HealthStat for Hospitals Guide - hse.ie · I3a/b/c/d and I4a/b Trimming of patient data at 2-sigma in order to ... The purpose of this document is to provide the reader with the necessary

HealthStat for Hospitals Guide

30 JUNE 2010

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Version History

The table below outlines the changes that have been made to the dashboard and as

such this latest version of the HealthStat for Hospitals Guide since its initial

publication on the internet with January 2009 data.

Dashboard Month (Data)

Metric Changes Details

January 2009 NONE Original Baseline Version of Dashboards and

Hospital Guide. February 2009 I7 Incorporation of the results of the previous Bed

Review as a basis by which to determine trend in figures.

R8b Change to the use of Patient ‘Visits’ as basis for assessment instead of Patient ‘Encounters’ due to variation in interpretations as to what constituted an encounter.

March 2009 A3/A4 Clarification to titles in order to make it clear that

referral wait times are those for ‘Outpatients’. I3a/b/c/d and I4a/b Trimming of patient data at 2-sigma in order to

remove the influence of outliers. I4a/b Target for Inpatient and Daycase ALOS set by

HealthStat to a variance from an absolute target adjusted for age and complexity from previous target based upon Best In Class performance.

R8b Scale increased to 250 in order to capture all hospital activity.

R9b Number of WTE Radiologists rounded to the nearest integer.

R9c Number of patient attendances at Emergency Department included in the denominator in order to more accurately reflect the full patient cohort of the hospital.

April 2009 A3b/A4b Traffic Light based on the routine referral wait time

for ‘Ultrasound’ instead of an aggregate ‘Overall’ calculation.

I4a/b Metrics associated to combined Inpatient and Daycase ALOS removed.

I6 Traffic light based on combined target of 60% of patients with a discharge plan and 30% with a discharge date in order to bring discharge date into the assessment.

R1 Description of variance as ‘over/under’ budget instead of ‘+/-‘ to improve clarity of understanding.

R9b/R10a Real numbers (to 2 decimal places) used for Whole Time Equivalent calculation due to influence of

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rounding. R10a/b/c Removal of ‘Other’ consultant WTE numbers and

clinic data from the calculations due to wide variation across hospitals with regards to ‘Other’ consultant numbers and activity.

None Incorporation of definitions associated to day procedures in Appendix E.

None Incorporation of definitions associated to primary diagnosis in Appendix F.

May 2009 A2 The total number of ED admissions in the month is

shown numerically at the foot of the metric to provide additional context for the wait time numbers.

A5 and A6 Switching of order of metrics (A5 now Average Wait Time and A6 Percentage of Clinics) and removal of traffic light on A6.

I2 and I3c Removal of Obstetrics from Chart and Overall Figure. R1 Change from ‘Under or Over’ to ‘Higher or Lower’

when describing Casemix variance. July 2009 R8b WTE data for this metric is now being submitted

directly by the hospitals to HealthStat (i.e. via Healthstat Template).

Sept 2009 A5, A6, R10a,

R10b, R10c OPD data for these metrics is now being sourced from the Monthly Data Returns (MDR) submitted to the Business Intelligence Unit – Acute Services Team (formerly PMU)

Nov 2009 R11 Metric R11 renamed R11b and Traffic Light removed.

This metric is now ‘for information only’ R11a New metric R11a introduced:Consultant Contracts

Percentage Within Contractual Ratio Dec 2009 A7 New Metric A7 – Patient Wait Times for urgent

colonoscopy (3 wait bands 0 -28 days, 29 -30days and 91+ days) introduced.

I3b New Metric I3b – ALOS by inpatient basket of primary diagnosis introduced.

All metrics with a traffic light

Weighting of metrics introduced: High (4) – Metrics A1a, A1b, A2, A5, I1, I2, R5, R9a, R10b, I3a Medium (3) – Metrics A3a, A3b, A4a, A4b, A7, I6, R1, R4 Low (1) – Metrics I4, R9c

A1a & A1b The figure for the total number of public elective (inpatient & day case) discharges in the previous month included under A1a/A1b charts.

A2 The figure for the total number of acute admissions from ED in the previous month included under A2 chart.

R1 Change from ‘Higher or Lower to ‘More Costly or Less Costly’ when describing Casemix variance

None Incorporation of additional definitions associated to ‘Inpatient Basket’ in Appendix F.

Jan 2010

13a/13b Order of metrics I3a/I3b reversed

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13a Metric 13a (inpatient basket) scored against target (target is customised, derived from casemix for each hospital, across each procedure included in the basket, based on international performance). Metric weighted ‘high’ (4)

I1 Metric calculation for day case basket of 24 has been amended to exclude emergency inpatients.

R5 R5 (Absenteeism): This metric has been amended to exclude staff on long term sick leave from the traffic light (scoring) calculation. Proportion of long-term leave still visible on the chart.

R7 Metric R7 (NCHD vs Consultant Ratio) has been discontinued. Subsequent metrics have been re-numbered in accordance.

Enabling Information

Enabling information introduced in table form at the top of each hospital dashboard (see page 19 for details)

March 2010

Metrics I1, I2, I3, I4 for Merlin Park

Data for metrics I1 (Day case rate), I2 (Day of procedure admission rate), I3 (ALOS) and I4 (Percentage of cases entered in HIPE) for Merlin Park combined with data for Galway University Hospital

Overall Traffic Light Traffic Light Rules amended to include that a hospital cannot score an Overall GREEN if it scores RED on ACCESS, INTEGRATION or RESOURCES. In such cases the Overall TL will be adjusted to AMBER.

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Contents

Version History ______________________________________________________2

Contents ____________________________________________________________5

1 Introduction______________________________________________________6

1.1 Transformation Programme__________________________________________ 6

1.2 Core Metrics_______________________________________________________ 6

1.3 This Document _____________________________________________________ 9

2 The Dashboard __________________________________________________11

2.1 Methodology ______________________________________________________ 11

2.2 Dashboard Visualisation ____________________________________________ 12

2.3 Dashboard Example________________________________________________ 15

3 Detailed Metric Descriptions________________________________________18

3.1 Access ___________________________________________________________ 20

3.2 Resources ________________________________________________________ 39

Appendix A: List of Hospitals __________________________________________56

Appendix B: HealthStat Monthly Hospital Template________________________58

Appendix C: Impact of Incomplete Hospital Data Submission on Traffic Lights _61

Appendix D: Consultant Led OPD Clinic to Specialty Group Mapping _________63

Appendix E: Day Case Procedures ______________________________________66

Appendix F: Primary Diagnosis Definitions included in Inpatient Basket_______76

Appendix G: DRG to Specialty Mapping _________________________________80

Appendix H: Definition of Terms _______________________________________95

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1 Introduction

The following section provides a brief introduction to the underlying rational and

drivers for the HealthStat hospital dashboard, the core metrics that have been used

as the basis for its creation, and an overview of this user guide.

1.1 Transformation Programme

The Health Service Executive (HSE) is currently undergoing a major transformation

programme that encompasses many elements. One component of this programme

is to - ‘Implement standards based performance measurement and management

throughout the HSE’. The objective of this part of the programme is to ensure that

the best performance management can be achieved by each hospital in the delivery

of patient services.

A major input to the delivery of this component has been the development and

implementation of a monthly hospital dashboard (subsequently referred to as ‘the

dashboard’) for those acute hospitals listed in Appendix A.

These dashboards allow each incorporated hospital to not only monitor their

performance across a number of metrics, but also to compare this to the

performance of other hospitals and, as such, provide for the first time a mechanism

whereby each hospital, hospital network and HSE executive can compare relative

and absolute performances of hospitals, in turn enabling them to identify systemic

issues, areas for improvement and examples of good practice.

1.2 Core Metrics The dashboard itself is centred around three key themes, namely:

i) Access (the waiting times experience by people using hospitals),

ii) Integration (the patient journey once in the system),

iii) Resources (right people in the right place, value for money,

effectiveness of applied resource).

Within each of these themes there are a number of individual metrics, and these and

the source of the data that is used to create them are summarised in the following

table:

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Table 1: Summary of Metrics and Data Sources

Section Metric Data Source

Access

A1a

Hospital Elective Medical and Surgical Procedures Waiting Time – Distribution of Adult Elective Waiting Times

NTPF PTR Monthly Report

A1b

Hospital Elective Medical and Surgical Procedures Waiting Time – Distribution of Child Elective Waiting Times

NTPF PTR Monthly Report

A2 Emergency Department to Acute Admission Waiting Times

HSE Business Intelligence Unit – Acute Services Team (formerly PMU) Winter Plan Report

A3a GP to Hospital Referral Wait Times for Routine Outpatient Physiotherapy

HealthStat Monthly Hospital Template

A3b GP to Hospital Referral Wait Times for Routine Outpatient Diagnostics


A4a

Consultant to Hospital Referral Wait Times for Routine Outpatient Physiotherapy


A4b

Consultant to Hospital Referral Wait Times for Routine Outpatient Diagnostics


A5 Average waiting time for OPD Consultant Led Clinics

HSE Business Intelligence Unit – Acute Services Team (formerly PMU)

A6 Percentage of Consultant Led Clinics with a Routine Waiting Time over 90 days


A7 Patient Wait Times for Urgent Colonoscopy


Integration

I1 Day Case Rates- Procedures Casemix

I2 Day of Procedure Admission Rate for Elective Inpatients

Casemix

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I3a ALOS by Inpatient Basket of Primary Diagnosis (trimmed at two standard deviations)

Casemix

I3b Inpatient Average Length of Stay (trimmed at two standard deviations)

Casemix

I4 Percentage of Cases Entered into HIPE

Casemix

I5 Delayed Discharges

HSE Business Intelligence Unit – Acute Services Team (formerly PMU) Delayed Discharge Report

I6 Appropriateness of Admissions and Care

Current data: Acute Hospital Bed Review – (May/June 2008)

Previous data: Acute Hospital Bed Review – (Jan-Feb 2007)

Resource

R1 Finance And Resource Usage

HSE Corporate Reporting Services and Casemix base price

R2 Financial Breakdown HSE Corporate Reporting Services

R3 Activity vs. Service Plan HSE Business Intelligence Unit – Acute Services Team (formerly PMU)

