Health Care System In Need Of Redesign, Medical Journal Of Australia

Main Category: Public Health
Article Date: 16 Mar 2008 - 13:00 PDT

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Redesign of the processes surrounding the delivery of clinical care is needed to cope with the increasing strain on Australia's health system, according to an article in the supplement to the latest Medical Journal of Australia entitled "Health services under siege: the case for clinical process redesign".

Professor Paddy Phillips, Head of the Department of Medicine at Flinders University in Adelaide, and his co-author Professor Clifford Hughes, CEO of the Clinical Excellence Commission in Sydney, say there is a need for effective and sustainable change within the health system, not just another restructure.

The authors recommend a redesign of underlying processes to improve the delivery of clinical care.

"Clinical process redesign focuses on the processes at the coalface and uses the experience of the clinicians involved in care to bring about sustainable change," Prof Phillips says.

"Redesign identifies the 'disconnects' in current clinical services and how they affect the final outcome. This is fundamental because this redesign is not about clinical practice redesign, but rather about improving the processes underpinning the delivery of clinical care."

The authors highlight several areas where delivery of care can be improved to help ease the pressures on the whole system. These include management of unplanned admissions to hospitals, and preparation for planned admissions.

By understanding the patient journey and maximising preadmission planning, the system will then have the capacity to respond to unexpected admissions with much more flexibility, the authors say.

"The traditional argument against such improved practices is that we free up one bed only to have somebody else occupy that bed," Prof Phillips says.

"Such a view is short-sighted and focused only on the acute care hospital phase of the patient journey.

"By improving flow of patients through EDs and back to the community, the protracted wait of many other patients is shortened and the access to appropriate care greatly enhanced."

The Medical Journal of Australia is a publication of the Australian Medical Association.

Medical Journal of Australia