Susan Dunn and Hirani Jayasinha, NSW ABF Taskforce
Download
Report
Transcript Susan Dunn and Hirani Jayasinha, NSW ABF Taskforce
ABF Clinical Engagement
Susan Dunn & Hirani Jayasinha
ABF Taskforce
May 2013
Why is Clinical Engagement Important?
Understand their operational contribution in ABF
Currently clinical practice is reflected in the costing process
which then informs the funding model
Collaboration in addressing unwarranted clinical variation
Identification of appropriate clinical practice
Understand the cost profile of the appropriate clinical cost
Aim is for funding to reflect the cost of appropriate care
Ensure correct funding messages are being heard
Drive improved patient outcomes
Key Strategic Approaches
Communication
Education & Tools
Relationships
Data
Relationships
Relationships
Promote a culture of partnership between clinicians, policy
makers and administrators with key agencies
– Clinical Excellence Commission (CEC)
– Agency for Clinical Innovation (ACI)
– Bureau of Health Information
– Health Education and Training Institute
– Local Health Districts (LHDs)/Specialty Health Networks
(SHNs)
Agency for Clinical Innovation
Relationships
ABF Taskforce have engaged with ACI , building relationships with
clinical Networks to discuss funding models and build costing models
based on best practice.
ACI promotes innovation, by engaging clinicians then designing and
implementing new models of care
Clinical Networks
– design and support implementation of models of care which spread
best practice across the NSW health system
– provide expert advice to the NSW Government and Ministry of
Health to improve patient care and address inequities in access
Signs of success,
– positive feedback and the Tupperware effect
Case Study – Renal Dialysis Network
IHPA required Home Delivered Services to be collected at a patient
level for each patient administrated service
Unwilling to put this burden of data collection onto clinical staff
Raised issue with key stakeholders in Renal Dialysis Network
Developed a solution framework
Met with Renal Network, Renal Dialysis Network and individual
stakeholders to outline issue and to discuss proposed solution
Gained support and commitment to work with the solution
Design phase has now commenced on a reporting solution based on
Prescription, census and leave option
LHD/SHN Relationships
Relationships
LHD/SHN Clinicians , ABF Coordinators, Non admitted
staff and SNAP staff
Majority of NSW ABF Workstream Working Groups have
clinical co –chairs and clinical membership
Providing input into policy direction and policy support
Improves ability to feedback to IHPA
Identify clinical champions
Provide regular information
Support and focused projects
Hunter New England LHD Case Study
Working with clinical groups and junior medical staff on improving
clinical documentation
Improved understanding of use of resources and variation in clinical
management of patients, including length of stay and use of
diagnostics
Activity/cost data included in Grand Rounds to emphasise issues with
respect to gaining a more holistic view of patient care and discuss
better ways of managing frequent repeating patients
Comment from a senior clinician that based on the aggregate cost it
would have been better for the patient and system to pay for a full
time carer
Illawarra Shoalhaven LHD Case
Study
Orthopaedics - identification of prostheses and comparisons
amongst sites has led to further work in standardising implants used
and renegotiating the price with the contractors
Costing has been used to identify the costs of readmissions due to
surgical infections
Provision of costing data to Grand Rounds to identify costs of long
stay patients and discuss impact if treatment was varied or supplied
in a different setting
Use of activity and costing data in working with sites and clinicians on
clinical pathways for selected DRGs
Reviewing benchmarking reports to compare with peers and
exemplar hospitals
Education - Health Education and
Training Institute
Relationships
Supports and promotes coordinated education and training
(clinical and non-clinical) across NSW Health System
Assures workforce competency and the capacity to deliver
safe, effective and efficient health care to the people of
NSW
Offers an online learning-course on ABF developed in
collaboration with ABF Taskforce
Education &
Tools
Education & Tools
Education - Other
Documentation – Factsheets, Practical Guide, Casemix
Handbook, SNAP Handbook
Tools – NWAU calculators: Acute and ED
Data
Data
Timely, Accurate, Transparent, Comparative, focused
ABM Business Information System
2011/12, DRG E65A CHRNIC OBSTRCT AIRWAY DIS +CCC
0
2000
4000
Allied
Other
6000
Blood
Path
8000
Imag
Pharm
Mean Costs($)
10000
Med
Pros
12000
Nurs
14000
16000
Data – ABM BIS
Key to pulling it together:
Communication
Site visits
Presentations to clinical groups
Linkage with local ABF Coordinators
Bulletins and factsheets
Handbooks, guidelines
Data timeliness and robustness
Transparency
Open and honest communication
Communication
Future Initiatives
Establishing NSW Clinical Casemix Advisory Committee –
to provide stronger links between NSW Health and
LHDs/SHNs
Developing further education materials (publications and
online modules) targeted to clinicians
Providing focused analysis of activity, costing and
benchmarking data for ACI Clinical Networks
– Incompatible ABO renal transplant
– Complex foot clinic
– ED Benchmarking
“What’s in it for me?”
Understanding that best clinical practice and ABF are not
mutually exclusive
Quality patient care costs less
Transparency
Timely, accurate, comparative data
Trust
Communication & collaboration