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Health Roundtable Briefing for Rigel+. August 2007. The Health Roundtable … An Innovation Clearinghouse. Share problems Share solutions Avoid reinventing wheels “Seed” large scale projects Provide CEO network. Health Roundtable. UHC. IHI.
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Health Roundtable Briefing forRigel+ August 2007
The Health Roundtable … An Innovation Clearinghouse • Share problems • Share solutions • Avoid reinventing wheels • “Seed” large scale projects • Provide CEO network Health Roundtable UHC IHI
Health Roundtable Process – to speed innovation 5. Confirmation 2. Persuasion 3. Decision 3. Decision 1.Knowledge 4. Implementation
Today’s Agenda • Roundtable Activity Summary 2007 • KPI Summary – Feb 2007 • Casemix Highlights – Dec 2006 • Plans for remainder of 2007
February – Lean Update March-May: NZ June-Aug: QLD Sep-Nov: Victoria Executive 1-day briefings Key Learnings: Executive sponsorship essential Teamwork on the same project required Tools work well, but culture change is difficult! Lean Healthcare Programs
Lean Project Examples CCDHB: Reduce the time it takes dressing packs to get from order to patient Mater: Reduce the turnaround time for urgent adult biochemistry profiles Southern Health:Reduce time between psychiatric unit discharge and contact w/ CMHS Eastern Health: Decrease the waiting time in urology outpatients by 50% Bayside Health: Reduce the lead time for urgent neurology referrals Waikato DHB: Reduce recruitment request authorisation delays Townsville: Eliminate cancellations of ambulatory ortho trauma patients Mater: Start first scheduled elective c-sections on time
Lean Project Examples Canterbury:Reduce Radiology delays for Neurology patients Capital & Coast: Reduce delays for Diabetes OPD appointments Health Waikato: Decrease ALOS of T&A by 50% to 0.33 days Counties Manukau: Reduce ED Occupancy to <6 hrs for all general surgery patients Waitemata: Reduce patient waiting for their relatives to collect them Auckland:Reduce haematology and biochemistry specimen turnaround time SCGH:Eliminate neurosurgical cancellations due to ICU “bed blocks” NT:Reduce DNA rate of long-distance outpatient referrals Project summaries available on the website: www.healthroundtable.org.au
ED Volume Trends Updated chart…
ED Volume Trends Updated chart…
ED Waiting Time to Ward - % in 8 Hours Data Issues – updating now…
ED Waiting Time to Ward - % in 4 Hours Data Issues – updating now…
HRT0704 Improving Outpatient Journey – Diabetic Patients Example Patient receives an appointment date for initial assessment Patient referred by GP/ other Patient attends initial assessment Patient Attends for follow-up care 2 Weeks 5.3 Weeks 9.8 Weeks Time to 1st Appt Shortest: Vulcan, Hermes 4 weeks, Sirius & Poseidon 5 weeks Longest: around 14 weeks
HRT0704 Diabetic Clinic Innovations We asked you which of the following innovations you were using:
HRT0606 – Maternity Benchmarking • First meeting of this new group – 29 June • 17 hospital facilities represented • Reviewed casemix data and facility data • Wide differences in practice identified
HRT0707 Key Innovations • Thunder – Night Team Coordinators • Hera/Capella – Standardised Handovers • Tornado – Credentials/Privileges database • Dionysis – Priority system for out-of-hours reviews • Vulcan – electronic tracking of items in M&M reviews Wash Your Hands compliance – more needed!
Casemix Analysis Changes - 2007 • Age Groups (0,1-16,17-49,50-64,65-79,80+) • Expanded to 6 categories • Aligned with census statistics for older patients • RSI Calculation (Emergency SameDay added) • Control for emergency admission practice differences • Separates same-day emergency admission/discharges from “regular” emergency admissions • Peer Groups Established • Your chosen peers included in briefing reports • Comparisons provided in hospital table for peer selection
RSI – By Region – Six months to Dec 2006 CSG Casemix report – available in “data download” section on website
RSI – All Members – Six months to Dec 2006 CSG Casemix report – available in “data download” section on website
Relative Stay Index – Individual Facilities Version3 2006 Six Months to December CSG Casemix report – available in “data download” section on website
By DRG By DRG Family By Group of DRGs By Department By Clinician Compared to 2003 average Compared to current average Compared to shortest quartile of hospitals Compared to shortest 10% of hospitals Length of Stay Analysis Options
Customised Analyses for Rigel LOW LOS – compared to group average • B63DMNTIA&CHRNIC DISTURB CRBRL FN (400) • J65TRAUMA TO SKN,SUB TISS&BREAST (100) • K60DIABETES (100) • U67PERSONLTY DSRD&ACUTE REACTIONS (100) • X60INJURIES (100) • HIGH LOS – compared to 4 shortest hospitals • B70STROKE (2700) • E62RESPIRATORY INFECTN/INFLAMM (1400) • G02MJR SMALL & LARGE BOWEL PR (1100) • O60VAGINAL DELIVERY (900) • U61SCHIZOPHRENIA DISORDERS (3100) (Numbers in parentheses are potential bed day savings per year) Customised briefing reports are available for downloading From the Roundtable library – indexed by codename.
Customised Analyses for Rigel2 LOW LOS – compared to group average • F42CRC DSRD-AMI+INVAS INVEST PR (100) • I13HUMER,TIBIA,FIBUL,ANKL PR (200) • I75INJ SH,ARM,ELB,KN,LEG,ANKLE (100) • J06MAJOR PR FOR BREAST CONDITIONS (100) • HIGH LOS – compared to 4 shortest hospitals • E62RESPIRATORY INFECTN/INFLAMM (1100) • E65CHRNIC OBSTRCT AIRWAY DIS (1000) • O60VAGINAL DELIVERY (1100) • U61SCHIZOPHRENIA DISORDERS (2600) • U63MAJOR AFFECTIVE DSORDERS (1500) (Numbers in parentheses are potential bed day savings per year)
Website • All Health Roundtable Meeting documents in member library – over 700 documents on key topics • Casemix data and reports available for downloading (by registered users) • Go to: www.healthroundtable.org.au • Click on “Data Analysis” tab, then “data download” • If not visible, contact us to grant permissions • Ad hoc reporting available using website casemix analyst (See Casemix Analyst section under Data Analysis) • Also, access to University Healthsystem Consortium reports on new technology, pharmaceuticals and key management issues – www.uhc.edu
Remaining Activities for 2007 Your ideas needed now for topics in 2008 and future direction of the Roundtable
We’re here to help! Contact us – david.dean@healthroundtable.org Tel: +61 2 9440 2016