Supporting Clinicians and Managers to Drive Change Together: Unlocking Data
NSW Health Symposium, 2014 Thursday 19 June 2014 Dr Teresa Anderson Mr Charlie Farah CE, SLHD Director, Performance SLHD Dr Gabriel Shannon, AM Mr Alfa D’Amato Staff Specialist Orange HealthDeputy Director, ABF Taskforce Dr Rohan Hammett Deputy Secretary, Strategy and Resource Supporting Clinicians and Managers to Drive Change Together: Unlocking Data
Limitations of Current System Labour intensive Limited data able to be reviewed Unable to respond to different needs of different departments No real time access to data
Limitations of Current System Labour intensive Limited data able to be reviewed Unable to respond to different needs of different departments No real time access to data Time consuming Inefficient Disengagement of clinicians – “too hard”
Why STARS? We can’t manage what we can’t analyse/monitor Managing processes in real time Efficient insight into data Combines and manages multiple sources of data
Data Source Collections Incidents related to: Falls Medication Pressure Ulcers Data Collections: Non Admitted Patient Data Data Collections: Admitted Patient Data Emergency Department Feeder Systems: Pathology Imaging Pharmacy Prosthesis Blood Operating Theatre Data Extracts: Overdue Patients (Weekly) Financial Class (3 times a Day) NEAT (Daily) Orders and Results Standalone Clinical Databases
What does STARS offer clinicians & managers? A tool to help: –increase our collective knowledge about our services –identify clinical variation / reduce unwarranted clinical variation –strengthen / implement ‘best-practice’ models of care, & monitor outcomes –improve clinical outcomes
What does STARS offer clinicians? Real time access to a huge amount of data User driven and flexible design Link to clinical databases
STARS Implementation Strong governance Managed by the Performance Unit Focus groups for individual application development Review of applications/functions used at other healthcare facilities (internationally) Data access and security Resources
Governance STARS Executive Steering Committee Managers: Chief Executive Senior Executive General Managers HIMs Clinicians: Medical / Surgical / O&G JMOs Nursing and Allied Health Mental Health
Take Home Messages STARS New innovative data management system Tool to identify and interrogate clinical variation Needs clinicians and managers to work together for it to gain maximum benefits Will only be as good as its data inputs and its users For successful local implementation needs – adequate resources – educated, engaged clinicians and managers – clear governance structures and processes already in place
The ABM Portal provides: Comparisons of activity, costs and prices for The ability to benchmark costs and LOS performance LHDs Facilities ABF Workstreams Specialties Clinicians Patients Eg. ED, acute, non-admitted
T HE ABM P ORTAL PROVIDES : A tool to assist in evaluating the efficiency, efficacy & appropriateness of health service delivery in order to review and improve care and practice, leading to better patient outcomes.
Who provides the patient and cost data? LHD, SHN and MoH staff Updated every 6 months Who uses the patient and cost data? LHD/SHN staff Used for: State Price Peer benchmarking Monitoring clinical variation Examples of data input systems: eMR Oracle FirstNet MH-OAT
DRG – E65B Chronic Obstructive Airways Disease without complications or comorbidities Major Hospital Peer Group 134 encounters 4.31 days average LOS $4,799 Ave cost per NWAU All Major Hospitals Average cost/NWAU = $4,338 All Major Hospitals Average length of stay = 4.93 days Orange Hospital
DRG – E65B Chronic Obstructive Airways Disease without complications or comorbidities Critical Care Pathology Orange Hospital Critical Care Pathology Peer average = $194 Clinical Variation Orange Hospital Orange average= $359 Orange average= $514 Peer average = $190 OrangeHospital
Acute $39,512 ED $17,877 ACUTE EMERGENCY DEPARTMENT NAP $2,621 NON-ADMITTED Single Patient Journey – Patient in Orange Hospital Chronology of patient treatments Patient had 5 inpatient episodes for COAD Hospital avoidance care Following respiratory illness - 9 visits over 3 months Total Cost: $60,010
Three recommendations for state governments: Set the right price for hospital care Provide the right information Manage the system in a way that doesn’t weaken price signals, and encourages underperforming networks to improve (p.5)
Activity Based Management Transparency These new tools provide a very rich source of patient activity and information, which fosters transparency and accountability across the healthcare system.
Activity Based Management Patient Journey We can now follow the patient journey across the health system. By analysing and integrating services, we can optimise patient care.
Key Messages Collaboration is the critical success factor Clinicians have to be involved early in governance and app design System needs to be fast and accessible Need the processes for data review to already be in place Education is critical Focus on understanding and explaining variation Set clear expectations regarding data review, feedback and accountability
ABM PORTAL & STARS For more information, live demonstrations of the ABM portal and the STARS programs are available to try out outside.