The Health Roundtable A simple approach to Counting and Costing Presenter: Grainne O’Loughlin & Noah Mitchell St Vincents Syd Activity Based Funding 7 th March Sydney b_HRT1215-Session_MITCHELL_STVS_NSW

The Health Roundtable KEY REASONS FOR IMPLEMENTING BARCODE SCANNING  Lack of ability to easily and accurately count the amount of servicing our allied staff provided for patients: previous stats systems have been functional but far from easy or accurate!  Implications for: allocating staff resources, determining equitable loads, ascertaining how much time staff are spending on non-patient related activities such as research, teaching, QI etc, trending or reviewing service demand over time, ‘showing’ services how much allied health time they are using  The nature of collecting interventions within a department e.g. of the SVH Physiotherapy Department  The Department is able to count the interventions easily and accurately: How? 2

The Health Roundtable KEY CHANGES IMPLEMENTED  The Activity BarCoding system. It was rolled out to our staff to start recording the interventions they provide to each patient.  Departments using the system  Physiotherapy  Nutrition  Speech Pathology  Social Work  Occupational Therapy  Palliative Care  Community Care Further departments looking at rolling it out:  Pharmacy  Heart and Lung Transplant Team  Hematology and Oncology Ambulatory Care 3

The Health Roundtable 4

 Staff Uptake and Attitude -Measured on a staff survey 5

The Health Roundtable OUTCOMES SO FAR 6

The Health Roundtable OUTCOMES SO FAR 7

The Health Roundtable Findings  As staff activity durations are a major cost, its interesting to compare differences between automatic and manual recording of activity durations. Manual recording shows a relationship to durations lasting round numbers eg 10,15,20,30,40,45,50 and 60 min Interestingly: activities around 25 and 35 min seem to round to 30min and around 55min and 65min rounds to 60min With hundreds of staff daily recording data manually 5 and 10 min rounding add up quickly 8

The Health Roundtable OUTCOMES SO FAR  Accurate Reports showing:  Average minutes of service per intervention  Average number of interventions per DRG  Total Interventions per DRG, Location, Receiving Unit etc  Ability to drill down to an individual patient to identify the exact number of minutes of service provided. --functionality of the reports is very important 9

The Health Roundtable Department Level Dashboard MoM KPIs CC% 10

The Health Roundtable Department Operational Summary 11

The Health Roundtable Intervention Cost Report 12

The Health Roundtable LESSONS LEARNT & NEXT STEPS  We recommend that other organisations look at the capability of the systems being used for activity recording/ costing purposes  We recommend that where possible, staff salaries (Award) are loaded into the activity systems so that true costs can immediately be related to activity  We have embarked on a second multi-site project (grown from 5 to 18 participants) looking at benchmarking allied health costs for selected DRGs 13

The Health Roundtable LESSONS LEARNT & NEXT STEPS  We will endeavour to correlate activity data with actual costs and patient outcomes and are excited about the FIM data review being undertaken by the HRT (compares allied health hours to changes in FIM score)  Ultimately, we will shape and review models of care based on efficiency and patient outcomes  We need an allocated ABC resource person at St Vincents as the number of users continue to increase (to facilitate training, orientation, troubleshooting and product development)  Other users in the audience – The Prince Charles, Redcliffe and Caboolture Hospitals – any comments? 14