rare autoimmune condition; triggered acute attacks – infusion treatment
Contraindicated Medication
Prescribed
25 year-old girl, diagnosed at 21 with rare autoimmune condition; triggered acute attacks – infusion treatment
Contraindicated Medication
Prescribed
Acute attack triggered, advised by
consultant to attend ED
25 year-old girl, diagnosed at 21 with rare autoimmune condition; triggered acute attacks – infusion treatment
Contraindicated Medication
Prescribed
Acute attack triggered, advised by
consultant to attend ED
After some time, infusion (1 of 2) given, and admitted Sunday night; concern about possible
renal damage
Medical TeamSpecialist Autoimmune TeamRenal TeamRadiology Team
25 year-old girl, diagnosed at 21 with rare autoimmune condition; triggered acute attacks – infusion treatment
Contraindicated Medication
Prescribed
Acute attack triggered, advised by
consultant to attend ED
After some time, infusion (1 of 2) given, and admitted Sunday night; concern about possible
renal damage
Medical TeamSpecialist Autoimmune TeamRenal TeamRadiology Team
In ward with very elderly patients; 3 nights without
sleep
25 year-old girl, diagnosed at 21 with rare autoimmune condition; triggered acute attacks – infusion treatment
Contraindicated Medication
Prescribed
Acute attack triggered, advised by
consultant to attend ED
After some time, infusion (1 of 2) given, and admitted Sunday night; concern about possible
renal damage
Medical TeamSpecialist Autoimmune TeamRenal TeamRadiology Team
In ward with very elderly patients; 3 nights without
sleep
Renal scan requested on Monday, carried out on Thursday; discharged on Friday with OPD appointment to review renal progress
25 year-old girl, diagnosed at 21 with rare autoimmune condition; triggered acute attacks – infusion treatment
Contraindicated Medication
Prescribed
Acute attack triggered, advised by
consultant to attend ED
After some time, infusion (1 of 2) given, and admitted Sunday night; concern about possible
renal damage
Medical TeamSpecialist Autoimmune TeamRenal TeamRadiology Team
In ward with very elderly patients; 3 nights without
sleep
Renal scan requested on Monday, carried out on Thursday; discharged on Friday with OPD appointment to review renal progress
25 year-old girl, diagnosed at 21 with rare autoimmune condition; triggered acute attacks – infusion treatment
Contraindicated Medication
Prescribed
Acute attack triggered, advised by
consultant to attend ED
After some time, infusion (1 of 2) given, and admitted Sunday night; concern about possible
renal damage
Good outcome; 5 nights in hospital but should have been three; for patient complete confusion as to what was happening between teams; no-one noticed that she hadn’t slept for three days and was becoming highly
distressed; why medication prescribed in first place that triggered attack; why through ED?
Integrated Care
Care pathways and models of care designed and delivered around the needs of patient,
not the system
Integrated Care
Clinical Processes &
Clinical Roles
Care pathways and models of care designed and delivered around the needs of patient,
not the system
Systems and Data
Workforce Planning &
Training
Integrated Care
Clinical Processes &
Clinical Roles
Care pathways and models of care designed and delivered around the needs of patient,
not the system
Systems and Data
Workforce Planning &
Training
Integrated Care
Clinical Processes &
Clinical Roles
Funding Models
Care pathways and models of care designed and delivered around the needs of patient,
not the system
Systems and Data
Workforce Planning &
Training
Integrated Care
Clinical Processes &
Clinical Roles
Funding Models
Care pathways and models of care designed and delivered around the needs of patient,
not the system
Governance & Structures
Performance Metrics
Systems and Data
Workforce Planning &
Training
Integrated Care
Clinical Processes &
Clinical Roles
Funding Models
Care pathways and models of care designed and delivered around the needs of patient,
not the system
Governance & Structures
Performance Metrics
Wider health service and whole of society commitment to
prevention
Achieving this requires a whole of system
approach to change at all levels, sustained over
a number of years
The building blocks for reform are in place
Quality FrameworkIntegrated Care Programmes: Older Person; Chronic; Children; Maternity; FlowHospital Groups, Community Healthcare Organisations, Ambulance ServiceReform at national level to enable delivery system and to develop commissioning capability
A new vision and strategy for people within the health service
Knowledge & Information Strategy
Healthy Ireland Implementation
Finance Operating Model
Activity Based Funding
Service Improvement
By the end of 2015 we will have
a prioritised action plan for reform, drawn
from these programmes, showing key
deliverables for each of next 12 quarters
Leaders make change happen; are you a leader?
Am I a leader?