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Improving Outpatient Services Across Bega Valley Health Service

Bega District Hospital
Project Added:
4 December 2014
Last updated:
8 December 2014

Improving Outpatient Services Across Bega Valley Health Service

Bega Valley Health Service, Southern NSW Local Health District (SNSWLHD)

Summary

Bega Valley Health Service Executive highlighted the need to develop sustainable outpatient clinics across the health service to improve patient access and experience and meet the demands of the community while being cost effective and aligning processes with Activity Based Funding (ABF) criteria. 

Download a poster about this project from the Centre for Healthcare Redesign graduation, December 2014. 

Aim

To improve outpatient services across Bega Valley Health Service to ensure a sustainable, efficient, cost effective outpatient service optimising patient experience and patient outcomes.

Benefits

  • Improved patient experience and patient outcomes
  • Streamlined outpatient service across Bega Valley Health Service
  • Improved communication between patients, staff, and other internal and external stakeholders
  • Improved sustainability and cost effectiveness

Background

Historically, administrative and financial systems supporting outpatient services across the Bega Valley has unsustainably structured and poorly understood. Outpatient services currently operate in clinical silos, having no framework or overarching governance structure.  

The Outpatient project links with the strategic direction of BVHS and Southern NSW Local Health District (SNSWLHD) as it aligns with the following priorities:

  • build financial sustainability
  • lead institutional and community change
  • develop a skilled permanent workforce that can effectively work in the new health service environment

Implementation

1. Develop a financial management framework

  • Cost/Benefits Analysis tool developed 
  • Monthly reporting of revenue generated by Outpatient Services
  • Billing processes implemented for specialist clinics to capture revenue
  • Processing of retrospective revenue generated for obstetric and gynaecology privately referred non-inpatient clinics

2. Enhance patient experience through improved communication and access

  • Appointment confirmation letters refined to provide patients with information regarding their outpatient clinic appointments – Bega Valley Community Consultation Committee included in consultation process
  • Map and new signage developed
  • Patients offered to receive appointment information via letter or email
  • Appointment reminders will be sent via text (SMS)

3. Establish an administrative officer position to support obstetric and gynaecology services

  • Executive approval of Decision Memorandum for position – July 2014
  • Governance of role established
  • Position Description developed

4. Development of outpatient manual

  • Business rules for the administrative and financial management of outpatient services developed, ensuring high data quality and capture of all billable services e.g. overseas ineligible, workers compensation, etc.
  • Business rules incorporated into administrative officer and midwife orientation
  • Develop a local intranet page for outpatient services as a resource for staff – still in development

Implementation sites

The scope of this project was for gynaecology and obstetric outpatient clinics only, with the overarching goal to “Improve outpatient services across Bega Valley Health Service”. Administrative and financial frameworks developed will be transferred to all other outpatient services across Bega Valley Health Service. 

Evaluation 

Evaluation of the solutions of the project will commence upon successful completion of the Implementation phase. Methods used to evaluate the success of the project will include:

  • patient surveys and staff interviews
  • monthly reporting of revenue 
  • weekly review of data quality
  • review of compliance with business rules – one month after implementation

Achievements to date

  • Administrative and financial framework established which includes business rules developed and being trialed.
  • Capture of patient level data has improved by an average of 29.8% for specialist obstetric and gynaecology and midwife clinics - February 2014 compared to October 2014.
  • Improved communication with patients and staff regarding outpatient services, which includes appointment confirmation letters, appointment reminders via SMS, new signage in place, map developed, Pregnancy Care Clinic brochure
  • Development of a local intranet page has commenced
  • New position description developed for new obstetric and gynaecology administration position. Position will be recruited.
  • Outpatient administration officer position recruited.
  • Staff understand responsibilities and have support for their roles
  • Rigorous process for identifying revenue generation for outpatient services that meets Activity Based Funding criteria.
  • A foundation to support future development of outpatient services, including workforce planning. 
  • Well-defined governance structure to ensure appropriate management of outpatient services. 
  • Improved data quality and clearly defined reporting process.
  • Improved processes to support appropriate contractual arrangements between the Local Health District and specialist medical officers
  • Established processes and business rules
  • Increase in revenue generated for obstetric and gynaecology clinics for the period February 2014 to September 2014
  • Billing process established for specialist obstetric and gynaecology outpatient clinics.

Partnership

The project was undertaken via the Agency for Clinical Innovation’s Centre for Healthcare Redesign program.

Lessons Learnt

  • Formal Agreements between the Health Service and specialist medical officers is vital for maximizing revenue generation for privately referred non-inpatient clinics.
  • Education, support (go to people), and resources (business rules) are important tools to ensuring staff are aware of their roles and responsibilities and have a reference point in times of uncertainty.
  • Sponsorship and communication are key factors to the success of a project.
  • Designing services to improve the patient experience is fundamental.

References

  • Contact with services outside of Southern NSW Local Health District which included Westmead Children’s Hospital.
  • Patient Experience Trackers (PETs)
  • Southern NSW Local Health District Strategic Plan 2013 – 2016 
  • Queensland Health Standard QH-IMP-300-1:2010; Outpatient Services Implementation Standard
  • Department of State Health Services Standards for Public Health Clinic Services; Revised 31/8/2004; Texas Department of State Health Services

Contact

Cara Steiner
Office Manager, Pambula
Bega Valley Health Service
Southern NSW Local Health District
Phone: 02 6495 8200
Email: Cara.Steiner@gsahs.health.nsw.gov.au

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