R4 Staff Whole Time Equivalent Variance from Staff Ceiling

HSE National Employment Monitoring Unit

R5 Percentage of Staff Hours Lost Due to Absenteeism


R6 Distribution of Staff HSE National Employment Monitoring Unit

R7a Allied Health Professional New to Return Patient Attendances


R7b Number of New and Return Visits per Staff Delivering Service


R8a Total Hospital Diagnostic Activity (Radiology)


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R8b

Hospital Diagnostic Activity per Whole Time Equivalent Radiographer and Radiologist

Radiographers WTE – HSE Staff Census

R8c Total Hospital Diagnostic Activity per Patient (Radiology)


R9a

OPD Consultant Led Clinics – Number of New Patients Seen per Whole Time Equivalent Consultant

HSE Business Intelligence Unit – Acute Services Team (formerly PMU) for New Patients Seen and HealthStat Monthly Template for WTE Consultants

R9b OPD Consultant Led Clinics - Distribution of Patient Attendance


R9c OPD Consultant Led Clinics – Percentage of Patients that Did Not Attend


R10a Public Private Split of Activity

Business Intelligence Unit – Acute Services Team (formerly PMU) Monthly Return

R10b Consultant Contracts Percentage Within Contractual Ratio

HIPE Report from Individual Hospitals

These metrics were identified and consolidated by the ‘Metrics Control Group’, which

is a HSE cross-departmental body created at the request of the CEO of the HSE to

define the frame around which the dashboards would be initially created and

operated.

It is recognised that this set of metrics does not reflect all hospital activity, and it is

anticipated that there shall be periodic reviews held by this group to consider

amendments to existing metrics, or the creation of new metrics, using as a basis

hospital feedback.

It should be noted that full definitions for each of these metrics can be found in

Section 3 of this document, and as such are not discussed further here.

1.3 This Document The purpose of this document is to provide the reader with the necessary information

required to understand and interpret the monthly hospital dashboards.

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Interpreting the dashboard may upon initial examination seem a relatively

straightforward exercise. This is however not the case due to:

i) the number of metrics incorporated (33),

ii) the number of data items used to generate them (c.350),

iii) the detailed definition and calculation associated with each,

iv) the individual context within which each hospital operates.

With regards to the structure of this document, section 2 details the overall

dashboard (data sources, visual representation and common features), whilst section

3 details each of the 33 metrics in turn.

There are also eight Appendices that provide information on:

a) The acute hospitals currently incorporated;

b) The HealthStat monthly hospital template;

c) Impact of incomplete hospital data submission on traffic lights;

d) The mapping of consultant led Outpatient Department (OPD) clinics to

specialty groupings;

e) A list of the “Basket of 24” daycase procedures;

f) Primary diagnosis definitions included in inpatient basket;

g) The mapping of Diagnosis Related Groups (DRG’s) to specialty

groupings;

h) A definition of terms relevant to the metrics.

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2 The Dashboard

The following section provides a brief overview of how the dashboard is generated

and explains in detail its visual representation and features.

2.1 Methodology The following diagram illustrates the methodology used in the generation of the

dashboard. When any underlying data required to generate the metrics is gathered

by an existing source e.g. Casemix, Business Intelligence Unit – Acute Services

Team (formerly PMU), National Employment Monitoring Unit (NEMU), Finance,

National Treatment Purchase Fund (NTPF), then this data is obtained from that

existing source (note that this accounts for approximately 250 of the data items

required). Where new data items are required, then these are obtained directly from

each hospital via the HealthStat Monthly Hospital Template (see Appendix B).

The following figure graphically represents the dashboard generation process and

shows that:

i) Once collected, all data is combined into a single data set on which a

variety of calculations are performed;

ii) The data is then disaggregated into hospital level data which is

published for each individual hospital.

Figure 1: Overview of Dashboard Generation Process

HealthStat Templates

BIU Acute Services Monthly Returns

Casemix PTR Report

Hospital Dashboard.pdf






Data Analysis

HSE Corporate Reporting

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2.2 Dashboard Visualisation Each dashboard consists of a set of common features that are summarised below

and graphically represented in Figure 2.

2.2.1 Title

The title lists the name of the hospital and the month upon which the hospital data

used to generate the dashboard is based.

2.2.2 High Level Diagnostic – traffic light indicators

Each of the three themes or sectors around which the dashboard is created (i.e.

Access, Integration and Resource) is also given a traffic light indicator, which is

based upon the mean of the aggregate of each of the individual traffic lights in that

sector. An overall traffic light indicator based on the three sector traffic lights for each

hospital is also shown.

The rules associated with the triggering of these traffic lights are detailed in Section 3

of this document and thus are not further elaborated upon here.

2.2.3 Key

The key graphically shows how the following items are visually represented in the

metrics:

Hospital Delivery – the performance of that hospital;

Group Average – the average performance of the hospitals;

Best in Ireland (average of top 3 in peer group) – the best performance in

Ireland as derived from the average performance of the top 3 hospitals in

peer group on that metric;

Target – the performance target against which hospital performance is

measured.

It should be noted that not all metrics contain each of the above elements as:

In some cases the metric may not be applicable to an individual hospital (e.g.

GP referrals for diagnostics) or the data may not have been submitted and in

such cases hospital delivery will be missing;

Where there is a target, it is performance against that target that takes priority

and so group average or ‘Best in Ireland’ performance is not shown;

Where there is no target, there will obviously be no target information and in

such cases either group average or ‘Best in Ireland’ performance may be

shown as a means of aiding further interpretation.

2.2.4 Source of Data

Under each metric the target for the metric and the source of the data are listed.

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2.2.5 Absolute Target and Marker

For some metrics, the performance of the hospital is measured against an absolute

target (e.g., All ED to Acute Admissions to occur within 6 hours in the case of metric

A2). These absolute targets can either be specified as in the previous example (it is

listed in the Service Plan for 2009) or unspecified, (e.g., metric I4, the percentage of

cases entered into HIPE - there is an 80% target that as yet has not been specified in

a formal manner). These targets are visually represented by a thick solid green line.

The metrics that have a specified absolute target are: A1a, A1b, A2, A7, I1, I2, R1,

R4, R5

The metrics that have an unspecified absolute target are: A3a, A3b, A4a, A4b, A5,

I3a, I4, I5, I6, R9c, and R10a

2.2.6 Relative Target and Marker

For some metrics, instead of measuring hospital performance against an absolute

target, they are measured against a relative target that is defined by ‘Best in Ireland’

performance.

The ‘Best in Ireland’ measure is defined as ‘the average of the performance of the

three best hospitals in peer group’ and is visually represented by a thinner green

dotted line joining each measure.

The metric that has relative targets is R9a.

2.2.7 Group Average

For metrics where it is not possible to measure performance against either an

absolute or relative target, group average markers have been included as a means

by which relative hospital performance can be assessed.

These group averages are visually represented by a thin blue dotted line.

The metrics that have group average markers are R2, R6, R7a and R8b.

2.2.8 Number of Instances

Where a number appears in a bracket in a metric, this refers to the absolute number

that makes up that part of the metric.

2.2.9 Individual Metric Traffic Light Indicator

For those metrics against which the hospitals performance is being directly

measured, there is an associated Traffic Light Indicator to visually depict the

hospital’s performance against that target.

These indicators can have one of three colours, which have the following associated

meanings:

Green – hospital performance on that metric is meeting or is within an

acceptable tolerance of the target;

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Amber – hospital performance on that metric is outside the target /

acceptable tolerance and is of concern;

Red – hospital performance on that metric is significantly outside the target /

acceptable tolerance and is of major concern.

The precise details by which each traffic light colour is triggered for each metric is

detailed in Section 3 of this document and as such is not further discussed here.

It should be noted at this point that, in the event of data being either not supplied or

the metric itself not being applicable to the individual hospital, the traffic light can be

switched off and in such instances it will have no colour. In the event of repeated lack

of submission of data however, it may be decided to switch the traffic light to red until

data is received and in such instances this shall be clearly communicated to the

individual hospital. See Appendix C for details of the Impact of an incomplete data

submission on traffic lights.

2.2.10 Hospital Key Points

Key points for each hospital are contained at the end of the dashboard. This

highlights any issues that will affect interpretation of the data e.g. if part of the dataset

is missing for that month.

Figure 2: Visual Representation of Common Elements to the Dashboard

2.2.1 Title

2.2.2 Traffic Light Indicator

2.2.9 Individual Metric Traffic Light

Indicator

2.2.5 Absolute Target and

Marker

2.2.4 Source of Data

2.2.3 Key

2.2.6 Relative Target and Marker

2.2.8 Number of Instances

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2.3 Dashboard Example The following section presents by means of example a full dashboard, and shows

that each dashboard is clearly constructed and delineated across the three themes of

Access, Integration and Resource.

Figure 3: Access Element of Hospital Dashboard

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Figure 4: Integration Element of Hospital Dashboard

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Figure 5: Resource Element of Hospital Dashboard

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3 Detailed Metric Descriptions

HSE HEALTH STATISTICS GLOSSARY OF TERMS

Metric Name: Overall Hospital Traffic Light Indicator

Description: Visual indication of the hospitals overall performance across Access, Integration and Resource

1. Data Inputs

Active Hospital Metric Traffic Lights for Access, Integration and Resource

2. Reporting Frequency

Monthly

3. Owner

Business Intelligence Unit - HealthStat

4. Reporting Entity


5. Target

Green

6. Calculation:

Metric Calculation

Not Applicable

Traffic Light Calculation

n = Sum of [(numerical value of each active traffic lights in Access, Integration and Resource) * (each active traffic light weighting)] / Weighted aggregate of active traffic lights for Access, Integration and Resource.

Where Red = 3, Amber = 2, Green = 1.

7. Traffic Light Rules for Overall Indicator:

If n is greater than or equal to 2.34 then the traffic light is Red;

If n is greater than or equal to 1.66 but less than 2.34 then the traffic light is Amber;

If n is less than 1.66 then the traffic light is Green.

