Upload
paediatricsonline
View
141
Download
4
Embed Size (px)
Citation preview
HOW ANY ONE CAN … DESIGN AND BUILD A BUSINESS CASE
+
THEN DEVELOP IT AS A SERVICE ENHANCEMENT
Irrespective of whether the outcome is success or failure
BACKGROUND PERSONAL HISTORY
• I didn’t want to be a Head of Department• We didn’t have a plan for the Department• Plan = Seeing patients that walked in +
responding to babies born +supervising / teaching staff
• Years passed – responding to crises + emails + dictating letters
LESSONS LEARNED
• Observing problems + powerless to change• Are we all on the same journey?
• Getting the ‘birds eye’ view• Identify how you can take action = 10
step path to Business Case Enlightenment
EXISTING SERVICE ENHANCEMENT?
Examples:• Admin staff positions
[7yr]• Paediatric Diabetes Spec
[4yr]• 4 extra SCN beds [3yr]• Converting VMO to staff
specialist position [1yr]• PICS [2yr?]
Examples:• MRI under GA service
[2yr]• NEAT AT-registrar [1yr]• Paediatric Neurologist
[4yr]• Nurse Practitioner [2yr?]• MD Paed skills centre
[2yr?]• Video-based teaching
[5yr]
NEWSERVICE?
STEP 1: IDENTIFY … AREA OF CRITICAL SERVICE DEFICIENCY
STEP 2: CONSULT …. WIDELY
• Consult senior staff in department• Canvass support from other partner departments ….
ED / O&G / allied health• Networked services [eg: MP4 / SCHN / Perinatal
services]• DOH / NSWK&F
STEP 3: TRACKING … HISTORY OF THE PROBLEM / NEED
• How did this predicament develop?• Strategies previously tried/
exhausted• Services currently denied?• Near-misses / IIMS / M+M
references?• Risk register / complaints?
Example: MRI under GA service, 3 hrs/month
STEP 4: FORMULATE … THE PROPOSED OPTIONS
• What is the solution proposed?• ‘Definitive’ Vs ‘Interim’ or • “phase 1 - nucleus” Vs “phase 2 - extras” proposal• Write in bulleted points, ranked in order of
importance• ‘Less is more’ – try to summarise the essence of the
proposal
Example: Paediatric Integrated Care Service
STEP 5: COSTING …INCLUDING ALL DETAILS
• Partner with a business manager• Complete the financial template• Include ‘on-costs’ – superannuation / AL / office• Revenue costs Vs revenue raised / cost savings..
- clinic billings: Medicare item nos. x activity
- Procedures or bed days saved
Example: Paediatric Neurologist position 0.1FTE
STEP 6: FUNDING..
• Activity based funding• Revenue enhancement• Revenue offset• Statewide networks• Innovation funding• Building a record for ‘financial responsibility’
Example: 4 extra SCN beds
STEP 7: LOBBYING …
• Selling the idea to the divisional / managerial / finance staff• Explain efficiencies made, exhausted existing resource options• Trade-offs prepared to be made to fund additional service• Promote any innovations in models of care• Consider title / acronym which will promote the service• Align it to LHD sponsored trends [‘HITH’ / ‘ICS’ / ‘ED bypass’]
Example: Nurse Practitioner
STEP 8: STAYING THE DISTANCE…
• Promoting need for the service at council-level meetings• Offering to be the subject of a departmental review• Highlight ongoing vulnerabilities for the service• Reference any complaints / concerns from other
hospital services• Failing to meet statutory obligations or capabilities?
Example: Paediatric Diabetes service 0.2FTE
STEP 9: RECRUITING … APPOINTEES MAY SELL / KILL
SERVICE• Job description needs to be ‘punchy’ on essential
criteria• Interview Qs need to be ‘discriminating’ for
applicants• Consider appointing a 12 mth. Locum [‘try before
you buy’]• Reference checks [flexible? promote a positive
working space? willing to do extra? task-completion? high-maintenance? ability to work in stressful situations? without supervision?personality disordered? bring out the best in others?]
Example: Administrative officer positions
STEP 10: SHOWCASING …BENEFITS, ONCE SUCCESSFUL
• Promote results achieved• Celebrate milestones• Publicise dept. + hospital• Presentations at council mtgs. and hospital grand
rounds• MP4 meetings + posters at conferences
Example: NEAT – Advanced trainee registrar
SUMMARY
• ‘Drone view’ not ‘street view’• Innovate don’t stagnate• Network not craftwork• Persistence for the distance