Outpatient
KPI
Management
Bernadette Comitti
Clinical Service Director Surgery, Perioperative & Outpatient Services
Matiu Bush
Patient Services Manager
Alfred Health Outpatient Clinics
• 180,000 attendances per annum
• Clinics located across sites
– Caulfield
– Sandringham
– The Alfred
• Mixture of CMBS and VACS clinics
• 28 clinic streams under the direction of the Surgery, Perioperative and
Ambulatory Services Programme
• 3 years ago commenced a process to bring the outpatient referral process
in line with our elective surgery process to provide a greater level of
transparency
3 key components required to understand our
demand, improve access to services and
clinic function
Referral
management
Data
management
and reporting
Implement
consistency in
the
management of
outpatient
referrals in line
with the
management of
elective surgery
referrals
Create a
performance
monitoring
framework by
clinic to guide
decision
making and
support the
access policy
implementation
Clinic flow
and function
Develop and
implement
practices that
enable
streamlined
efficient patient
management
Realignment of service provision
Patient service centre
• Create one central location for all referrals into the organisation to be
received and managed with consistent practices across various outpatient
clinics and between the two work streams (elective surgery and outpatient
services)
Outpatient referral
management &
telephone call centre
Elective surgical and
procedural bookings &
telephone call centre
Elective medical bed
bookings
Reporting framework
• The use of the VINAH data definitions allowed the creation of a refined
data set for demand and activity reporting by clinic
• Demand Data divided into 3 key areas
– Referral in
> Divided into GP, Emergency and inter-unit referrals
– Urgent
> Wait time to appointment
> Patients seen within 30 days
– Non urgent
> Wait time to appointment
> Wait time to appointment greater than 6 months
Reporting framework
• Activity data divided into 5 areas
– Activity
> Total attendances and failed to attend rate
– Rescheduled and cancellations
> Hospital and patient initiated postponements
– New and review appointments
> Total attendances and failed to attend rates
– Discharge percentage
> Percentage of patients discharged
– Review appointments awaiting (unmet demand)
> Number and percentage overdue in each category
OUTPATIENT ALL UNITS REPORT
Outpatient Demand
REFERRAL IN
Total number of referrals received
Number of URGENT
% of URGENT
Number of NON URGENT
% of NON URGENT
Number of referrals not triaged at consensus date
% of referrals not triaged at consensus date
% ED Referrals
% Intra Unit Referrals
% GP Referrals
Referral In Process
"Referral In" received date to "referral accepted" date (days)
Number of URGENT referrals seen within 30 days
URGENT (P1 & P2)
% of URGENT referrals seen within 30 days
Median wait time to first appointment
90th percentile wait time to first appointment
Number of URGENT referrals where waiting time to first appointment exceeds 30 days
Number of NON URGENT referrals on request list
Number of NON URGENT referrals seen within 6 months
% of NON URGENT referrals seen within 6 months
Median wait time to first appointment
90th percentile wait time to first appointment
NON URGENT (P3 & P4)
Number of NON URGENT referrals where waiting time to first appointment exceeds 6 months but not more than 12 months
% of NON URGENT referrals where waiting time to first appointment exceeds 6 months but not more than 12 months
Number of NON URGENT referrals where waiting time exceeds >365 days
% of NON URGENT referrals where waiting time exceeds >365 days
Outpatient Activity
Total appointments scheduled
ACTIVITY
RESCHEDULED
CANCELLATIONS
NEW
Total attendances
Total FTA
% FTA
Patient initiated reschedule
% Patient initiated reschedule
Hospital initiated reschedule
% Hospital initiated reschedule
Total number of rescheduled appointments
Patient initiated cancellations
% Patient initiated cancellations
Hospital initiated cancellations
% Hospital initiated cancellations
Total cancellations
Total New appointments attended
% New appointments
Total New FTA
% New FTA
Total New appointments resulting in placement on elective surgery waiting lists
% of New appointments placed on the elective surgery waiting list
REVIEW
DISCHARGED
DISCHARGE
DOCUMENTATION
Total Review appointments attended
% Review appointments
Total Review FTA
% Review FTA
Total number discharged
% Discharge
Communication with referrer about findings of new appointment within 5 working days of completed new appointment
Discharge summary sent to referrer within five working days of discharge from the clinic
Organisational Learning's
ELECTIVE SURGERY MANAGEMENT
• Policy compliance
OUTPATIENT MANAGEMENT
• New Policy audit framework
• Elective surgery request form
processing timeframes
• Referral processing timeframes
• Cat 1, 2 and 3 surgery timeframes
• Appointment timeframes for Urgent
and Non urgent referrals
• Best practice waitlist management
• Validating/auditing of appointment
queues
• GP Discharge communication
• Communication with GP and Pt
Leveraging off existing
reporting tools and audit
know how.
Informed decision making
• Data validation
• Accurately measure activity and demand pressures within medical
and surgical clinic streams
• Identify options for multidisciplinary disease based treatment
streaming
• Identify trends of performance over time
• Identify high performing units within Outpatients