1. The Health Roundtable 4-4c_HRT1215-Session_TRENTINO_CG_WA Reporting Hospital Acquired Complications using CHADx: Our Experience Presenter: Kevin Trentino Royal Perth Hospital : Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012 1

2. The Health Roundtable KEY PROBLEM  No current automated system to report hospital acquired complications to hospital executive  Little understanding of incidence of system wide hospital acquired complications and impact on patient outcomes and hospital resources locally  In seeking assistance our search didn’t identify other implementations of CHADx at the hospital level nationally  difficult to code/implement? 2

3. The Health Roundtable AIM OF THIS INNOVATION  Report the incidence of hospital acquired diagnoses using CHADx across all inpatient discharges presenting to Storm, Altair, Titan, Titan2, Titan3.  Investigate the association of hospital acquired diagnoses with multi-day hospital length of stay, hospital costs and emergency readmissions within 28 days  Implement systems for automated CHADx reporting 3

4. The Health Roundtable BASELINE DATA  Hospital acquired complications were present in 7% of discharges.  Multi-day discharges crude mean LoS was significantly higher for those with hospital acquired complications  After adjustment discharges with a hospital acquired complication had almost four times the mean LoS of discharges without a hospital acquired complication 4

5. The Health Roundtable KEY CHANGES IMPLEMENTED  Developed an abstract model for implementing the CHADx classification system  Integrated into clinical activity warehouse 5

6. The Health Roundtable OUTCOMES SO FAR  Composite CHADx flag as a measure in our hospital business intelligence (BI) tool: analysis services cubes.  cubes refreshed daily  allow users to analyse composite CHADx rates by specialty, DRG, ward etc…  Template reports have been created to quantify incidence of specific CHADx groups and subclasses.  Dashboards (including CHADx) for Wards being tested 6

7. The Health Roundtable LESSONS LEARNT  An automated system to report and analyse complications using the CHADx model important tool to increase the awareness of system wide hospital acquired complications  small number DRGs account for a large proportion of hospital acquired complications.  These insights will assist in designing targeted approaches to reducing hospital acquired complications, improving patient safety and reducing hospital costs. 7