In the lead up to APAC, I had the pleasure of interviewing Associate Professor Andrew Way, Chief Executive of the prestigious Alfred Health in Melbourne, one of Australia’s high performing public healthcare providers.
Our conversation covered the importance of clinical decision making, the possibilities of big data, and the impact of the ‘first follower’ in bringing about change.
I started with what concerns kept him awake, and surprisingly he said little…
“…though the concern is that sometime, someone will make a decision they shouldn’t, either because they don’t have the experience or knowledge, or because they fail to escalate issues to ensure the very best decision is made.
“That’s why placing the patient and their family as the primary customer, sets the expectation among our staff that appropriate escalation of issues and decisions is the cultural norm. We expect escalation especially from senior medical staff. We actively encourage this behaviour and praise it when it occurs and raise concerns when it doesn’t.
“The other concern is that treatment decisions are made without the right information; maybe critical elements of the patient’s story are lost in handover or the mechanisms we currently use to collate and present information are not up to the task.
“The new rapidly emerging frontier in health is how to ensure appropriate and relevant data is captured and then combined with appropriate decision making; better informing healthcare providers and patients and families about their choices.”
The conversation then turned to big data as the game changer in health. Andrew spoke with admiration about the direction taken in working with IBM…
“Collating discursive search data, linking it to big data, and then using this as a tool to better inform joint decisions, is ground breaking.
“Big data algorithms doing this kind of thing already exist; one simple example looks into the future identifying that group of hospital patients likely to die in the next 30 days to allow better end of life planning.
“The benefits will be realised when we find more reliable and systematic ways to interrogate what clinicians see and then use this relevant information to empower them around their own performance and patient outcomes.
“Much of the data we currently collect is for accountability and some for research. Not much is oriented to support and encourage core business. For example, clinically relevant data reported in real time and used for improvement – this will really be the game breaker.
We discussed the role of conferences such as APAC in introducing new expectations and challenging the way organisation’s think and deliver services
“Our approach has been to work with the willing and showcase exemplars. The ‘first follower’ is the most important person. Others are pulled in as they see and hear about the success that often follows.
“Last year, we sent a group of Clinical Service Directors to the second APAC Forum in Auckland with the express task of learning how to better understand the trade-offs between volume, quality and cost; in particular how an investment in quality might decrease costs. They returned enthused about the impact of this approach at the frontlines of their services.
“We actively learn from the experiences of others, which we then internalise and systematically adapt for the benefit of our own patients.
“Our Hospital at Night program is a great example of this approach, and how we might better rearrange an existing resource to actively progress care, recovery and rehabilitation 24 hours, 7 days a week.
“Then there’s the Time Quality Care initiative, which has been instrumental in improving the patient’s care experience, particularly in emergency. (The Alfred’s Emergency Departments’ performance has ranked in the top five ED performance targets across the last four quarters.)
“We’re looking forward to sharing our experiences with others during APAC including our journey to become the first Victorian major metropolitan health care service to be accredited under the new standards.
“As always I suspect there will be much more for us to learn.”
APAC will be held in Melbourne September 1-3. Alfred Health will host an all-day intensive on site at The Alfred as part of the conference.
More about Andrew Way…
In his five years as Chief Executive at Alfred Health, Andrew Way has concentrated on improving access, ensuring high-quality safe services with low mortality, and engaging with patients’ experiences, all within a strong financial framework.
Before relocating to Melbourne, Andrew had an extensive career in the NHS in the UK including his last appointment as the CEO of the Royal Free Hampstead NHS Trust, a major London teaching hospital associated with University College London. In this role Andrew was one of the creators of UCL Partners, one of the UK’s six Academic Health Science Centres.
He holds board directorships to several organisations including Baker IDI Heart and Diabetes Institute and led the development of Victoria’s first Academic Health Science Centre – Monash Partners.
More about Alfred Health…
Alfred Health is a leading major metropolitan health service, serving more than 680,000 people living in Melbourne’s bayside and inner southeast area. It has a reputation for integrating clinical practice across with research and education to deliver leading care to its community.
Services are provided from three hospital locations – The Alfred, Caulfield Hospital and Sandringham Hospital – and through several clinics and community based programs.
The Alfred is home to one of Australia’s busiest trauma centres and the largest and most advanced intensive care unit in the region.