overview of health roundtable approach to the use of data … · 2017-08-08 · getting traction...
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www.healthroundtable.org
Getting Traction with Clinicians – Using Health
Roundtable data to improve performanceChris O’Gorman – Health Consultant
February 20 2015
Summary
• Overview of Health Roundtable
• Approach to the use of data
• Getting Traction
© 2014 Confidential Draft Discussion Document 2
Non-profit membership
group
Honour Code
86 Health Services
146 Facilities
Share problems
Share solutions
Provides informal
network
Non-political
The Health Roundtable …An Innovation Clearinghouse since 1995
© 2014 Confidential Draft Discussion Document 3
Our Honour Code
No member shall criticize the performance of other
member hospitals, or use any of the information to
the detriment of a fellow member.
No external distribution of data or conclusions
based on Health Roundtable data is made without
the unanimous consent of all participants.
© 2014 Confidential Draft Discussion Document 4
However, we encourage members to celebrate their innovations and share their own data publicly!
Our Role: Help you answer basic questions
Are our results different?
Why are we different?
Who can we learn from?
How do they do it?
How can we make it happen here?
© 2014 Confidential Draft Discussion Document 5
Riding the 200-year old “elephant”
Guiding your elephant to a new destination…
Direct the Rider• Set imaginable goals
• Find “bright spots”
• Script the moves
Motivate the Elephant• Capture feelings
• Shrink the change
• Identify with the change
Shape the Path• Make “right” easiest
• Use checklist triggers
• Display progress publicly
© 2014 Confidential Draft Discussion Document 6
Focus on Benchmarking for Innovation…
Screening tools
Search for differences
• Data Methods
• Clinical Practices
No “right or wrong”
Identify exemplars
Gradual fine-tuning
© 2014 Confidential Draft Discussion Document 7
Member experts and specialists come together to share problems and innovative solutions………
© 2014 Confidential Draft Discussion Document 8
What Core Data do we collect?
© 2014 Confidential Draft Discussion Document 9
Inpatient episodes
Emergency Presentations
Ambulatory/Outpatients Attendances
� All the above data is routinely collected for Departmental and internal purposes
� Additional fields for Discharge Unit/Department, and Doctor ID expands report options
Health Roundtable Comparative Data
© 2014 Confidential Draft Discussion Document 10
Ambulatory
Data
Sub-Acute Data
Emergency Collection
� Presentation Trends
� Triage compliance
� Access targets
� Timeliness of careHospital KPIs
� Efficiency
� Emergency
� Safety
� Surgery
� Workforce
Inpatient Collection
� Length of Stay
� Quality of Care
� DRG View
� Departmental View
� Mortality Analysis
Optional Extracts
� Maternity
� Patient Safety
� Nursing Related
� Paediatric
� Regional
Optional Collections
� Costing
� Allied Health
� Imaging
� Community Mental Health
� Surgical Journey
What we strive to avoid……!!
© 2014 Confidential Draft Discussion Document 11
“My patients are older & sicker”
How do we risk adjust your data?• The Health Roundtable measures
Length of Stay and also reports a
“Relative Stay Index” (RSI) which is a
risk adjusted Length of Stay
standardised across:
– 700 Diagnosis Related Groups
– 7 Patient Age Groups
– 3 Admission Types
– 2 Arrival Sources
– 5 Discharge Destinations
– 2 Comorbidity Levels
Illustration of RSI for Gall Bladder
Surgery (H08A)
The CEO Briefing
A quick snapshot of comparative
results!
• Relative Stay Index Trend
• Top 10 DRG Opportunities
• ED Target Comparisons
• Hospital Standardised Mortality
Rate
• Hospital KPIs Summary
The “Top 10” Report
• Shows the 10 DRG families where potential bed
day savings are greatest.
• Also lists any DRG families where your RSI results
are the leading group of hospitals.
Inpatient Briefings• A detailed DRG-level reports showing how you
compare to peer health services on key measures
such as length of stay, readmission rate,
complication rate, and discharge home rate.
IP Briefings – Example Pages
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IP Briefings – Example Pages
IP Briefings – Example Pages
Departmental Report
• Reports comparing your clinical units with the
most comparable peer departments across
Australia and NZ
Departmental Report – Example Page
Departmental Report – Example Page
22
Mortality Report• A report detailing mortality results and trends for the past
6 months using hospital standardised mortality ratios. This
report is restricted to hospital personnel receiving specific
approval from their hospital senior executive.
Mortality Report – Example Page
24
Emergency Department Report• A detailed report of Emergency Department
activity with monthly trends including overall
volume, access targets
Key Performance Indicators ReportIndictors covering areas of Efficiency, Emergency, Safety, Surgery and Workforce
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Defining a Patient Journey
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Link elements of Journey across time periods
Measure ALOS, cost and revenue earned across journey
Identify areas for improvement
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Ingredients for getting traction with performance
reports – Internal or Roundtable
• Leadership – Chief Executive and Clinical leaders
sponsorship/commitment
• Organisational framework – a forum to identify, action
and review data/information and leads
• A clear accountability structure for performance - who is
responsible for action and results?
• Credible, understandable information/reports that
support local information/reports
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Ingredients for getting Traction with performance
reports – Internal or Roundtable
• Open, regular communication with clinicians
• Local champions – Executives, Clinicians
• Someone “on the ground” who knows the data/definitions
or has direct link to technical experts, and can co-ordinate
action – Improvement Group/Service Reform &
Innovation, Health Information Services, etc
• Local action, monitoring and review – closing the loop
30
“Place the quality and safety of patient care above all
other aims for the NHS. (This, by the way, is your safest
and best route to lower cost.)” First of four Guiding principles for senior Government officials and senior executives in the NHS from
Don Berwick (Chair)
A promise to learn– a commitment to act:
Improving the Safety of Patients in England
National Advisory Group on the Safety of Patients in England
August 2013
March 2013 through to July 2013 study of the various available accounts of Mid Staffordshire, as well as the recommendations of
Robert Francis and others, to distil for Government and the NHS the lessons learned, and to specify the changes that are needed.
Using data to making change happen!
• Process Improvement = Data + Change
• Useful & accurate data moves
organisations to acceptance and action
©2013 Confidential Draft Discussion Document32
Think carefully about how you
interpret a chart!
Thank You
Chris.o’[email protected]
+61 3 417 037 039
www.healthroundtable.org
twitter/healthroundtable
LinkedIn/healthroundtable