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A Pain in the Gut

Project Added:
16 April 2015
Last updated:
23 April 2015

A Pain in the Gut

Summary

This project will audit the medical records of Australian Refined Diagnostic Reference Group G70 – Other Digestive System Disorders (AR-DRG G70) patients at Gosford Hospital to investigate the reasons for increasing length of stay (LoS) and implement strategies to decrease this rate. 

Poster from the Centre for Healthcare Redesign Graduation, April 2015 Poster from the Centre for Healthcare Redesign Graduation, April 2015.

Aim

To improve patient outcomes for the AR-DRG G70 at Gosford Hospital and reduce the LoS for these patients by September 2015.

Benefits

  • Improved patient journey and patient outcomes.
  • Improved accuracy with clinical documentation to reflect actual care provided and enable correct coding.
  • Development of a standardised approach to review AR-DRG G70 patients with identified clinical variation.

Project Status 

Project status: Implementation - the initiative is ready for implementation, is currently being implemented, piloted or tested.

Project started:  2 April 2014.

Background 

During a Health Round Table (HRT), Central Coast Local Health District (CCLHD) identified data that indicated patients within the AR-DRG G70 group had a relative stay index of 143% at Gosford Hospital, which is significantly higher than peer hospitals (HRT 2014). It determined that by reducing the LoS by 43%, CCLHD could save 880 bed days annually and reduce the relative stay index of patients at Gosford Hospital.

Between July 2012 and June 2013, 611 episodes of care for AR-DRG G70 patients were provided at Gosford Hospital (HRT 2013). CCLHD reported the average LoS for this group was 3.9 days, compared with a NSW peer average of 1.9 days. This is 94% higher than the NSW peer average.

Implementation 

  • An interactive session was conducted with CCLHD staff. This involved a demonstration by linical coders, which showed how incomplete documentation can impact how patients are coded and affect funding and LoS. This session is to be repeated at six-monthly intervals, with an event for medical interns to be arranged.
  • A diverticulitis protocol is currently under development.

Implementation site

Gosford Hospital 

Partnership

Central Coast Medicare Local

Evaluation

  • Project outcomes will be reflected in HRT data and through the Activity-Based Management (ABM) portal.
  • A coding audit is planned for six weeks post-implementation, to ensure coding is reflected correctly in documentation.
  • A staff satisfaction survey will be introduced one month post-implementation.

Lessons Learnt

  • The AR-DRG contains 458 disorders that are not easily comparable.
  • The escalation of treatment for diverticulitis is surgeon dependant.

Resources

Contact

Jenny Mallyon
Clinical Nurse Educator
Gosford Hospital
Central Coast Local Health District
Phone: 02 4320 3956
Email: Jennifer.Mallyon@health.nsw.gov.au

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