Note: If n is less than 1.66 (i.e. GREEN) for the Overall Traffic light but greater than or equal to 2.34 (i.e. RED) for ACCESS, INTEGRATION or RESOURCES the Overall Traffic Light will be adjusted to AMBER.

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Metric Name: Enabling Information

Description: Description: Visual representation of timely access to selected services (enabling information) within a hospital i.e.

1. Access within 24 hours for all GP referrals in catchment area to Medical Assessment Unit (MAU) for medical opinion;

2. Rapid access for hospital MAU to diagnostics; within 3 hours for ultrasound;

3. Rapid access for hospital MAU to diagnostics; within 24 hours for CT scans;

4. Direct GP/community access to ultrasounds within 4 weeks.

1. Data Inputs

Data sourced directly from hospitals (HealthStat hospital template)

Note: Direct GP/Community access to ultrasounds within 4 weeks is currently the only service for which data is collated and being presented.

2. Reporting Frequency

Six monthly or as updates received from hospitals

3. Owner


4. Reporting Entity

Hospitals currently being reported on by HealthStat

5. Target

If a service (as per 1 to 4 above) is provided, access to that service should be provided within the stated time-frame for that service.

6. Calculation:

Not applicable

7. Traffic Light Rules for Overall Indicator:

If a service is provided and it is provided within the stated timeframe it will be denoted by the letter ‘Y’ (Yes) within a GREEN box.

If a service is provided and it is not provided within the specified timeframe it will be denoted by the letter ‘N’ (No) within a RED box.

If the service is not provided it will be denoted by the letter ‘N’ (No) within a RED box.

Note: This information is not scored and hence not included in the overall score of the hospital but it is considered important additional information on performance.

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3.1 Access


Metric Name: Sector Traffic Light For Access

Description: Visual indication of the hospitals performance for Access

1. Data Inputs:

Active Hospital Metric Traffic Lights for A1a, A1b, A2, A3a, A3b, A4a, A4b, A5 and A7

2. Reporting Frequency:

Monthly

3. Owner:


4. Reporting Entity:


5. Target

Green

6: Calculation:

Metric Calculation

Not Applicable


n = [(Sum of (numerical value of each active traffic lights in Access) * (each active traffic light weighting)) / Weighted aggregate of active traffic lights for Access].


7. Traffic Light Rules:




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Metric Name: A1a - Hospital Elective Medical/Surgical Waiting Times – Distribution of Adult Elective Waiting Times

Description: Graphical representation of the National Treatment Purchase Fund (NTPF) aggregate waiting times for inpatient and daycase elective medical/surgical procedures for adults for the previous month.

1. Source of Data Inputs:

NTPF Patient Treatment Register (PTR) Monthly Report.


Monthly

3. Owner:

NTPF


NTPF

5. Target:

100% of adults treated within 6 months from the time of identification of clinical need for the elective procedure.

Source: National Service Plan 2009.

6: Calculation:

Metric Calculation

Each category (e.g. 0 to 3 month adult elective wait time) shows the aggregate of adult inpatient and daycase waiting list in that timeframe as a percentage of the total number of cases for that grouping.


n = [(number of adult cases waiting within 6 months) / (total number of adult cases on PTR)] * 100


The traffic lights are based upon the absolute target detailed in 5 as calculated in 6.

If n is 65% or less then the traffic light is Red;

If n is greater than 65% but less than or equal to 85% then the traffic light is Amber;

If n is greater than 85% then the traffic light is Green.

TL Weighting = High (4)

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Metric Name: A1b - Hospital Elective Medical and Surgical Procedures Waiting Times – Distribution of Child Elective Waiting Times

Description: Graphical representation of the National Treatment Purchase Fund (NTPF) aggregate waiting times for inpatient and daycase elective procedures for children for the previous month.


NTPF Patient Treatment Register (PTR) Monthly Report.


Monthly

3. Owner:

NTPF


NTPF

5. Target:

100% of children treated within 3 months from the time of identification of clinical need for the elective procedure.

Source: National Service Plan 2009

6: Calculation:

Metric Calculation

Each category (e.g. 0 to 3 month wait time) shows the aggregate of inpatient and daycase waiting list in that timeframe as a percentage of the total number of cases for that grouping.


n = [(number of child cases waiting within 3 months) / (total number of child cases on PTR)] * 100







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Metric Name: A2 – Emergency Department to Acute Admission Wait Times

Description: Graphical representation of the wait times for acute admission from Emergency Department (ED) from the point of decision to admit, as recorded in the hospital at 2pm each day and aggregated for the previous month.

This is shown in four time categories (0 to 6 hours, 6 to 12 hours, 12 to 24 hours and > 24 hours) as a percentage of the total wait time (e.g. if half of all patients requiring admission are admitted within 6 hours, the figure for this time category shall be 50%).


Business Intelligence Unit – Acute Services Team Winter Plan Report


Monthly

3. Owner:

Business Intelligence Unit – Acute Services Team



5. Target:

100% of patients to be admitted within 6 hours of decision to admit.


6. Calculation:

Metric Calculation

Each category (e.g. 0 to 6 hours) shows the patients waiting to be admitted within that timeframe as a percentage of the total number of patients waiting to be admitted.


n = [(No. of patients waiting 0-6 hours) / (no. of patients waiting 0-6 hours + no. of patients waiting 6-12 hours + no. of patients waiting 12-24 hours + no. of patients waiting >24 hours)] * 100







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Metric Name: A3a – GP to Hospital Referral Wait Time for Routine Outpatient Physiotherapy

Description: Visual representation of the length of time in calendar days to the next available routine GP referral appointment slot for a Physiotherapy appointment.


Section 1.6 of the HealthStat monthly hospital template (see Appendix B)


Monthly

3. Owner:



Hospitals

5. Target:

All routine referrals should be seen within 70 days.

Source: This target is not formally specified but has been set by HealthStat to 70 days using as a basis, the assessment of targets and wait times in other comparable countries.

6. Calculation:


n = (physiotherapy routine referral wait time / 70days) *100.


If n is 135% or more then the traffic light is Red;

If n is greater than or equal to 115% but less than 135% then the traffic light is Amber;

If n is less than 115% then the traffic light is Green.

TL Weighting = Medium (3)

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Metric Name: A3b – GP to Hospital Referral Wait Time for Routine Outpatient Diagnostics

Description: Visual representation of the length of time in calendar days to the next available routine GP referral appointment slot for Ultrasound, X-Ray, CT and MRI.




Monthly

3. Owner:



Hospitals

5. Target:

All routine ultrasound referrals should be seen within 70 days.


6. Calculation:


n = (ultrasound routine referral wait time / 70days) *100.






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Metric Name: A4a – Consultant to Hospital Referral Wait Time for Routine Outpatient Physiotherapy

Description: Visual representation of the length of time in calendar days to the next available routine Consultant referral appointment slot for Physiotherapy




Monthly

3. Owner:



Hospitals

5. Target:



6. Calculation:


n = (physiotherapy routine referral wait time / 70days) *100.






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Metric Name: A4b – Consultant to Hospital Referral Wait Time for Routine Outpatient Diagnostics

Description: Visual representation of the length of time in calendar days to the next available routine Consultant referral appointment slot for Ultrasound, X-ray, CT and MRI.




Monthly

3. Owner:



Hospitals

5. Target:

All routine ultrasound referrals should be seen within 70 days.


6. Calculation:


n = (ultrasound routine referral wait time / 70days) *100.






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Metric Name: A5 – Average Waiting Time for OPD Consultant Led Clinics

Description: Visual representation of the length of time in calendar days to the next available routine referral to a consultant led OPD clinic. This is presented both overall and by the following specialty groupings (Paediatrics, Otolaryngology, Orthopaedics, Ophthalmology, General Surgery and General Medicine).

Note: the mapping used for these specialty groupings is shown in Appendix D


Business Intelligence Unit – Acute Services Team Monthly Data Return


Monthly

3. Owner:




5. Target:



6. Calculation:

Metric Calculation

Overall figure = (sum of wait times for all consultant led clinic) / total number of clinics

Specialty figure = (sum of wait times for consultant led clinics in that specialty) / number of consultant led clinics in that specialty


n = (overall routine referral wait time / 90 days) * 100.






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Metric Name: A6 – Percentage of Consultant Led Clinics With a Routine Wait Time over 90 days

Description: Visual representation of the percentage of consultant led clinics in each hospital that have a wait time for a routine referral of greater than 90 calendar days. This is presented both overall and by the following specialty groupings (Paediatrics, Otolaryngology, Orthopaedics, Ophthalmology, General Surgery, and General Medicine).

Note: the mapping used for these specialty groupings is shown in Appendix D




Monthly

3. Owner:




5. Target:

0% of clinics having a wait time over 90 days for a new referral


6. Calculation:

Metric Calculation

Overall figure = (total number of consultant led clinics with waiting time over 90 days / total number of consultant led clinics) * 100.

Specialty figure = (number of consultant led clinics in that specialty with a waiting time over 90 days / total number of consultant led clinics in that specialty) * 100.


Not Applicable


Not Applicable

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Metric Name: A7 – Patient Wait Times for Urgent Colonoscopy

Description: Graphical representation of the wait times for an urgent colonoscopy. The number of patients waiting is a snapshot number taken during the last week of the month.

This is shown in three time categories (0 to 28 days, 29 to 90 days, and 91+ days) as a percentage of the total wait time (e.g. if half of all patients receive a colonoscopy within 28 days of being referred, the figure for this time category shall be 50%).




Monthly

3. Owner:




5. Target:

100% of patients receiving access to colonoscopy for urgent referral within 28 days.


6. Calculation:

Metric Calculation

Each category (e.g. 0 to 28 days) shows the patients treated within that timeframe as a percentage of the total number of patients treated.


n = [(No. of patients waiting 0-28 days) / (no. of patients waiting 0-28 days + no. of patients waiting 29-90 days + no. of patients waiting >90 days)] * 100



If n is less than 100% then the traffic light is Red;

If n is 100% then the traffic light is Green.


