1. The Health Roundtable 3-3c_HRT1215-Session_SMEATON_ISHLHD_NSW High Five DRG Project Presenter: Alexander Smeaton Hospital Wollongong Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012 1

2. The Health Roundtable KEY PROBLEM Health Round Table data identified that our RSI in the below DRGs was substantially higher compared to all other Health Round Table members  E62  E65  B70  G02  F62 2

3. The Health Roundtable AIM OF THIS INNOVATION  To Save 800 bed days across the district in the identified high RSI DRGs  To develop documented models of care for each high RSI DRG 3

4. The Health Roundtable BASELINE DATA  Blaze Hospital DRG CodeDRG NameEpisodesALOSTWH RSIALL HRT RSIExemplar weighted Average Potential Bed Day Savings E62Respiratory Infection/Inflam mations 7085.3122%93%83%1185 E65COAD5505.5116%91%71%1168 B70Stroke3559.6116%88%76%1155 060Vaginal Delivery 15952.8113%96%90%881 F62Heart Failure & Shock 3357.1137%96% 717 F73Syncope & Collapse 4652.9146%96%81%595 B69TIA & Precerebral Occlusion 2245.3164%93%84%581 G02Major Small & Large Bowel Procedures 16112.4105%96%82%441 4

5. The Health Roundtable BASELINE DATA Blaze 3 DRG Code DRG NameEpisodesALOSSHH RSI ALL HRT RSI Exemplar weighted Average Potenti al Bed Day Savings E65COAD4176.1117%91%72%989 E62Respiratory Infection/Inflammations 3175.9113%93%79%567 F62Heart Failure & Shock1636.2117%96%77%344 F73Syncope & Collapse2592.2131%96%72%253 B70Stroke904.5119%88%63%189 5

6. The Health Roundtable KEY CHANGES IMPLEMENTED  Improved clinical Documentation in the medical records  Clinical engagement in the coding process  Development of clinical pathways for identified DRGs  Implementation of DRG Facilitators at Blaze  Implementation of DRG LOS Facilitator across the district 6

7. The Health Roundtable OUTCOMES SO FAR  Target of 800 bed day savings within identified DRGs met  Reduction in RSI in identified DRGs B70 @ Blaze RSI decreased from 116% - 100% B70 @ Blaze3 RSI decreased from 119% - 60% G02 @ Blaze RSI decreased from 105% - 91% E62 @ Blaze3 RSI decreased from 113% - 97% E65 @ Blaze3 RSI decreased from 117% - 102% F73 @ Blaze RSI decreased from 146% - 124% F73 @ Blaze3 RSI decreased from 131% - 120% 7

8. The Health Roundtable LESSONS LEARNT  Clinician engagement essential from the beginning  Requires dedicated project team  Sustainability is key  Real time education and review of clinical documentation is essential 8