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 Health Deputy Director, ABF Taskforce Dr Rohan Hammett Deputy Secretary, Strategy and Resource

Supporting Clinicians and Managers to Drive Change Together:

Unlocking Data

Clinicians and

managers Ministry SLHD

CEC ACI Other States

Ambulance Service

Other Districts

DATA MINING AND ANALYTICS

The holy grail: access to timely, accurate 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

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

Where we are now:

District led

Specialty / Clinician driven

STARS DEMONSTRATION

-78.24

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

THE ABM PORTAL 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.

ABM Portal

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

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

Clinical Variation

Orange Hospital

Acute $39,512 ED $17,877 NAP $2,621

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.