31

Integration


Metric Name: Sector Traffic Light For Integration

Description: Visual indication of the hospitals performance for Integration

1. Data Inputs:

Active Hospital Metric Traffic Lights for I1, I2, I3a, I4 and I6


Monthly

3. Owner:

Business Intelligence Unit – HealthStat



5. Target

Green

6: Calculation:

Metric Calculation

Not Applicable


n = [(Sum of (numerical value of each active traffic lights in Integration) * (each active traffic light weighting)) / Weighted aggregate of active traffic lights for Integration].






32


Metric Name: I1 - Day Case Rates – Procedures

Description: Graphical representation of the percentage of the overall number of elective patients that are treated as day cases for the listed procedures included in the basket of 24 (see Appendix E).

Note: the timeframe upon which this data is based is a rolling 12 months from the previous month (e.g. March 09 Dashboard will be based upon March 08 to Feb 09 data as coded into the Hospital In-Patient Enquiry scheme (HIPE)).

Note: The types of investigative scopes included in the day-case basket are those scopes that should not result in the patient potentially being admitted overnight in the event that something is discovered and treated on the spot, or age/co-morbidities are such that they may potentially also need to an overnight stay,


Casemix


Monthly

3. Owner:

Casemix


Casemix

5. Target:

75% or more of the Basket of 24 procedures should be treated as day cases

Source: This target is not formally specified but has been set by HealthStat to 75% using as a basis the aggregation and averaging of procedure specific targets for those procedures contained in the Basket of 24.

6. Calculation:

Metric Calculation

Basket of 24 Day Case Rate = Total number of day cases for those procedures / (Total number of elective inpatients for those procedure + total number of day cases for those procedures)


n = (Basket of 24 Day Case Rate / 75%) * 100





Weighting = High (4)

33


Metric Name: I2 – Day of Procedure Admission Rate for Elective Inpatients

Description: Graphical representation of the percentage of elective inpatients receiving the procedure or surgery for which they were admitted on the day that they were admitted.

This is shown both overall and by the following specialty groupings (Surgical, Medical, Paediatrics, Gynaecology, Trauma & Orthopaedics, Cardiology, Urology, and Gastroenterology).

Note: the timeframe upon which this data is based is a rolling 12 months from the previous month (e.g. March 09 Dashboard will be based upon the completeness of the HIPE data between March 08 and Feb 09).

Note: the HIPE mapping used for these specialty groupings are shown in Appendix F.

Note: Obstetrics not included in calculations


Casemix


Monthly

3. Owner:

Casemix


Casemix

5. Target:

75% of elective inpatients should be admitted on the day of their procedure

Source: This target is not formally specified but has been set by HealthStat to 75% using as a basis, the assessment of targets and performance in other comparable countries.

6. Calculation:

Metric Calculation

Overall Day of Procedure Admission Rate = (total number of elective inpatients receiving a procedure or surgery admitted on their day of procedure or surgery / total number of elective inpatients in receipt of a procedure or surgery) * 100

Specialty Day of Procedure Admission Rate = (total number of elective inpatients in that specialty receiving a procedure or surgery admitted on their day of procedure or surgery / total number of elective inpatients in that specialty in receipt of a procedure or surgery) * 100


n = (Overall Day of Procedure Admission Rate / 75%) * 100






34


Metric Name: I3a – ALOS by Inpatient Basket of Procedures

Description: Graphical representation of average length of inpatient stay by procedure (see Appendix F).

Note: the timeframe upon which this data is based is a rolling 12 months from the previous month (e.g. March 09 Dashboard will be based upon March 08 to Feb 09 data as coded into the Hospital In-Patient Enquiry scheme (HIPE)).

Note: this data is trimmed for outliers using as a basis 2 Standard Deviations.

1. Source of Data Inputs

Casemix


Monthly

3. Owner:

Casemix


Casemix

5. Target:

The ‘Overall’ target is a custom target derived using as a basis the casemix for each hospital within each inpatient procedure included in the basket (e.g. if a hospital has only 1 case in the Abdominal Pain category (target of 2.13 days) and only 1 case in the Cerebrovasular Disease (target 16.58 days) then the overall target is ({2.13 + 16.58} / 2 = 9.355 days).

Each procedure target within the basket is in turn based upon comparable international performance targets.

The ‘Overall’ ALOS is simply the sum of each individual ALOS divided by the number of patients.

The ‘Overall’ ALOS variance should be 0 days or less.

Source: This target is not formally specified but has been set by HealthStat to the above.

6. Calculation:

Metric Calculation

Overall ALOS Variance = Overall ALOS – Casemix Complexity Adjusted Target


n = (Overall ALOS Variance / Casemix Complexity Adjusted Target) * 100.

7. Traffic Light Rule:

If n is 10% or greater then the traffic light is Red;




35


Metric Name: I3b - Inpatient Average Length of Stay

Description: Graphical representation of the overall average length of stay for all inpatients in days. Note: the timeframe upon which this data is based is a rolling 12 months from the previous month (e.g. March 09 Dashboard will be based upon March 08 to Feb 09 data as coded into the Hospital In-Patient Enquiry scheme (HIPE)).

Note: this data is trimmed for outliers using as a basis 2 Standard Deviations.

1. Source of Data Inputs

Casemix


Monthly

3. Owner:

Casemix


Casemix

5. Target:

Not applicable

6. Calculation:

Metric Calculation

Overall ALOS = Total inpatient bed days / Total inpatients

7. Traffic Light Rule:

Not applicable

36


Metric Name: I4 – Percentage of Cases Entered into HIPE

Description: Graphical representation of the percentage of cases coded into the Hospital Inpatient Enquiry Scheme (HIPE) as compared to the number of discharges registered on the hospitals Patient Administration System (PAS).

Note: the timeframe upon which this data is based is a rolling 12 months from the previous month (e.g. March 09 Dashboard will be based upon the completeness of the HIPE data between March 08 and Feb 09).


Casemix


Monthly

4. Owner:

Casemix


Casemix

6. Target:

An absolute target of 80% completeness has been defined, which is based upon current completeness rules in HIPE (i.e. all coding is to be completed within 10 weeks of discharge).

As such, assuming that the volume of cases being coded into HIPE remains relatively consistent throughout the year then, as a minimum, a completion rate of 80% should be achievable for all hospitals.

7. Calculation:

Metric and Traffic Light Calculation

Percentage Completion (n) = (total number of cases entered into HIPE in 12 month period / total number of discharges in 12 month period) * 100


If n is less than 80% then the traffic light is Red;


Weighting = Low (1)

37


Metric Name: I5 – Delayed Discharges

Description: Graphical representation of the percentage of bed days lost with respect to the total number of available bed days, due to their inappropriate occupancy by delayed discharge patients (e.g. those who have been identified as being medically fit for discharge into a non-acute setting).

The number of delayed discharge patients, broken down by reason for delay, is also displayed by clicking on the ‘raw data’ drill down button under the chart of this metric on the system. This is a snapshot number taken during the last week of the month.


Business Intelligence Unit- Acute Services Team Delayed Discharge Report


Monthly

3. Owner:




5. Target:

Not applicable

6. Calculation:

Metric Calculation

Percentage of Bed Days Lost = Number of Bed Days Lost in the Month / Number of Bed Days Available in that Month

7. Traffic Light Rules

Not applicable

38


Metric Name: I6 – Appropriateness of Admission and Care

Definition: Tabular representation of the results of the HSE ‘Acute Hospital Bed Review’. Information contained in the table is:

The percentage of inpatients admitted into an acute setting unnecessarily / inappropriately;

The percentage of inpatients receiving treatment in an acute setting unnecessarily / inappropriately;

The percentage of inpatients with a discharge plan;

The percentage of inpatients with a discharge date.

This information is presented both for the individual hospital (for those that were included in the survey) and as an average.


Acute Hospital Bed Review – the date of the review as specified on the dashboard


6-monthly (TBC)

3. Owner:

Individual hospitals


None

5. Target:

60% of inpatients should have a discharge plan

30% of inpatients should have a discharge date

Source: These targets are not formally specified but has been set by HealthStat to the above using as a basis Irish inpatient ALOS, current levels of performance and an assessment of performance in comparable countries.

6. Calculation:

n = {[(% of patients with discharge plan / 60%) + (% of patients with discharge date / 30%)] / 2} * 100





Weighting = Medium (3)

39

3.2 Resources


Metric Name: Sector Traffic Light for Resource

Description: Visual indication of the hospitals performance for Resource


Active Hospital Metric Traffic Lights for R1, R4, R5, R9a, R9c and R10b.


Monthly

3. Owner:




5. Target:

Green

6. Calculation:

Metric Calculation

Not Applicable


n = (Sum of (numerical value of each active traffic lights in Resources) * (each active traffic light weighting)) / Weighted aggregate of active lights for Resources

Where Red = 3, Amber = 2, Green = 1





40


Metric Name: R1 – Finance and Resource Usage

Description: Tabular representation of:

Year To Date (YTD) Expenditure versus YTD Budget

Casemix adjusted base price


Finance Monthly Data Return for YTD Expenditure and YTD Budget

Casemix for base price


Monthly for expenditure and budget

Yearly for base price

3. Owner:

HSE Finance for expenditure and budget

Casemix for base price


Finance

Casemix

5. Target:

Absolute target based upon the percentage variance of hospital expenditure from budget.

Source: All hospitals should work within their allocated annual budgets.

7. Calculation:

Metric Calculation

budget variance = (actual expenditure – budget)


n = (budget variance / budget) * 100


If n is 0.5% or greater then the traffic light is Red;

If n is greater than 0.25% but less than 0.5% then the traffic light is Amber;

If n is 0.25% or less then the traffic light is Green.


41


Metric Name: R2 – Financial Breakdown

Description: Graphical representation of allocation of YTD expenditure into the following categories:

non-payroll,

payroll-agency,

payroll-overtime,

basic-payroll.


Finance Monthly Data Return for non-payroll, payroll-overtime and basic-payroll.

HealthStat monthly hospital template for payroll-agency.


