A sample academic presentation, a full slide deck with speaker notes, prepared to Australian postgraduate standard. Preview the slides below, or download the editable PowerPoint.
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Slide-by-slide outline
Slide 1: Emergency Department Patient-Flow Redesign in an Australian Hospital
- Discipline: health services management and quality improvement
- Setting: a metropolitan public hospital emergency department
- Focus: reducing access block and improving timely care
- Frame: a structured improvement project with measured outcomes
Speaker notes: This presentation describes a quality-improvement project to redesign patient flow in a metropolitan public hospital emergency department. The aim is to reduce access block and improve the timeliness of care. It follows a recognised improvement methodology with measured, routinely collected outcomes.
Slide 2: Agenda
- Problem and policy context
- Aim and improvement questions
- Method and measures
- Baseline, interventions and outcomes
- Recommendations and spread
Speaker notes: The deck sets out the flow problem and its policy context first. It then defines the improvement aim and the measures used. Baseline analysis, the interventions tested and the results follow, with recommendations for sustaining the change.
Slide 3: Background
- Access block delays care and raises clinical risk
- The four-hour target frames timely emergency care nationally
- Crowding is linked to worse outcomes and staff strain
- Oversight sits within national safety and quality standards (ACSQHC)
Speaker notes: Access block, where admitted patients wait in the department for an inpatient bed, is a long-standing driver of crowding. The national four-hour target frames expectations for timely care. Crowding is associated with poorer outcomes, which makes flow a safety issue, not only an efficiency one.
Slide 4: Aim and Questions
- Aim: improve four-hour performance from 62 to 80 per cent within nine months
- Where are the main delays in the patient journey?
- Which interventions most improve flow?
- Are gains sustained without harming quality?
Speaker notes: The aim is specific, measurable and time-bound, consistent with improvement practice. The questions locate delays, test interventions and check that speed does not compromise safety. Balancing measures guard against unintended harm.
Slide 5: Method
- The Model for Improvement with sequential plan-do-study-act cycles
- Process mapping of the full patient journey
- Data drawn from the department information system over 12 months
- Statistical process control charts to track change over time
Speaker notes: The project used the Model for Improvement with short plan-do-study-act cycles. Process mapping identified delay points across triage, assessment, decision and disposition. Control charts distinguished real change from routine variation using routinely collected data.
Slide 6: Results, Baseline
- Baseline four-hour compliance of 62 per cent
- Median length of stay of 5 hours 20 minutes
- Did-not-wait rate of 6.8 per cent
- Main delays: senior review and inpatient bed access
Speaker notes: Baseline analysis confirmed that the two largest delays were waiting for senior clinical review and waiting for an inpatient bed. The did-not-wait rate signalled lost access for some patients. These findings directed the choice of interventions.
Slide 7: Results, Interventions
- Senior early assessment at triage for complex patients
- Streaming of low-acuity presentations to a fast-track area
- Criteria-led discharge to speed safe departures
- Coordinated inpatient bed access with ward teams
Speaker notes: Four linked interventions targeted the identified delays. Senior early assessment brought decisions forward, while streaming protected capacity for low-acuity patients. Criteria-led discharge and an active bed-access model addressed the back end of the journey.
Slide 8: Results, Outcomes
- Four-hour compliance improved from 62 to 78 per cent
- Median length of stay fell by 48 minutes
- The did-not-wait rate dropped to 3.9 per cent
- Balancing measure: 72-hour re-presentation was unchanged
| Measure | Baseline | Post-intervention |
|---|---|---|
| Four-hour compliance | 62% | 78% |
| Median length of stay | 5h 20m | 4h 32m |
| Did-not-wait rate | 6.8% | 3.9% |
Speaker notes: Four-hour performance rose substantially, approaching the target, and length of stay fell. The did-not-wait rate almost halved, indicating better access. Importantly, unplanned re-presentation did not worsen, suggesting quality was preserved.
Slide 9: Discussion
- Front-loading senior decisions had the largest single effect
- Bed access required whole-of-hospital engagement
- Sustaining gains depends on embedded daily flow routines
- Single-site results may not transfer directly to other settings
Speaker notes: The greatest gains came from bringing senior decision-making forward, consistent with the wider literature. Back-end flow improved only when wards shared responsibility for bed access. Sustaining change requires embedding daily routines rather than one-off effort.
Slide 10: Recommendations
- Embed senior early assessment as standard practice
- Institute daily hospital-wide flow huddles
- Maintain control charts for ongoing monitoring
- Pilot the model in a second department before wider spread
Speaker notes: The recommendations focus on making the successful changes routine and monitored. Daily flow huddles keep the whole hospital accountable. Testing in a second setting before broad spread respects the limits of single-site evidence.
Slide 11: Conclusion
- A structured redesign improved emergency flow measurably
- Timeliness improved without compromising safety
- Whole-of-hospital involvement was essential
- Sustained monitoring will protect the gains
Speaker notes: The project shows a structured, measured redesign can improve emergency flow within a realistic timeframe. Gains were achieved without harming quality. Continued monitoring and hospital-wide ownership are needed to hold the improvement.
References
Australasian College for Emergency Medicine 2022, Access Block and Emergency Department Crowding: Position Statement, ACEM, Melbourne.
Australian Commission on Safety and Quality in Health Care 2021, National Safety and Quality Health Service Standards, ACSQHC, Sydney.
Australian Institute of Health and Welfare 2023, Emergency Department Care in Australia, AIHW, Canberra.
Ben-Tovim, DI, Bassham, JE & Bolch, D 2020, ‘Redesigning care at an Australian hospital’, BMJ Quality and Safety, vol. 29, no. 8, pp. 621 to 629.
Cameron, PA, Joseph, AP & McCarthy, SM 2020, ‘Access block can be managed’, Medical Journal of Australia, vol. 213, no. 4, pp. 152 to 155.
Forero, R, Hillman, KM & McCarthy, S 2019, ‘Access block and emergency department overcrowding’, Emergency Medicine Australasia, vol. 31, no. 2, pp. 168 to 178.
Health Roundtable 2021, Improving Patient Flow in Australian Hospitals, Health Roundtable, Sydney.
Langley, GJ, Moen, RD & Nolan, KM 2009, The Improvement Guide, 2nd edn, Jossey-Bass, San Francisco.
Speaker notes: These sources inform the policy framing, the improvement methodology and the access-block evidence discussed across the deck.