Discussion
The success of this project to date has been due to multiple factors, with the critical success factors being the team itself and the support of clinical leads behind the project. The composition of FISM has meant that the team is able to utilise their broad clinical experience and lengthy engagement within the local health service to effectively communicate and collaborate with all relevant stakeholders both within the hospital and community setting. The co-location of the team, established networks and respect from peers and colleagues have also enabled FISM to thrive and work effectively as a team to improve outcomes within this setting.
Within a short timeframe, evidence suggests that FISM has been able to reduce the average length of stay and reduce readmission rates. With time and analysis of existing data and trends, it is anticipated that further KPIs will be achieved because of this service. Anecdotally, multiple MDT stakeholders have indicated that implementation of FISM has improved communication between medical teams and the rest of the MDT to improve patient outcomes and flow throughout the hospital. Consumers have also provided positive and constructive feedback during hospital avoidance phone calls following discharge. This has led to improved coordination of services and relevant equipment, as well as clinical education and advice that has contributed to reduced hospital readmission rates. FISM has also been able to identify gaps in service delivery from an inpatient perspective and has been able to raise awareness of these in anticipation of resolving them and improving patient flow.
Key Learnings and Limitations:
Stakeholder engagement both prior to and post implementation of this service has been critical for the success of this project. Some stakeholders were not engaged thoroughly prior to commencement of FISM and hence provided opportunities for timely review, collaboration and refinement of processes to optimise service delivery and success of the project.
Engagement with FISM from various MDT members has been fluctuant at times due the nature of a hospital setting and regular staffing changes that impact on awareness and understanding of our role. This indicates that regular education and engagement with relevant staff is necessary for the ongoing success and sustainability of FISM.
Ensuring adequate time prior to implementation for service and procedure development, stakeholder engagement and strategic planning has also been a critical feature of the success of FISM. These processes also require regular evaluation and refinement with key stakeholders.
It has also been essential to engage data analytics and digital teams in early stages of service development to capture baseline and post-implementation data based on KPIs to evaluate service effectiveness, and develop/support any new processes required as a result. Regular evaluation of the service and data has also meant adjustments and refinement of processes to capture data more accurately.
Further opportunities remain to expand our service to capture all general medical teams at Ipswich Hospital. Increasing and early identification and utilisation of local facilities (e.g. Transit Lounge and rural facilities) is another opportunity of which FISM is already exploring but is yet to be utilised fully.