Monthly

3. Owner:

Finance


Finance

Hospitals

5. Target:

Not applicable

6. Calculation:

Metric Calculation

YTD percentage spend in each category = YTD monetary expense in that category / YTD overall monetary expense


Not applicable

42


Metric Name: R3 – Activity vs. Service Plan

Description: Graphical representation of the YTD performance of the hospital as a measure of percentage of cases completed above or below their service plan in the following groupings:

Total,

OPD Cases,

Daycases,

Inpatients.




Monthly

3. Owner:




5. Target:

Not applicable

6. Calculation:

Metric Calculation

Total = (Total Number of Cases Treated Overall - Total Service Plan Target Number of Cases Overall) / Total Number of Cases Treated Overall * 100

By Category = (Total Number of Cases Treated in that Category - Total Service Plan Target Number of Cases in that Category)/ Total Number of Cases Treated in that Category * 100


Not applicable

43


Metric Name: R4 – Staff WTE Variance from Staff Ceiling

Description: Graphical representation of the number of WTE staff employed by the hospital as a measure of variance from their staff ceiling over a rolling three month time period.


HSE National Employment Monitoring Unit (NEMU)


Monthly

3. Owner:

NEMU


NEMU

5. Target:

Absolute target based upon the percentage variance of hospital WTE staff complement from staff ceiling.

Source: All hospitals should work within their staff ceilings.

6. Calculation:

Metric Calculation

Variance = (Actual WTE - Ceiling WTE) / Actual WTE


n = (Variance / Ceiling WTE) * 100


If n is greater than or equal to 1.5% then the traffic light is Red;

If n is greater than or equal to 0.05% but less than 1.5 % then the traffic light is Amber;

If n is less than 0.05% then the traffic light is Green.


44


Metric Name: R5 – Percentage of Staff Hours Lost Due to Absenteeism

Description: Graphical representation of the amount of time lost due to absenteeism, shown as a percentage of the total amount of available time for work. This is broken down between Uncertified, Certified and Long Term absenteeism and is shown both in total and for the following staff groupings:

Medical / Dental,

Nursing,

Health and Social Care Professionals,

Management / Administration,

General Support Staff,

Other Patient and Client Care.

Note: While Uncertified, Certified and Long term leave are displayed the data is scored on certified and uncertified leave only.


Section 1.3 of the HealthStat monthly hospital template (see Appendix B).


Monthly

3. Owner:



Hospitals

5. Target:

3.5% Absenteeism or less

Source: This is the latest Absenteeism target as defined and communicated by the HSE.

6. Calculation:

Metric Calculation

Total Absenteeism = (Total Hours Absent for uncertified and certified leave / Total Hours Available) * 100.

Staff Group Absenteeism = (Hours Absent in that Staff Group / Hours Available in that Staff Group) * 100.


n = (Total Absenteeism / 3.5) * 100



If n is between 115% and less than 135% then the traffic light is Amber;



45


Metric Name: R6 – Distribution of Staff

Description: Graphical representation of the distribution of staff amongst the same staff groupings as listed in R5 above in addition to ‘Agency’ staff. This is shown for each grouping as a percentage of the total number of WTE staff employed for each hospital.


HSE Performance Management Report


Monthly

3. Owner:

NEMU


NEMU

Hospitals

5. Target:

Not applicable – As a means of drawing some comparison however, the group average staff distribution across each category is represented by a thin blue dotted line.

6. Calculation:

Metric Calculation

Percentage of staff in category = (number of staff in category / total number of staff (including agency)) * 100


Not applicable

46


Metric Name: R7a – Allied Health Professional New to Return Patient Attendances

Description: Graphical representation of ratio of new to return visits seen by Allied Health Professionals (AHPs) in the hospital for the previous month.

This is shown both overall and by the following professions:

Social Work

Occupational Therapist

Physiotherapy




Monthly

3. Owner:



Hospitals

5. Target:

Not applicable - As a means of drawing some comparison however, the group average ratio is shown both overall and by specialty grouping by a thin blue dotted line.

6. Calculation:

Metric Calculation

Overall New to Return Visit Ratio = 1:(Total Number of Return Visits / Total Number of New Visits)

Profession New to Return Visit Ratio = 1: (Total Number of Return Visits in that Profession / Total Number of New Visits in that Profession)


Not applicable

47


Metric Name: R7b –Number of New and Return Visits per Staff Delivering Service

Description: Graphical representation of the number of new and return patient visits undertaken by Allied Healthcare Professionals (AHP) in the hospital.

This is measured for Social Workers, Occupational Therapists and Physiotherapists and aggregated for an Overall Measure.


Section 1.4 of the HealthStat monthly hospital template (see Appendix B) for the number of new and return visits, the number of patients seen, and the number of staff ( Social Workers, Occupational Therapists and Physiotherapists) delivering service.


Monthly

3. Owner:



Hospitals

5. Target:

Overall number of visits per staff delivering service should be comparable to the ‘Best in Ireland’ number of visits.

Source: There is no formal specification or set of comparisons against which to derive an absolute target so in this instance performance is measured against ‘Best in Ireland’ performance.

6. Calculation:

Metric Calculation

Overall number of visits per Staff Delivering Service = (Total number of new visits + Total number of return visits) / Total number of AHP Staff Delivering Service

Profession number of visits per Staff Delivering Service = Total number of visits (new + return) for that profession / Total number of AHP Staff Delivering Service


Not applicable


48


Metric Name: R8a – Total Hospital Diagnostic Activity (Radiology)

Description: Graphical representation of the absolute number of diagnostic imaging undertaken within the hospital during the previous month.

This is categorised as CT Scan, X-Ray/Plain Film, Ultrasound, PET Scans, Nuclear Medicine, Neuro, MRI, Mamography, Interventional and CATH Labs, and is split between Internal, Outsourced and Insourced activity.

Note that CT and X-Ray/Plain Film are shown separately due to scaling issues.




Monthly

3. Owner:



Hospitals

5. Target:

Not Applicable

6. Calculation:

Metric Calculation

Diagnostic Activity = Absolute number of diagnostic imaging undertaken within the hospital during the previous month


Not Applicable.

49


Metric Name: R8b – Hospital Diagnostic Activity per Whole Time Equivalent Radiographer and Radiologist

Description: Graphical representation of the amount of imaging diagnostic activity per radiographer and per radiologist.


Section 1.5 of the HealthStat Monthly Hospital Template (see Appendix B) for the amount of imaging diagnostic activity.

Section 1.1 of the HealthStat Monthly Hospital Template (see Appendix B) for the number of WTE Radiologists.

NEMU Monthly Data Return for the number of WTE Radiographers.


Monthly

3. Owner:



Hospitals

NEMU

5. Target:

Not applicable – As a means of drawing some comparison, the group average for diagnostic activity per radiographer and per radiologist are represented by a thin blue dotted line

6. Calculation:

Metric Calculation

Total Diagnostic Activity per Radiographer = (Sum of all internal and insourced imaging activity) / Total number of WTE Radiographers

Total Diagnostic Activity per Radiologist = (Sum of all internal and outsourced imaging activity) / Total number of WTE Radiologists


Not applicable.

50


Metric Name: R8c –Total Hospital Diagnostic Activity per Patient (Radiology)

Description: Graphical representation of the amount of imaging diagnostic activity per patient.


Section 1.5 of the HealthStat Monthly Hospital Template (see Appendix B) for the amount of imaging diagnostic activity.

Business Intelligence Unit – Acute Services Team Monthly Data Return for number of patients.


Monthly

3. Owner:



Hospitals


5. Target:

Not applicable – As a means of drawing some comparison, the group average for diagnostic activity per patient is represented.

6. Calculation:

Metric Calculation

Total Diagnostic Activity per Patient = Sum of all internal and outsourced imaging activity / Total number of Inpatients, Daycases, Outpatients and ED attendances


Not applicable

51


Metric Name: R9a – OPD Consultant Led Clinics – Number of New Patients Seen per Whole Time Equivalent Consultant

Description: Graphical representation of the number of new patients seen per whole time equivalent at the Consultant led OPD Clinics undertaken in the hospital for the previous month. This is shown both overall and by the following specialty groupings:

Paediatrics

Otolaryngology

Orthopaedics

Ophthalmology

Medicine

Surgery

Note that ‘Other’ consultant WTE numbers and clinic details are excluded from this calculation due to large discrepancies between hospitals in this category.


Business Intelligence Unit – Acute Services Team Monthly Data Return for the number of new patients seen at each consultant led clinic. Section 1.1 of the HealthStat Monthly Hospital Template (see Appendix B) for the number of consultants.


Monthly

3. Owner:

Business Intelligence Unit


Hospitals


5. Target:

Overall number of new patients seen per WTE should be comparable to the ‘Best in Ireland’ number of new patients seen.

Source: There is no formal specification or set of comparisons against which to derive an absolute target so in this instance performance is measured against ‘Best in Ireland’ performance.

6. Calculation:

Metric Calculation

Overall Number of new patients = (Overall Number of New Patients / Total Number of WTE Consultants)

No. of new patients in that Speciality = (Number of new patients in that speciality / Total Number of WTE Consultants in that Speciality


n = (Overall number of new patients/ Best in Ireland number of new patients) * 100






52


Metric Name: R9b – OPD Consultant Led Clinics – Distribution of Patient Attendance

Description: Graphical representation of ratio of new to return patients at the Consultant led OPD Clinics undertaken in the hospital for the previous month. This is shown both overall and by the following specialty groupings:

Paediatrics

Otolaryngology

Orthopaedics

Ophthalmology

General Surgery

General Medicine





Monthly

3. Owner:




5. Target:

Not applicable

6. Calculation:

Metric Calculation

Overall New to Return Ratio = 1:(Total Number of Return Patients / Total Number of New Patients)

Speciality New to Return Ratio = 1: (Total Number of Return Patients in that Speciality / Total Number of New Patients in that Speciality)


Not applicable

53


Metric Name: R9c – OPD Consultant Led Clinics – Percentage of Patients that Did Not Attend

Description: Graphical representation the percentage of Did Not Attends (DNA) at the Consultant led OPD Clinics undertaken in the hospital for the previous month. This is shown both overall and by the following specialty groupings:

Paediatrics

Otolaryngology

Orthopaedics

Ophthalmology

General Surgery

General Medicine





Monthly

3. Owner:




5. Target:

An absolute target of 10% has been set

Source: This target is not formally specified but has been set by HealthStat to 10% using as a basis of assessments the current performance of Irish hospitals, and the performance and targets for OPD DNA’s in other countries.

