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Summary
Victorian Healthcare Experience Survey data shows consumers are not adequately engaged in their care, decision making and activities to maintain function during their hospital stay. This places older patients at risk of functional decline, increased length of stay and poor health outcomes.
We worked with 33 Victorian health services to implement the international End PJ paralysis movement to to encourage older patients to get changed out of their ‘PJs’, go for a walk and sit out of bed for meals. This improves their chances of getting better quickly and going home.
Outcome
Across the 33 participating sites, we saw:
- a 19 per cent increase in the median percentage of patients who mobilised and were in their everyday clothes by 2 pm
- a 16 per cent increase in the median percentage of patients sitting out of bed for lunch
- anecdotal feedback about the positive impact on patients’ mental health.
Some sites also recorded a decrease in length of stay, pressure injuries and falls.
Targets
Decreased functional decline in at-risk hospital patients.
Measures
- Percentage of patients who are in their everyday clothes by 2pm
- Percentage of patients who mobilised by 2pm
- Percentage of patients on your ward who sat out of bed to eat lunch
- Number of new pressure injuries per month
- Number of falls per month
- Readmission rate
- Length of stay
- Discharge destination (% of patients discharged home)
- Cardiac, renal and stroke
- Chronic disease
- Consumer engagement and support
-
Emergency and critical care
- Delirium Evaluation in the Timely delivery of Emergency Care Trial (DETECT)
- Artificial intelligence in cardiac arrest (AIDE)
- Acute coronary syndrome project
- Establishing the Victorian ECMO service
- Gippsland region telehealth
- Sepsis bundle of care
- Improving emergency access collaborative
- Lower complexity urgent care
- Standardising inotropes and vasopressors
- Supporting statewide Medical Emergency Team/rapid response
-
Medications, treatment and infection prevention
- Antibiotic allergy de-labelling program
- Central pharmacy
- Choosing Wisely champion hospital
- Choosing Wisely Scaling Collaboration
- Decreasing infections associated with peripheral intravenous cannulas
- No unecessary tests
- Partnered pharmacist medication charting (PPMC) scaling project
- Sepsis improvement
- ‘Think sepsis. Act fast.’ scaling collaboration
- Mental health and wellbeing
-
Mothers, babies and children
- Assessment and care of the jaundiced newborn at home
- Better births for women collaborative
- Closing the gap on maternal immunisation
- Developing ambulatory care services for women in Peninsula Health
- Expanding our Maternity and Neonatal eHandbooks
- Improving the management of paediatric sepsis
- Medical management of miscarriage at home
- Obstetric triage decision aid
- Perineal protection project - audit tool
- Postpartum Haemorrhage Collaborative
- Reducing clinical variation in paediatric adenotonsillectomy
- Reducing preventable stillbirths in Victoria
- Reducing unnecessary prescribing in infant reflux
- Safer baby
- Sharing service data through a maternity dashboard
- Reducing paediatric outpatient and emergency department referrals
- Strengthening safety oversight
-
Older people and palliative care
- Families And Carers as part of healthcare Teams (FACT) Pilot Project
- Advance care plans across the health system in rural Victoria
- Creating Age-Friendly Health Systems in Victoria
- Falls review tool: Pilot project
- Building an age-friendly Indigo health system
- Collaborative model for a falls response service
- Delirium collaborative
- Early intervention palliative and supportive care clinic
- End PJ paralysis: Preventing functional decline in inpatients
- Frailty recognition and response in the community
- Geri-Connect
- Geri-Connect scaling project
- Guiding the safe use of bed rails
- Hospitals and patients working in unity (HOW-R-U?)
- Informing best practice for managing patients with hip fractures
- Preventing delirium
- RAPID Assist
- We are Ambulance Victoria Engaged (WAVE)
-
Patient flow, outpatient care and telehealth
- Bendigo Cancer Centre survivorship service
- Telehealth for people with young onset dementia (BRIGHT-YOD)
- Critical care telehealth
- Critical care telehealth scaling project
- Improving after hours care at Monash
- North east robotics development
- Outpatient demand management strategy
- Rapid access musculoskeletal care
- Remote drug and alcohol recovery for the Southern Otways region
- Low-risk fever and neutropenia program
- Using big data modelling to improve access to outpatient clinics
- Virtual fracture clinics
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