Allied Health Statistics AAHBC 2015

Why collect statistics? Informing decision making and resource allocation Monitoring key processes Improving systems and processes Measuring performance against targets Measuring contribution to the health care process Predicting implications of changes in practise Quality activities to ensure that services are being delivered in the most efficient way Benchmarking activities across organisations Service and contract negotiation AAHBC 2015

Allied Health Activity Has been divided into 4 categories by the National Allied Health Casemix Committee (NAHCC) 2001 Allied Health Activity Clinical Care Teaching & Training (TT) Research Clinical Services Management (CSM) Individual Patient Attributable (IPA) Non Individual Patient Attributable (NIPA) AAHBC 2015

Clinical Care Activities which provide a service to an individual, community or group to influence health status Clinical Care is comprised of both: IPA: Individual Patient Attributable NIPA: Non-Individual Patient Attributable AAHBC 2015

IPA Individual Patient Attributable A clinical care activity that can be assigned to an individual patient (medical record number known) Examples: Treatment of a client Writing a discharge report for a patient Telephone call about a client to a community agency to arrange home support AAHBC 2015

NIPA Non Individual Patient Attributable Any clinical care activity that can not be assigned to an individual patient Examples: Unit meetings/ward rounds/case conferences/handover/caseload allocation. Group activity eg antenatal (UR unknown) Patient education material development Preparation, planning, delivery and evaluation of an education program to group Health promotion event Travel associated with clinical care which can not be directly related to a specific patient AAHBC 2015

Teaching and Training Formal teaching and training activities which relate to the imparting of knowledge, skills and clinical competency Undergraduate students and post graduate students Practitioners in own discipline Other practitioners Examples: Preparation time associated with the delivery of formal Teaching & Training eg. inservices, lectures, seminars Delivery of inservices, lectures, seminars Supervising a student treating a patient Meeting/consultation/communication on teaching activities Interaction with training institutions AAHBC 2015

Research Activities which are undertaken to advance the knowledge and delivery of care to an individual, group or community. Research is limited to activities that lead to and follow formal approval of the project by a research committee or equivalent body. AAHBC 2015

Clinical Services Management Professional and management activities which support and are essential to clinical care. Examples: Staff management Staff meetings Quality improvement Supervision: general matters unrelated to a specific patient or group Work related to a submission/proposal for a new service/ program Undertaking professional development Statistics gathering and reporting Travel specifically associated with Clinical Services Management (CSM) AAHBC 2015

Statistics Entry Algorithm Does the activity provide a service to an individual, group or community, to influence health status ? Does the activity relate to formal Teaching and Training activities ? Does the activity relate to a formal research project? (ie leads to and follows formal approval of the project by an ethics committee)? NO NO YES YES Clinical Care Teaching & Training YES NO Can the Clinical Care activity be attributed to a patient(s) ? Clinical Services Management (CSM) YES NO Individual Patient Attributable (IPA) Non Individual Patient Attributable (NIPA) Research AAHBC 2015

Is the meeting about…..? A specific patient (IPA) An approved program for patients that is currently being designed (NIPA) A program for patients that you think would be a good idea and want to discuss with others (CSM) A formal research project that you are collecting data for (Research) A clinical placement with a training institution (Teaching & Training) AAHBC 2015

Is the telephone call about….? An individual patient (IPA) Students (Teaching & Training) Research (Research) AAHBC 2015

Is the travel for ….? A patient home visit (IPA ) A meeting to discuss a new service (CSM) A meeting to discuss the teaching activities at your site (TT) AAHBC 2015

Is the literature review to help…..? Provide optimum treatment to a patient that you are treating (IPA) Develop a research proposal to submit to the ethics committee (Research) Prepare a lecture for students or staff (Teaching & Training) AAHBC 2015

How would you code? Develop an education package that has been endorsed by management and that is directly related to the clinical care of a certain patient group -> NIPA Work planning for the day (including non-clinical care activities) -> CSM Department student coordinator meets with University staff in relation to student placement program -> Teaching and Training (TT) AAHBC 2015

How would you code? Clinician provides training session to a group of nurses as a regular and formal part of their in-service program Clinician: -> Teaching and Training Clinician presents a talk to other AH staff in a structured continuing education program Presenter: -> Teaching & Training Audience: -> CSM AAHBC 2015

How Would You Code? Clinician observes a student providing an intervention to a client for supervision purposes only Student: -> IPA Clinician: -> Teaching and Training Clinician treats a patient. Supervisor observes to perform competency assessment as part of formal department learning program Clinician: -> IPA Supervisor: -> CSM . AAHBC 2015

How Would You Code? Student observes a clinician providing an intervention to a client. Session takes longer than normal due to interaction with the student eg explanations Normal session time -> IPA ( clinician) Extra time taken -> Teaching & Training Student treats the patient without the clinician present. Afterwards the clinician discusses the treatment session with the student without the patient present. Student: -> IPA Supervisor: -> Teaching & Training AAHBC 2015

Common confusions (from previous audits) Professional development Program development , delivery and evaluation Group development, delivery and evaluation AAHBC 2015

Professional Development (CSM vs TT) Receiving teaching and training such as attending inservices, lectures, seminars and is professional development. This includes journal reading, journal clubs, implementation of the staff member’s professional development plan etc. -> CSM Preparation and delivery of inservices, tutorials or seminars -> TT AAHBC 2015

New program development, and delivery (CSM vs NIPA) Conceptual stage Preparation of a briefing note or submission, needs analysis or literature review for planning a new service -> CSM After approval has been obtained This would include activities associated with the design and development of specific programs such as session structure, content and research for the program, further literature review. -> NIPA AAHBC 2015

Program evaluation and review NIPA vs CSM Review of the processes in a current intervention e.g. Meeting to discuss location change of inpatient cardiac rehab to improve process for next intervention with current group of patients -> NIPA An evaluation of the program overall is considered a quality improvement activity and should be assigned to CSM. -> CSM AAHBC 2015

Group development & delivery CSM v NIPA v IPA A meeting to plan for new group service -> CSM A discussion about what to include in the design of the approved new group -> NIPA Delivery of the approved new group program IPA where practical to divide the time between individual patients NIPA where it is not practicable to divide clinician’s time AAHBC 2015

Group outcomes and evaluation IPA v NIPA v CSM Evaluation of individual group member’s outcomes -> IPA Review of the processes in a current group session to plan the process for the next session -> NIPA Evaluation of the program overall (quality activity) -> CSM AAHBC 2013

Annual audit All AAHBC membership organisations are required each July to undertake an Activity Coding Audit. The Activity Coding Audit is circulated to all AAHBC membership organisations by the AAHBC Activity Coding Working Party. AAHBC 2015

Summary This presentation has been endorsed by the AAHBC membership organisations and should not be altered. If you have any queries regarding this presentation please contact your AAHBC representative. Further information at: www.nahcc.org.au AAHBC 2015