6. Calculation:

Metric Calculation

Percentage DNA = (Total Number of DNA / sum (Total Number of New + Return +DNA)) * 100


n = (Percentage DNA / 10%) * 100





Weighting = Low (1)

54


Metric Name: R10a – Public Private Split of Activity

Description: Graphical representation of the split of hospital activity (daycase, inpatient elective and inpatient non-elective) between public and private patients.

This is shown both in total and by the following specialty groupings:

Paediatrics

Otolaryngology

Orthopaedics

Ophthalmology

General Surgery

General Medicine




Monthly

3. Owner:




5. Target:

NA

6. Calculation:

Metric Calculation

Total percentage of public patients = [(Total number of public patients / Total number of public patients + Total number of private patients)] * 100


NA

8. Traffic Light Rules

NA

55


Metric Name: R10b – Consultant Contracts

Description: Graphical representation of the compliance of consultants with the public:private patient ratio stipulated in their contract. This is shown for inpatients and daycases respectively and refers to aggregate performance in the hospital.


HIPE Report from Individual Hospitals


Quarterly

3. Owner:

BIU


Hospitals

5. Target:

90% of consultants should be within their contracted ratio for public:private inpatient mix. [Note: target on inpatients only]

Source: This target of 90% compliance has been set by HealthStat to take into consideration the difficulty in balancing caseload on a quarterly basis.

6. Calculation:

Metric Calculation

The aggregate percentage of consultants who are within their contracted public:private patient ratio is shown for Inpatient and Daycase categories per hospital.


n = [(inpatient compliance percentage) / (90%)] * 100



If n is 80% or less then Traffic Light is Red;

If n is greater than 80% but less than or equal to 95% then Traffic Light is Amber;

If n is greater than 95% then Traffic Light is Green.

Weighting = High(4)

56

Appendix A: List of Hospitals

The following Appendix lists the 29 acute casemix hospitals currently incorporated in the

HealthStat hospital dashboard.

Table A1: List of Acute Hospitals Currently Incorporated into HealthStat.

Acute Hospitals in HealtStat

Adelaide & Meath inc. National Children’s Hospital, (AMNCH - Tallaght)

Beaumont Hospital

Cavan General Hospital

Connolly Hospital, Blanchardstown

Cork University Hospital

Galway University Hospital

Kerry General Hospital (Tralee)

Letterkenny General Hospital

Louth County Hospital, Dundalk

Mallow General Hospital

Mater Hospital

Mayo General Hospital

Mercy University Hospital

Merlin Park University Hospital

Mid Western Regional Hospital, Dooradoyle (Limerick Regional)

Midland Regional Hospital at Mullingar

Midland Regional Hospital at Portlaoise

Midland Regional Hospital at Tullamore

Our Lady of Lourdes Hospital, Drogheda

57

Our Lady’s Hospital, Navan

Portiuncula Hospital

Sligo General Hospital

South Infirmary – Victoria Hospital, Cork

St Colmcille’s Hospital, Loughlinstown

St James’s Hospital

St Luke’s General Hospital, Kilkenny

St Vincent’s University Hospital

Waterford Regional Hospital

Wexford General Hospital

58

Appendix B: HealthStat Monthly Hospital Template The following Appendix contains a copy of the ‘HealthStat Monthly Hospital Template’, which each of the participating hospitals completes in order to provide some 100 of the 350 data items used to generate the Dashboards.


Adelaide, Meath inc. National Childrens Hospital, Tallaght

Dear colleague,

The HSE has developed an across the board performance metrics process called HealthStat, with a range of both aggregate/top line, and operational detail.

As part of this process the HSE requires you to provide some additional monthly information that will be incorporated with data from other existing sources (i.e. NEMU, Casemix, PMU, Corporate Finance) to produce your hospital dashboard. In this Template we are requesting data from you for August 2009.

This additional information is to be recorded in the following Excel template (which also includes guidance as to how it will be completed). It is required to be signed off by you as hospital CEO/GM, and returned to [email protected] with a copy to your network manager. Emails will be considered as a valid sign-off with the excel template attached and received direct from you or with your name in Cc.

It is advised that each hospital CEO/GM take the opportunity to inform their consulting teams that the information is being collected.

If you have any queries, then please also refer to the email above or call 01-6352970.

Note that the completed template will be supplemented with the other validated sources to produce your hospital dashboard.

August 2009 data is due by close of business 5th October 2009.

NEW DATA ITEM. Section 1.4 Please provide the number of WTEs (including managers) that produced the activity for the month reported. Examples are provided to assist.

PLEASE NOTE. metric R10a shows the throughput of new patients per WTE consultant. The graph originates from template section 1.1 Hospital Staff (consultant WTE) and section 1.8 Hospital OPD Consultant led clinics (new patients). It is essential that the WTE consultants and the activity new patients are matched. Both should be mapped according to Appendix D in the HealthStat for Hospitals User Guide (available on www.hse.ie/eng/Healthstat/linksinfo/). e.g. a Consultant Dermatologist should be mapped to WTE Medicine in 1.1 and the associated Dermatology OPD clinic activity mapped to Medicine in 1.8. Visiting consultants that produce OPD activity should also be included with the appropriate WTE portion entered in 1.1 and activity in 1.8.

If you have any queries, then please email [email protected] or call 01-635 2970.

Many thanks for your continued help and support.

Mark Turner

Assistant National Director

Decision Support

59

60

61

Appendix C: Impact of Incomplete Hospital Data Submission on Traffic Lights The following appendix details the instances where submission of incomplete hospital data via the template listed in Appendix B results in the automatic generation of a red traffic light in the HealthStat dashboard of that hospital.

This functionality has been provided in order to encourage each hospital to fully complete their data returns on a monthly basis. It should however be noted that the HealthStat team can subsequently disable these automatically generated traffic lights in the event that there is a valid reason for an incomplete submission.

Section 1.1 of HealthStat Monthly Hospital Template – Hospital Staff

In the event that no consultant numbers are provided then an automatic red traffic light shall be generated for metric R10a.

Section 1.2 of HealthStat Monthly Hospital Template – Agency Staff

No impact on any traffic light in the event of an incomplete submission.

Section 1.3 of HealthStat Monthly Hospital Template – Hospital Absenteeism

In the event that no hours are submitted for Uncertified, Certified and Long Term Absenteeism then an automatic red traffic light shall be generated for metric R5.

In the event that no available staff hours are provided then an automatic red traffic light shall be generated for metric R5.

Section 1.4 of HealthStat Monthly Hospital Template – Hospital Activity


Section 1.5 of HealthStat Monthly Hospital Template – Hospital Diagnostic Activity


Section 1.6 of HealthStat Monthly Hospital Template – Wait Times for GP to Hospital Referral

In the event that GPs can make direct referrals for physiotherapy, but no associated wait time information is provided, then an automatic red traffic light shall be generated for metric A3a.

In the event that GPs can make direct referrals for x-ray, ultrasound, CT or MRI, but no associated wait time information is provided for any of these services, then an automatic red traffic light shall be generated for metric A3b.

62

Section 1.7 of HealthStat Monthly Hospital Template – Wait Times for Outpatient (Consultant) Hospital Referrals

In the event that consultants can make direct referrals for physiotherapy, but no associated wait time information is provided, then an automatic red traffic light shall be generated for metric A4a.

In the event that consultants can make direct referrals for x-ray, ultrasound, CT or MRI, but no associated wait time information is provided for any of these services, then an automatic red traffic light shall be generated for metric A4b.

1.8 Wait Bands and Number of New Referrals for GP and Consultant Hospital Referrals

for Outpatient Physiotherapy Services


63

Appendix D: Consultant Led OPD Clinic to Specialty Group Mapping

The following Appendix contains the mapping used to allocate consultant led OPD clinic

specialties to the specialty groupings that are used in metrics A5, A6, and R9 (a, b and c) of

the Dashboard.

Whilst drop downs for each of these specialty groups are provided in the template, it is

sometimes the case that free text names are entered into the specialty field, and it is the

mapping of those names to the specialty groups that is shown in the following tables.

Table D.1: Consultant Led OPD Clinic Specialty Mapping for General Medicine

Speciality Group Sub-specialty Group Clinic code Medicine Cardiology 100 Medicine Dermatology 300 Medicine Endocrinology 400 Medicine Gastro-Enterology 700 Medicine Genito-Urinary Medicine 800 Medicine Geriatric Medicine 900 Medicine Haematology 1100 Medicine Neurology 1300 Medicine Obstetrics/Gynaecology 1500 Medicine Obstetrics 1502 Medicine Gynaecology 1503 Medicine Fetal Assessment 1516 Medicine Oncology 1600 Medicine Radiation Oncology 1603 Medicine Brachytherapy 1630 Medicine Total Body Irradiation 1640 Medicine Oncology Extended Care 1670 Medicine Psychiatry 2100 Medicine Old Age Psychiatry 2101 Medicine Psychology 2110 Medicine Radiology 2200 Medicine Neuroradiology 2203 Medicine Nephrology 2300 Medicine Respiratory Medicine 2400 Medicine Rheumatology 2500 Medicine Varicose Veins 2614 Medicine Infectious Diseases 2700 Medicine Tropical 2702 Medicine General Medicine 5000 Medicine Audiological Medicine 6000 Medicine Public Health Medicine 6100 Medicine Clinical Neurophysiology 6200 Medicine Clinical Pharmacology 6300 Medicine Clinical Physiology 6400 Medicine GP Medicine 6500

