Supporting the development of new health facilities, interview with Leith Mcmillan.

Day Hospital Consulting is at the forefront of healthcare innovation, offering customised solutions to enhance patient flow and operational efficiency within the day hospital sector.

In our recent conversation with the Director of Day Hospital Consulting, Leith Macmillan, we delved into her invaluable experience with LogiqcQMS in the day hospital domain. 

Leith brings forth an impressive career spanning over 40 years in Clinical and Executive Management roles within the Private Health Industry, with a focus on the Day Hospital/Surgery environment and, more recently, in short-stay overnight private hospitals. Her early work in operating theatres and advanced business studies uniquely position her to understand the needs of healthcare professionals. 

How long has Day Hospital Consultancy been in operation?

Day Hospital Consultancy has been in operation for nearly 17 years as of December 2023. However, I have been involved in the healthcare industry since I graduated in 1983, where I started my journey in the operating theatre in Brisbane and rural regions.

What is the scope of consulting services DHC provides?

Our scope encompasses a broad range of services catering to both greenfield and brownfield sites. In the context of our work, a brownfield site refers to an existing building that we fit out into a day hospital facility, while greenfield sites are entirely new projects coming out of the ground.

Our services encompass several key components:

First, we work on designing and planning the health facility. We work closely with the healthcare expert architects and the clinical team to design the patient clinical pathway through the Private Health Facility /Day Hospital. We also develop a model of care that aligns with the clinical pathway. It is really important to get that design spot on, ensuring the input from the clinical functions.

A second component is around compliance and regulation, which involves licensing from the state private health department, hospital accreditation and compliance with the National Safety and Quality Healthcare Standards (NSQHS). This process begins at the very early stages, even before the hospital is built. 

The third component is procurement. This entails obtaining quotes from medical representatives, having choices to present to the facility’s owners, building the FFE (furniture, fittings and equipment) register and, as choices are made, all the different equipment and furniture. 

We also work on setting up the operational systems. This includes sourcing IT systems, transitioning to electronic medical records, patient management systems, quality management systems, and inventory and tracking systems for instrumentation and consumables. We manage the procurement of the central sterilising department (CSD) and ensure its smooth operation. 

Within administration, the services are around setting up billing and hospital management systems. Additionally, I am moving into designing the Human Resources (HR) Plan, including recruitment, engaging key personnel, such as the director of nursing and the finance officer. 

Next up is policy and procedure development. We make sure every operational phase aligns with the model of care, ensuring that policies align with the processes and adhere to relevant legislation and regulations. Additionally, we conduct thorough risk analysis and rating for each policy and process.

We also manage clinical and corporate governance. This involves setting up committee structures, developing terms of reference, ensuring the effective functioning of these committees, making sure that the right personnel are seated within them, and that there is a robust reporting structure. 

Lastly, the commissioning. Ensuring that everything is lined up for the facility’s opening day. This includes making sure the hospital is licensed and accredited, as well as having some form of funding through reimbursement from health insurance funds.

What are the key challenges faced by the day hospital sector at the moment? 

There are several challenges, but the main recurring one is funding and reimbursement to new sites- ensuring that we have appropriate funding and reimbursement models for new greenfield or brownfield sites on the day of opening the facility. Also, we need to ensure that there is interaction with the private health insurance funds and that they align with the hospital’s cost management in conjunction with the delivery of high-quality patient care.

Other challenges revolve around workforce shortages, particularly in the context of an ageing workforce and the fewer nurses in the community. The challenge here lies in recruiting and retaining skilled clinical staff.

There are other challenges concerning mandatory accreditations against national standards and just general compliance. The level of quality has been raised – reflected in the mandatory NSQHS standards – this can be challenging for smaller facilities with fewer resources. This is where Day Hospital Consulting provides support. Consulting services can serve as a valuable resource, especially for the smaller facilities, as they provide legislative and regulatory updates and facilitate networking, providing essential feedback to the executive and management team.

Another challenge revolves around technology adoption, specifically integrating and adopting new healthcare technology, such as electronic health records, and incorporating them into the patient clinical pathway. We ensure these technologies are implemented smoothly while maintaining data security and patient privacy.

Certain challenges emerged during the COVID-19 pandemic, such as those related to supply chain disruptions. Dealing with global disruptions in the supply chain impacted the availability of medical supplies and equipment. We need to ensure a consistent supply of the necessary medical items required for surgical procedures. 

DHC partners with LogiqcQMS to provide a quality management system for your clients. What are the benefits to your clients in using a platform like LogiqcQMS in managing safety, quality, and risk?

The primary benefit is streamlining the processes. The electronic quality management system automates and streamlines the entire quality and risk management process, significantly reducing the administrative burden on staff. Historically, we relied on spreadsheets, manual updates of policies and manual tracking of tasks, which created an enormous workload and ultimately increased staff costs. LogiqcQMS has proven to be highly efficient in this regard.

The second benefit is enhanced compliance. Clients can easily stay compliant with regulatory requirements and accreditation standards thanks to built-in compliance checks that ensure that tasks are being actioned by the task sheet.

Another valuable benefit is real-time data access. With LogiqcQMS, we can access critical quality and safety data in real-time, facilitating timely decision-making and ultimately leading to promptly addressing emergent issues.

Additional benefits include improved documentation. We now have the capability to document our incidents and near misses, as well as our quality improvement activities, which are all essential for auditing processes and reporting. We have this data readily available, so it can be presented to the relevant committees and personnel. 

I find the risk assessment to be highly efficient, as it allows us to assign risk ratings to all our policies. Having a risk register that mitigates risks more effectively is also very convenient and the dashboard provides a comprehensive view of the potential risks for the Day Hospital.

Additionally, features like customised reporting and centralised information are highly beneficial. They enhance collaboration and communication, allowing staff to seamlessly receive and action tasks. This fosters a culture within the organisation that prioritises safety, quality, and risk management. I find this aspect to be truly exceptional.

In summary, partnering with an electronic quality management system empowers my staff during the commissioning of a new facility to proactively manage safety, quality, and risk in the Day Hospital environment. It promotes efficiency, transparency, and accountability while ensuring compliance with regulatory requirements, all while maintaining our commitment to delivering exceptional patient care. It truly supports the entire process.