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ABF Success Factors Presenter: Dr Craig Margetts

Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012. ABF Success Factors Presenter: Dr Craig Margetts. Hospital Code Name: Various. 4-4c_HRT1215-Session_MARGETTS_TBA_QLD. KEY PROBLEM. Avoiding the healthcare management pendulum

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ABF Success Factors Presenter: Dr Craig Margetts

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  1. Innovation Poster Session HRT1215 – Innovation Awards Sydney 11th and 12th Oct 2012 ABF Success FactorsPresenter: Dr Craig Margetts Hospital Code Name: Various 4-4c_HRT1215-Session_MARGETTS_TBA_QLD

  2. KEY PROBLEM Avoiding the healthcare management pendulum From Finances and FTEs (about 5 years) To Quality, Quantity and Qualifications (about 5 years) How to have both and foster a clinically-driven management approach from the coal-face up? How to avoid “reporting-up fatigue” from constant additions to reporting requirements How enhance collaboration between Clinicians Clinical Managers Executive Managers

  3. AIM OF THIS INNOVATION To implement reporting process designed around: Clinicians (who did not plan to be accountants) Department/Division/Facility/Health Service goal alignment Identifying opportunities to eliminate waste Providing detailed advice to assist in external target negotiations Aligning Clinical, Quality and Business goals As a by-product Improving clinician understanding of business requirements Improving business understanding of clinical priorities Providing long-term financial, quality and business stability

  4. BASELINE DATA 4 organisations with budgetary and clinical-business challenges:

  5. KEY CHANGES IMPLEMENTED 6 Key Strategies (to compliment Quality / Pt Safety Initiatives):

  6. KEY CHANGES IMPLEMENTED Job Code Budget development Detail, Detail, Detail – Signed off by each CC manager in person By Cost Centre, Job Code, Pay Type and Month Expressed as FTEs, Hours, $ and % With routine reporting to match (including staff names) Patient/Dept/Division P&L (Margin Analysis) Regular reporting (monthly) to Clinical Divisions regarding Variable Contribution Margins Fixed Contribution Margins Overall Margin Ownership & Clinical Engagement to100% once information and concepts were understood (data quality improved dramatically)

  7. KEY CHANGES IMPLEMENTED Departmental Variance Reporting & Analysis Comprehensive suite of variance analyses: 3- Level OPD referrals Template in GP software saves time and increases compliance Default is Bulk-Billing Clinic to a named specialist (level 2) Opt out to “Public” (level 3) Opt out to “Chardonay”-Private clinic (level 1) IP Volume ActivityVariance IP Mix Other Productivity GL Variance Utilisation(Variable) Supplies Efficiency Leave (VSH) Labour Overtime Price Controllableby Dept Mgr Rates Labour Supplies FixedCosts Facilities IndirectCosts Other

  8. KEY CHANGES IMPLEMENTED Detailed Activity Budget Development Detail, Detail, Detail – Signed off by each CC manager in person By: Department/Division, Inpatient/Outpatient, Elective/Emergency (IP), New/Repeat (OP), Triage Category/OPD Referral Category/Waiting List Category Month Expressed as Patient/Client numbers, Weighted Seps/OOS With routine reporting to match (including staff names) Monthly Statistical (MonSta) Report from each Department Single monthly report required to management from clinicians Template to facilitate interpretation of routine reports Move focus from Problem Identification  Problem Resolution

  9. OUTCOMES 4 organisations with budgetary and clinical-business challenges:

  10. LESSONS LEARNT Detailed budgeting takes time, but ensures clarity of goals Financial & FTE Clinical: Quality, Access, Activity Reporting BACK to executive is equally as important as providing reports down to managers All formats must be in lock-step: Budget Format Routine Reporting (down) format Routine Reporting (up) format Clinical and Organisational Aspirations, Goals and Targets It takes 10 reporting cycles of BELIEVED information to make a difference… 20 to make lasting change

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