64

Medicine Clinical Genetics 6700 Medicine Nuclear Medicine 6900 Medicine Radiotherapy 7500 Medicine Metabolistic Medicine 7700 Medicine Clinical Immunology 7900 Medicine Intensive Care 8002 Medicine Pain Relief 8003 Medicine Immunology 8800 Medicine Gold 9001 Medicine Heart Failure Clinic 9016 Medicine Chest Pain Clinic 9017 Medicine PKU Clinic 9020 Medicine Colorectal Clinic 9026 Medicine Stoma Care Clinic 9027 Medicine Colonoscopy Clinic 9028 Medicine Haematology Clinic 9029 Medicine Ultrasound Clinic 9031 Medicine Anaemia Coordinator Renal Clinic 9038 Medicine Daily Fertility Clinic 9047 Medicine Hypertension Clinic 9048 Medicine Cardiac Disease Management 9049

Table D.2: Consultant Led OPD Clinic Specialty Mapping for General Surgery

Speciality Group Sub-specialty Group Clinic code Surgery Neurosurgery 1400 Surgery Steereotactic Radiosurgery 1620 Surgery Plastic Surgery 2000 Surgery Cosmetics 2010 Surgery General Surgery 2600 Surgery Breast Surgery 2601 Surgery Gastro-Intestinal Surgery 2602 Surgery Vascular Surgery 2604 Surgery Dental Surgery 7000 Surgery Oral Surgery 7001 Surgery Orthodontics 7002 Surgery Cardio-Thoracic Surgery 7600 Surgery Open Heart Surgery 7610 Surgery Urology 7800 Surgery Anaesthetics 8000 Surgery Maxillofacial 9004 Surgery Pre Op Assessment Clinic 9035

Table D.3: Consultant Specialty Mapping for Paediatrics

Speciality Group Sub-specialty Group Clinic code Paediatrics Paediatric Ortholaryngology (ENT) 630 Paediatrics Paediatric Neurology 1302 Paediatrics Paediatric Neurosurgery 1402 Paediatrics Paediatric- Orthopaedics 1802 Paediatrics Paediatrics 1900 Paediatrics Paediatric Cardiology 1902

65

Paediatrics Neonatology 1904 Paediatrics Paediatric Endocrinology 1905 Paediatrics Paediatric Gastro-Enterology 1906 Paediatrics Paediatric A/E Medicine 1908 Paediatrics Paediatric Respiratory Medicine 1912 Paediatrics Paediatric Dermatology 1915 Paediatrics Paediatric- General Medicine 1917 Paediatrics Paediatric Dentistry 1950 Paediatrics Paediatric Gynaecology 1951 Paediatrics Paediatric Ophthalmology 1952 Paediatrics Paediatric Urology 1953 Paediatrics Paediatric- General Surgery 7200 Paediatrics Paediatric Incontinence Clinic 9021 Paediatrics Antenatal and Post Natal Clinic 9042 Paediatrics Maternity Day Unit 9043

Table D.4: Consultant Specialty Mapping for Otolaryngology

Speciality Group Sub-specialty Group Clinic code Otolaryngology Otolaryngology (ENT) 600 Otolaryngology ENT / Opthalmology / Plastics 620

Table D.5: Consultant Specialty Mapping for Orthopaedics

Speciality Group Sub-specialty Group Clinic code Orthopaedics Orthopaedics 1800 Orthopaedics Acute Back Pain 1850 Orthopaedics Orthopaedic Pre-Op Clinic 9023

Orthopaedics Fracture Liaison and Dexa Scanning Clinic 9037

Table D.6: Consultant Specialty Mapping for Ophthalmology

Speciality Group Sub-specialty Group Clinic code

Ophthalmology Ophthalmology 1700

66

Appendix E: Day Case Procedures

The following Appendix contains a list of the procedures and associated definitions contained

with the Basket of 24 Procedures and the definitions associated with the remaining

procedures listed in metric I1:

1. Orchidopexy

37803-00 Orchidopexy for undescended testis, unilateral

37803-01 Orchidopexy for undescended testis, bilateral

37809-00 Revision orchidopexy for undescended testis, unilateral

37809-01 Revision orchidopexy for undescended testis, bilateral

2. Circumcision

30653-00 Male circumcision

3. Inguinal Hernia Repair

30609-02 Laparoscopic repair of inguinal hernia, unilateral

30614-02 Repair of inguinal hernia, unilateral

30609-03 Laparoscopic repair of inguinal hernia, bilateral

30614-03 Repair of inguinal hernia, bilateral

4. Excision of Breast Lump

31500-00 Excision of lesion of breast

31515-00 Re-excision of lesion of breast

5. Anal Fissure Dilation or Excision

90315-01 Excision of other lesion or tissue of anus

90315-00 Endoscopic excision of lesion or tissue of anus

6. Haemorrhoidectomy

32138-00 Haemorrhoidectomy

32138-01 Laser haemorrhoidectomy

32138-02 Stapled haemorrhoidectomy

7. Laparoscopic Cholecystectomy

30445-00 Laparoscopic cholecystectomy

30448-00 Laparoscopic cholecystectomy with removal of common bile duct calculus via

cystic duct

67

30449-00 Laparoscopic cholecystectomy with removal of common bile duct calculus via

laparoscopic choledochotomy

8. Varicose Vein Stripping or Ligation

32508-00 Interruption of sapheno-femoral junction varicose veins

32508-01 Interruption of sapheno-popliteal junction varicose veins

32511-00 Interruption of sapheno-femoral and sapheno-popliteal junction varicose veins

32504-01 Interruption of multiple tributaries of varicose veins

32505-00 Subfascial interruption of one or more perforating varicose veins

32514-00 Reoperation for varicose veins

9. Transurethral Resection of Bladder

36839-02 Endoscopic laser destruction of a single lesion of bladder ≤ 2 cm or tissue of

bladder

36845-03 Endoscopic laser destruction of a single lesion of bladder > 2 cm in diameter

36845-02 Endoscopic laser destruction of multiple lesions of bladder

36839-00 Endoscopic destruction of a single lesion of bladder ≤ 2 cm or tissue of

bladder

36845-00 Endoscopic destruction of single lesion of bladder > 2 cm in diameter

36845-01 Endoscopic destruction of multiple lesions of bladder

36839-04 Endoscopic resection of a single lesion of bladder ≤ 2cm or tissue of bladder

36845-04 Endoscopic resection of a single lesion of bladder > 2 cm in diameter

36845-05 Endoscopic resection of multiple lesions of bladder

10. Excision of Dupuytren's Contracture

46369-00 Palmar fasciectomy for Dupuytren's contracture

46372-00 Palmar fasciectomy for Dupuytren's contracture involving 1 digit (ray)

46375-00 Palmar fasciectomy for Dupuytren's contracture involving 2 digits (rays)

46378-00 Palmar fasciectomy for Dupuytren's contracture involving ≥ 3 digits (rays)

46387-00 Revision of palmar fasciectomy for Dupuytren's contracture involving 1 digit

(ray)

46390-00 Revision of palmar fasciectomy for Dupuytren's contracture involving 2 digits

(rays)

46393-00 Revision of palmar fasciectomy for Dupuytren's contracture involving ≥ 3 digits

(rays)

11. Carpal Tunnel Decompression

39331-00 Endoscopic release of carpal tunnel

68

39331-01 Release of carpal tunnel

12. Excision of Ganglion

30107-00 Excision of ganglion, not elsewhere classified

46495-00 Excision of mucous cyst of digit of hand

46494-00 Excision of ganglion of hand

46495-01 Excision of ganglion of distal digit of hand

46498-00 Excision of ganglion of flexor tendon sheath of hand

46500-00 Excision of ganglion of dorsal wrist

46502-00 Excision of recurrent ganglion of dorsal wrist

46501-00 Excision of ganglion of volar wrist

46503-00 Excision of recurrent ganglion of volar wrist

13. Arthroscopy (all arthroscopic examinations of joints)

50100-00 Arthroscopy of joint, not elsewhere classified

50100-01 Arthroscopic biopsy of joint, not elsewhere classified

49557-00 Arthroscopy of knee

49560-00 Arthroscopic removal of loose body of knee

49560-02 Arthroscopic lateral release of knee

49557-01 Arthroscopic biopsy of knee

49558-00 Arthroscopic debridement of knee

49560-01 Arthroscopic trimming of ligament of knee

49566-00 Arthroscopic synovectomy of knee

49557-02 Arthroscopic excision of meniscal margin or plica of knee

49560-03 Arthroscopic meniscectomy of knee

49561-02 Arthroscopic removal of loose body of knee with debridement, osteoplasty or

chondroplasty

49562-02 Arthroscopic removal of loose body of knee with chondroplasty and multiple

drilling or implant

49561-00 Arthroscopic lateral release of knee with debridement, osteoplasty or

chondroplasty

49562-00 Arthroscopic lateral release of knee with chondroplasty and multiple drilling or

implant

49561-01 Arthroscopic meniscectomy of knee with debridement, osteoplasty or

chondroplasty

69

49562-01 Arthroscopic meniscectomy of knee with chondroplasty and multiple drilling or

implant

49563-00 Arthroscopic repair of meniscus of knee

49558-01 Arthroscopic chondroplasty of knee

49559-00 Arthroscopic chondroplasty of knee with multiple drilling or implant

49558-02 Arthroscopic osteoplasty of knee

14. Bunion Operations

49821-00 Correction of hallux valgus or rigidus by arthroplasty, unilateral

49824-00 Correction of hallux valgus or rigidus by arthroplasty, bilateral

49839-00 Correction of hallux valgus or rigidus by arthroplasty with insertion of

prosthesis, unilateral

49842-00 Correction of hallux valgus or rigidus by arthroplasty with insertion of

prosthesis, bilateral

49827-00 Correction of hallux valgus by transfer of adductor hallucis tendon, unilateral

49830-00 Correction of hallux valgus by transfer of adductor hallucis tendon, bilateral

49833-00 Correction of hallux valgus by osteotomy of first metatarsal, unilateral

49836-00 Correction of hallux valgus by osteotomy of first metatarsal, bilateral

49837-00 Correction of hallux valgus by osteotomy of first metatarsal and transfer of

adductor hallucis tendon, unilateral

49838-00 Correction of hallux valgus by osteotomy of first metatarsal and transfer of

adductor hallucis tendon, bilateral

15. Removal of Metalware

47927-01 Removal of pin, screw or wire from femur

47927-00 Removal of pin, screw or wire, not elsewhere classified

47930-01 Removal of plate, rod or nail from femur

47930-00 Removal of plate, rod or nail, not elsewhere classified

52102-00 Removal of pin, screw or wire from maxilla, mandible or zygoma

16. Extraction of Cataract with or without Implant

42703-00 Insertion of artificial lens into posterior chamber and suture to iris and sclera

