Outpatient KPI Management Bernadette Comitti Clinical Service Director Surgery, Perioperative & Outpatient Services Matiu Bush Patient Services Manager

Alfred Health Outpatient Clinics 180,000 attendances per annum Clinics located across sites –Caulfield –Sandringham –The Alfred Mixture of CMBS and VACS clinics 28 clinic streams under the direction of the Surgery, Perioperative and Ambulatory Services Programme 3 years ago commenced a process to bring the outpatient referral process in line with our elective surgery process to provide a greater level of transparency

3 key components required to understand our demand, improve access to services and clinic function Referral management Data management and reporting Clinic flow and function Implement consistency in the management of outpatient referrals in line with the management of elective surgery referrals Create a performance monitoring framework by clinic to guide decision making and support the access policy implementation Develop and implement practices that enable streamlined efficient patient management

Realignment of service provision Create one central location for all referrals into the organisation to be received and managed with consistent practices across various outpatient clinics and between the two work streams (elective surgery and outpatient services) Patient service centre Outpatient referral management & telephone call centre Elective surgical and procedural bookings & telephone call centre Elective medical bed bookings

Reporting framework The use of the VINAH data definitions allowed the creation of a refined data set for demand and activity reporting by clinic Demand Data divided into 3 key areas –Referral in > Divided into GP, Emergency and inter-unit referrals –Urgent > Wait time to appointment > Patients seen within 30 days –Non urgent > Wait time to appointment > Wait time to appointment greater than 6 months

Reporting framework Activity data divided into 5 areas –Activity > Total attendances and failed to attend rate –Rescheduled and cancellations > Hospital and patient initiated postponements –New and review appointments > Total attendances and failed to attend rates –Discharge percentage > Percentage of patients discharged –Review appointments awaiting (unmet demand) > Number and percentage overdue in each category

OUTPATIENT ALL UNITS REPORT Outpatient Demand REFERRAL IN Total number of referrals received Number of URGENT % of URGENT Number of NON URGENT % of NON URGENT Number of referrals not triaged at consensus date % of referrals not triaged at consensus date % ED Referrals % Intra Unit Referrals % GP Referrals Referral In Process "Referral In" received date to "referral accepted" date (days) URGENT (P1 & P2) Number of URGENT referrals seen within 30 days % of URGENT referrals seen within 30 days Median wait time to first appointment 90th percentile wait time to first appointment Number of URGENT referrals where waiting time to first appointment exceeds 30 days NON URGENT (P3 & P4) Number of NON URGENT referrals on request list Number of NON URGENT referrals seen within 6 months % of NON URGENT referrals seen within 6 months Median wait time to first appointment 90th percentile wait time to first appointment Number of NON URGENT referrals where waiting time to first appointment exceeds 6 months but not more than 12 months % of NON URGENT referrals where waiting time to first appointment exceeds 6 months but not more than 12 months Number of NON URGENT referrals where waiting time exceeds >365 days % of NON URGENT referrals where waiting time exceeds >365 days

Outpatient Activity ACTIVITY Total appointments scheduled Total attendances Total FTA % FTA RESCHEDULED Patient initiated reschedule % Patient initiated reschedule Hospital initiated reschedule % Hospital initiated reschedule Total number of rescheduled appointments CANCELLATIONS Patient initiated cancellations % Patient initiated cancellations Hospital initiated cancellations % Hospital initiated cancellations Total cancellations NEW Total New appointments attended % New appointments Total New FTA % New FTA Total New appointments resulting in placement on elective surgery waiting lists % of New appointments placed on the elective surgery waiting list REVIEW Total Review appointments attended % Review appointments Total Review FTA % Review FTA DISCHARGED Total number discharged % Discharge DISCHARGE DOCUMENTATION Communication with referrer about findings of new appointment within 5 working days of completed new appointment Discharge summary sent to referrer within five working days of discharge from the clinic

Organisational Learning's ELECTIVE SURGERY MANAGEMENT Policy compliance Elective surgery request form processing timeframes Cat 1, 2 and 3 surgery timeframes Best practice waitlist management Communication with GP and Pt OUTPATIENT MANAGEMENT New Policy audit framework Referral processing timeframes Appointment timeframes for Urgent and Non urgent referrals Validating/auditing of appointment queues GP Discharge communication

Leveraging off existing reporting tools and audit know how.

Informed decision making Data validation Accurately measure activity and demand pressures within medical and surgical clinic streams Identify options for multidisciplinary disease based treatment streaming Identify trends of performance over time Identify high performing units within Outpatients