The MNHHS-QCAT Guardianship Process Initiative (‘the initiative’) is an innovative partnership between Metro North Hospital and Health Service (MNHHS) and the Queensland Civil and Administrative Tribunal (QCAT). The initiative is facilitating earlier patient discharge by delivering timelier tribunal hearings for MNHHS inpatients.
The project was a finalist in the Connecting Healthcare Category at the 2017 Queensland Health Awards for Excellence.
Ensure that the patient’s needs are met and their general health care interests are protected.
Prior to the initiative, application preparation was inconsistent. There was no HHS-wide coordination of communication with QCAT. Hospital-based hearing capacity was insufficient and inequitably distributed. Hearing dates were scheduled without consideration of quantum of pending applications. There was a 66 day average wait during the six months to June 2016. QCAT were not resourced to provide additional hearings. Financial and capacity losses were being incurred by MNHHS due to clinically stable patients occupying scarce beds in constrained facilities. There was a risk of suboptimal patient outcomes due to deconditioning and adverse events associated with extended hospital stay.
Through the initiative, a new position has been established to standardise application preparation and centralise interagency communication. Two QCAT positions have been funded, dedicated to processing applications and scheduling hearings for patients. And in an Australian first, MNHHS has entered into an arrangement to fund additional hearing day capacity from QCAT.
Formal AusHSI evaluation reported a wait time reduction of around 48 days per patient, translating to an overall length of stay reduction of around 25 days per patient. Accounting for project cost, median cost per bed day of capacity created was $101.
Inpatients with complex needs typically require the services of multiple government agencies. Cross-agency funding models pursued with non-traditional partners from outside the health cluster can yield substantial efficiencies and warrant exploring in greater scope and depth.
