Hospital Model of Care Planning Principles Working Document

Department of Health Statewide Service Strategy Clinical Service Reform 10 October 2007

PLANNING PRINCIPLES
On behalf of the Clinical Senate, I am delighted to present the Hospital Model of Care Planning Principles. The planning principles were developed through the collaborative effort of the Clinical Senate and the MJNH Clinical Service Steering Committee. These planning principles are to be used within your organisation or network as the basis for all current and future facility and clinical service planning. Please note that this is a working document, and as such it may change over time as implementation of the principles indicates potential improvements. I commend this document to you and congratulate the Clinical Senate on developing such a valuable and relevant set of guiding principles. I look forward to continued collaboration as we reform the delivery of health care services in this state. MICHAEL RICE CHAIR, CLINICAL SENATE

Hospital Planning Principles

Table of Contents
1. Introduction ................................................................................................1 2. Model of Care Planning Principles ...........................................................1 3. Enabling Principles....................................................................................3 4. Facility Planning Principles ......................................................................4

Hospital Planning Principles

1. Introduction
This document outlines the Model of Care Planning Principles and a number of additional guiding principles that specifically apply to the expected facility outcome of new hospital developments including the Marjorie Jackson-Nelson Hospital (MJNH).

2. Model of Care Planning Principles

The following principles were established through discussions with the Clinical Senate and the MJNH Clinical Steering Committee. It is expected that these principles will guide the models of care across all health services including development of the new MJNH.
1.

Clarity of role delineation which supports safety & quality This means that: A well defined and understood service profile will be established for the hospital which is reflective of its designated service delineation and its local catchment Services will be integrated to sustain staff skill levels, provide flexibility and quality after-hours services and to enable professional development and quality patient outcomes Services requiring highly specialised infrastructure, equipment or staff will be collocated Teaching, research and training will be integrated into the planning process to provide opportunities for students, academics and researchers to learn and add to the body of health knowledge.

2.

Recognises that each facility is part of a system with appropriate links This means that: The service model will enable links to tertiary hospitals, metropolitan and country general hospitals, general practitioners, GP Plus Health Care Centres, Mental Health Care Community Centres, rehabilitation facilities, other community based services, academic institutions, clinical networks, GP Plus Health Networks and others involved in the provision of care Services, and in some instances staffing, will be coordinated across the public and private sectors

3.

Focuses on the needs of patients, carers and their families This means that the hospital will: Have models of care that will identify the needs of patients/families/carers Minimise unnecessary patient movement through the facility Facilitate ease of movement through the facility by relevant and clear way-finding mechanisms Enable patients/families/carers to be partners in the planning and delivery of their health care Provide a culturally specific focus on the needs of Aboriginal and Torres Strait Islander people using the DH, Aboriginal Health Impact Statement

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4.

Best use of resources This means that the hospital will: Have effective functional relationships between services to minimise the need to duplicate infrastructure and staff Have efficient patient pathways Be designed to allow for best practice operational policy Have enhanced operational benefits through the use of technology Consider operational cost implications in the design process Have appropriate co-location of services

5.

Planned and Unplanned Admissions Models of care will reflect the needs of planned and unplanned admissions and provide for the changing demographics of hospital admissions with particular reference to increasing acuity levels and the effects of ageing. Uses the resources (capital and operating) available in the whole system (public & private) This means that the hospital will: Maximise opportunities for private sector collaboration Remove barriers to private sector engagement Ensure resources are used efficiently including human resources

6.

7.

Will be able to adapt to changing needs This means: Considering practices of the future, beyond current work methods Designing the hospital so that it can be easily reconfigured in response to changing clinical practice, technology and service requirements Designing the hospital in a flexible way that enables similar functions to be accommodated in multipurpose areas Using generic designs wherever possible Flexible employment arrangements

8.

Will contribute to equity in health outcomes for the whole SA population This means that the hospital will: Be physically accessible through appropriate transport arrangements Have effective and efficient referral pathways through effective communication technology Have a service profile that is culturally appropriate, specifically for Aboriginal and Torres Strait Islander people and encourages those most in need to utilise the hospital

9.

Affordable/Cost Effective This means that the hospital will: Have a design that contributes to efficient work practices Be constructed within budget Be able to provide quality and safe care within its established operating budget Be sustainable from an environmental perspective

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Attract and retain appropriate levels of skilled and excellent staff

10.

Based on and contributes to evidence This means that the hospital will have: A design that facilitates evidenced based best practice A service delivery model that reflects current evidence and considers future clinical developments, changing workforce and technology impacts Capacity to measure service outcomes to contribute to evidence base Spaces within work areas such as tutorial rooms and student/research rooms that facilitate learning Specialised multidisciplinary education facilities including lecture theatres, clinical skills laboratories, library and video-conferencing facilities

3. Enabling Principles
The model of care will be underpinned by a number of enabling principles:
1.

Effective change management knowledge & resources This means that new health facility developments will: Be based on a common goal for all staff Have effective leadership Maintain realistic expectations based on a strategy for change

2.

Effective communication to the broader community which aims to shift the focus of the community to care in the most effective setting This means that new health facility developments will: Have a model of care that links hospital services to community supports Encourage patients/carers/families to receive their care in settings that may not necessarily be a hospital setting Encourage self responsibility for health care

3.

Aligned industrial relations which facilitates cross system work by staff This means that the hospital will: Have integrated appointments between health services and between academic sectors Develop new roles which are fully integrated with clear lines of accountability and responsibility Have flexible employment arrangements

4.

Technology which supports & facilitates partnerships This means that the hospital will: Have communication technology facilitating o Transfer of patient information to assist in partnerships in care o Access to decision-making support o Access to research and other evidence assisting in patient care Use technology to enhance patient care based on the best evidence Foster a culture of innovation

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Maximise public/private partnerships wherever possible Ensure flexibility to adopt new technologies Minimise duplication of documentation
5.

A workforce plan which can sustain the model This means that the hospital will: Have a staffing plan based on patient needs Encourage the development of an alternative health workforce Have a workforce plan that is reflective of current workforce planning and the workforce development initiatives Have a workforce plan that encourages Aboriginal and Torres Strait Islander participation in the delivery of health services and endeavours to increase the cultural competence of the general workforce Acknowledge the impact of staff working external to the hospital including GPs, Community Health Care Workers etc.

4. Facility Planning Principles

In addition to the model of care and the enabling principles the following principles will be used as a guide to decision making during the development of the hospital. 1. Value for money This means that: Planning will consider both current and future service needs Expectations will be managed within the planning principles and the ability to fund Responsible use of space will be encouraged Ensure environmental initiatives are taken into consideration Planning will recognise current Government initiatives with regards to Shared Services 2. Creating supporting and safe environments for everyone This means that: The ambience will be welcoming and caring Design will allow appropriate levels of patient privacy and confidentiality The environment coveys professional, safe care in a friendly and supportive way 3. Clinical, teaching, research and academic facilities to support integration This means that: All space allocation will occur within benchmarked spatial standards Will be configured to function as effectively as possible within available capital Research models will consider the Shine Young report recommendations

File: MJNH Models of Care Principles Final.doc

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