How Nick McInnes is using his MBA degree to improve emergency care
Nick McInnes’s passion for efficiency is improving healthcare in Victoria, starting at Peninsula Health’s Frankston Hospital in Melbourne’s fast-growing outer southeast.
After graduating from Melbourne Business School, Nick is using his MBA to improve emergency care at the hospital, and the changes he’s introducing are beginning to bear fruit.“I’m the project lead for the Improving Emergency Access Collaborative at Peninsula Health,” Nick says. “The collaborative is 11 hospitals who got together under the governance of Better Care Victoria to improve access to emergency departments.”
Two years into his current role in Frankston, Nick has notched up several successes, including a pioneering countdown-to-discharge system, which has improved how clinicians plan and coordinate getting patients home safely and seamlessly.
“If you think of a hospital like a hotel, you have to check people out by a certain time to allow others to check in. So, we needed to get discharges quite early in the day to have good flow,” Nick says.
“We developed a set of rules and tools to govern the discharge process. Now, all patients in hospital for more than 24 hours have an expected discharge date. At least 48 hours prior, we know where they’re going – home or to further care – how they’re getting there, and the family are informed 24 hours beforehand. In trials, the proportion of pre-10-am discharges increased from about seven per cent to over 30 thirty per cent. That's unprecedented for us.”
Nick is an Italian Australian who grew up in France, studied an undergraduate medical science degree in Canberra, then a Master of Public Health in Stockholm, followed by a Master of Health Care Management in Milan before arriving at Melbourne Business School to study a Full-time MBA.
While in studying in Milan, he turned an internship at the Humanitas Research Hospital – the subject of several Harvard Business School case studies – into a manager role at this beacon of healthcare efficiency.
“We reduced infection rates on wards by about a third and halved wait times in the chemotherapy day clinics,” Nick says. “You can make substantial changes by looking objectively at your processes, determining what is adding value and getting rid of everything else.”
Nick first worked at Frankston Hospital on an internship during his MBA in 2015, when he helped introduce a digital check-in and tracking system to improve patient flows and reduce waiting times in the outpatient clinics.
“We now have a state-of-the-art outpatients’ department where the first thing patients see when they walk in are three touch-screen kiosks so they can self-check-in. You know where patients are, how long they've been waiting, and the next step in their visit.”
After finishing his MBA, Nick worked for Johnson & Johnson in Brussels for a year before missing Melbourne so much that he decided to return. When Peninsula Health heard, they pounced.
Nick recently helped introduce a daily “tiered huddle system” at Frankston Hospital to increase what he calls the “cadence of management”. It begins early in the morning, when operations directors have quick and structured huddles with their ward staff about safety, quality and patient flows issues to be resolved locally or escalated to the next tier.
Then all the decision makers – from the Chief Executive to the operations directors, IT, pharmacy, imaging, supply and support, and others – gather to get a sense of the day ahead and issues they can help solve.
“With this very high cadence of management, we solved some historic problems, that had been with us for years, within its first week.”
Nick’s passion for health efficiency started with his first master degree and still has some way to go.
“When I was 25, I gave myself these really naive goals. My 10-year plan was to be CEO of a hospital and my 20-year plan was to be CEO of my hospital, designed from scratch and as efficient as possible.
“I'm a little behind schedule with my 10-year plan, but I think the MBA has certainly nudged me along. We'll see how we go for the 20-year plan.”