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Western Health case study

Improving efficiencies and optimising results

Western Health is a 980 bed Public health service in Victoria with 120,000 annual separations.  It provides Tertiary Acute care, Sub-Acute Care, Community Services, Day Hospital and Transition Care.

Western Health had a requirement to eliminate inefficiencies, improve productivity, report in real-time and optimise their budget results by digitising and automating Auditing workflow. 

Challenge

Western Health’s Auditing team’s efficiencies and productivity were impeded by using manual processes, involving 39 spreadsheets, each of which contained up to 26 cells for Audit target criteria mapping.

Each Episode was manually checked by Auditors, and if it met any target criteria, it would be manually entered into the relevant Unit’s spreadsheet in the specific cell. 

WIES difference was both manually calculated and entered into these spreadsheets. 

Track your data

Reporting and analysis on this Audit data were not possible given that cells contained free text.  This process was associated with significant costs (time and labour) and laden with human error.  Audit results were only available at the end of the month, the resulting lag time from patient discharge being 6-8 weeks.

Ensure quality of coded data

Solution

Data Agility consulted with a range of stakeholders at Western Health and identified that Code Focus, a performance optimsation software solution was required.

We were then able to propose a way forward for implementation, including a series of detailed prioritisations to eliminate inefficiencies, improve productivity, allow real-time reporting and optimise their budget results.

Staff needed to shift their focus on improving their Coding metrics. We could digitise and automate the Auditing workflow to improve productivity, which would also deliver significant time saving.

A key area for improvement was time and labour efficiencies. The work backlog demanded additional headcount and Western Health was aiming to hire additional resources.  Using Code Focus, they would be able to accurately align resources to demand resulting in zero backlog.

Real-time, accurate reporting on each Unit by the most common ICD and DRG changes was required by Western Health. Code Focus could deliver an improvement in accurate, complete and timely data. This would also lead to improved User and Clinician Education, in addition to improved quality in Clinical Documentation.

eQueries were used at Western Health, generated in Western Health’s Digital Medical Record (DMR). These could be captured in Code Focus. eQueries would be able to be emailed to and from Clinicians, improving efficiencies and effectiveness given it resolved projected funding gaps in a timely manner.

Coder, Auditor and Educator training was undertaken as part of the implementation. Initially, some of the Coding team were unsure as to how they would manage with Code Focus.  However, once they saw that that there was no data entry because fields were auto-populated, that the user interface was simple and very easy to navigate, they felt very comfortable using the solution and adopted it very quickly.

Results

The installation of Code Focus at Western Health had a profound impact on the business.

They now have a platform and solution that can cater to their needs and supports their organisational requirements.

Time Savings:

  • Efficient and optimised Auditing allows staff to focus on Coding
  • Reduced average coding completion time from over 30 days to 17 days and decreasing
  • Decreased the number of Episodes audited to achieve an optimised WIES target result
Ensure quality of coded data

Cost Savings:

  • With time saved, it has eliminated the need for contract staff, reduced casual staff and overtime limits
  • Workforce Capacity Planning is optimised according to demand (surge and seasonality)

Cost Savings:

  • Continuously improving Coding “First Time Right” metrics
  • 22,000 Audits (B and C DRGs)
  • 9,500 Coding / ICD-10 changes
  • 6,500 DRG changes
  • 104% Target
  • $28.5m additional funding

Having used Code Focus for almost two years, Western Health is in “Phase 2”, looking at continuously refining its workflows and results.  Staff are now fine-tuning reports, in particular, focussing on Unit trend reports to further improve Quality and Service Planning whilst achieving an optimised funding result.  HIS is very much focussed on continuing to apply learnings from Auditing to their Coding (First Pass) so as to optimise “First Time Right” metrics. 

    Ready for real-time auditing of your clinical coding?

    Want to learn more about how you can improve your clinical coding, and ensure correct revenue and workforce efficiency? Get real-time access to your clinical coding and auditing data. Book a demo today to learn more about how Code Focus works.

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