42701-00 Insertion of foldable artificial lens

42701-01 Insertion of other artificial lens

42707-00 Replacement of artificial lens

42710-00 Replacement of artificial lens by posterior chamber insertion and suture to iris

and sclera

42704-00 Removal of artificial lens

70

42698-00 Intracapsular extraction of crystalline lens

42702-00 Intracapsular extraction of crystalline lens with insertion of foldable artificial

lens

42702-01 Intracapsular extraction of crystalline lens with insertion of other artificial lens

42698-01 Extracapsular extraction of crystalline lens by simple aspiration (and irrigation)

technique


technique with insertion of foldable artificial lens


technique with insertion of other artificial lens

42698-02 Extracapsular extraction of crystalline lens by phacoemulsification and

aspiration of cataract


aspiration of cataract with insertion of foldable artificial lens


aspiration of cataract with insertion of other artificial lens

42698-03 Extracapsular extraction of crystalline lens by mechanical phacofragmentation

and aspiration of cataract


and aspiration of cataract with insertion of foldable artificial lens


and aspiration of cataract with insertion of other artificial lens

42698-04 Other extracapsular extraction of crystalline lens

42702-08 Other extracapsular extraction of crystalline lens with insertion of foldable

artificial lens

42702-09 Other extracapsular extraction of crystalline lens with insertion of other

artificial lens

42731-01 Extraction of crystalline lens by posterior chamber sclerotomy with removal of

vitreous

42698-05 Other extraction of crystalline lens

42702-10 Other extraction of crystalline lens with insertion of foldable artificial lens

42702-11 Other extraction of crystalline lens with insertion of other artificial lens

42737-00 Needling of posterior capsule of lens

42734-00 Capsulotomy of lens

42788-00 Capsulotomy of lens by laser

42791-02 Corticolysis of lens material by laser

71

42719-00 Capsulectomy of lens

42722-00 Capsulectomy of lens by posterior chamber sclerotomy

42731-00 Capsulectomy of lens by posterior chamber sclerotomy with removal of

vitreous

42719-02 Mechanical fragmentation of secondary membrane

42716-00 Removal of juvenile cataract

17. Correction of Squint

42830-00 Administration of botulinum toxin for strabismus

42848-00 Muscle transplant for strabismus

42833-00 Strabismus procedure involving 1 or 2 muscles, one eye

42833-01 Strabismus procedure involving 1 or 2 muscles, both eyes

42839-00 Strabismus procedure involving ≥ 3 muscles, one eye

42839-01 Strabismus procedure involving ≥ 3 muscles, both eyes

42845-00 Readjustment of adjustable sutures following previous surgery for correction

of strabismus, one eye

42845-01 Readjustment of adjustable sutures following previous surgery for correction

of strabismus, both eyes

42848-01 Reoperation of muscle transplant procedure for strabismus, second procedure

42851-00 Reoperation of muscle transplant procedure for strabismus, third or

subsequent procedure

42833-02 Reoperation of strabismus procedure involving 1 or 2 muscles, 1 eye, second

procedure

42833-03 Reoperation of strabismus procedure involving 1 or 2 muscles, both eyes,

second procedure

42839-02 Reoperation of strabismus procedure involving ≥ 3 muscles, 1 eye, second

procedure

42839-03 Reoperation of strabismus procedure involving ≥ 3 muscles, both eyes,

second procedure

42836-00 Reoperation of strabismus procedure involving 1 or 2 muscles, 1 eye, third or


42836-01 Reoperation of strabismus procedure involving 1 or 2 muscles, both eyes,

third or subsequent procedure

42842-00 Reoperation of strabismus procedure involving ≥ 3 muscles, 1 eye, third or


42842-01 Reoperation strabismus procedure involving ≥ 3 muscles, both eyes, third or


72

18. Myringotomy

41626-00 Myringotomy, unilateral

41626-01 Myringotomy, bilateral

41632-00 Myringotomy with insertion of tube, unilateral

41632-01 Myringotomy with insertion of tube, bilateral

19. Tonsillectomy

41789-00 Tonsillectomy without adenoidectomy

41801-00 Adenoidectomy without tonsillectomy

41789-01 Tonsillectomy with adenoidectomy

41804-00 Removal of lingual tonsil

20. Sub Mucous Resection

41671-00 Submucous resection of nasal septum

41671-03 Septoplasty with submucous resection of nasal septum

41692-00 Submucous resection of turbinate, unilateral

41692-01 Submucous resection of turbinate, bilateral

41674-00 Cauterisation or diathermy of nasal turbinates

41674-01 Cauterisation or diathermy of nasal septum

21. Reduction of Nasal Fracture

47738-00 Closed reduction of fracture of nasal bone

47741-00 Open reduction of fracture of nasal bone

22. Operation for Bat Ears

45659-00 Correction of bat ear

23. Dilation & Curettage / Hysteroscopy

35630-00 Diagnostic hysteroscopy

35640-00 Dilation and curettage of uterus [D&C]

35640-01 Curettage of uterus without dilation

35640-03 Suction curettage of uterus

35643-00 Dilation and curettage [D&C] following abortion or for termination of pregnancy

35643-01 Suction curettage of uterus following abortion or for termination of pregnancy

35643-02 Dilation and evacuation of uterus [D&E]

16564-00 Postpartum evacuation of uterus by dilation and curettage

16564-01 Postpartum evacuation of uterus by suction curettage

35710-00 Falloposcopy

35688-01 Sterilisation via vaginal approach

73

35633-02 Hysteroscopy with tubal catheterisation

35634-00 Division of uterine septum via hysteroscopy

35633-01 Polypectomy of uterus via hysteroscopy

35623-00 Myomectomy of uterus via hysteroscopy

24. Laparoscopy

30390-00 Laparoscopy

Cataract Procedures

42698-00 Intracapsular extraction of crystalline lens

42702-00 Intracapsular extraction of crystalline lens with insertion of foldable artificial

lens

42702-01 Intracapsular extraction of crystalline lens with insertion of other artificial lens

42698-01 Extracapsular extraction of crystalline lens by simple aspiration (and

irrigation) technique

42702-02 Extracapsular extraction of crystalline lens by simple aspiration (and

irrigation) technique with



aspiration of cataract


aspiration of cataract with insertion of foldable artificial lens


aspiration of cataract with insertion of other artificial lens

42698-03 Extracapsular extraction of crystalline lens by mechanical

phacofragmentation and aspiration of cataract


phacofragmentation and aspiration of cataract with insertion of foldable artificial lens


phacofragmentation and aspiration of cataract with insertion of other artificial lens

42698-04 Other extracapsular extraction of crystalline lens

42702-08 Other extracapsular extraction of crystalline lens with insertion of foldable

artificial lens

42702-09 Other extracapsular extraction of crystalline lens with insertion of other

artificial lens

42731-01 Extraction of crystalline lens by posterior chamber sclerotomy with removal of

vitreous

74

42698-05 Other extraction of crystalline lens

42702-10 Other extraction of crystalline lens with insertion of foldable artificial lens

42702-11 Other extraction of crystalline lens with insertion of other artificial lens

Investigative Scopes

50100-00 Arthroscopy of joint, not elsewhere classified

50100-01 Arthroscopic biopsy of joint, not elsewhere classified

49557-00 Arthroscopy of knee

49560-00 Arthroscopic removal of loose body of knee

49560-02 Arthroscopic lateral release of knee

49557-01 Arthroscopic biopsy of knee

49558-00 Arthroscopic debridement of knee

49560-01 Arthroscopic trimming of ligament of knee

49566-00 Arthroscopic synovectomy of knee

49557-02 Arthroscopic excision of meniscal margin or plica of knee

49560-03 Arthroscopic meniscectomy of knee

49561-02 Arthroscopic removal of loose body of knee with debridement, osteoplasty or

chondroplasty

49562-02 Arthroscopic removal of loose body of knee with chondroplasty and multiple

drilling or implant

49561-00 Arthroscopic lateral release of knee with debridement, osteoplasty or

chondroplasty

49562-00 Arthroscopic lateral release of knee with chondroplasty and multiple drilling or

implant

49561-01 Arthroscopic meniscectomy of knee with debridement, osteoplasty or

chondroplasty

49562-01 Arthroscopic meniscectomy of knee with chondroplasty and multiple drilling or

implant

49563-00 Arthroscopic repair of meniscus of knee

49558-01 Arthroscopic chondroplasty of knee

49559-00 Arthroscopic chondroplasty of knee with multiple drilling or implant

49558-02 Arthroscopic osteoplasty of knee

35630-00 Diagnostic hysteroscopy

30390-00 Laparoscopy

Inguinal Hernia Procedures

75

30609-02 Laparoscopic repair of inguinal hernia, unilateral

30614-02 Repair of inguinal hernia, unilateral

30609-03 Laparoscopic repair of inguinal hernia, bilateral

30614-03 Repair of inguinal hernia, bilateral

30615-00 Repair of incarcerated, obstructed or strangulated hernia (Only when

accompanied by a principal diagnosis beginning with K40)

Varicose Veins Procedures

32508-00 Interruption of sapheno-femoral junction varicose veins

32508-01 Interruption of sapheno-popliteal junction varicose veins

32511-00 Interruption of sapheno-femoral and sapheno-popliteal junction varicose veins

32504-01 Interruption of multiple tributaries of varicose veins

32505-00 Subfascial interruption of one or more perforating varicose veins

32514-00 Reoperation for varicose veins

Tonsillectomy

41789-00 Tonsillectomy without adenoidectomy

41789-01 Tonsillectomy with adenoidectomy

76

Appendix F: Primary Diagnosis Definitions included in Inpatient Basket

The following Appendix contains a list of the definitions associated with the Primary Diagnosis

included in the Inpatient Basket:

Acute Upper Respiratory Infections and Influenza

J00 Acute nasopharyngitis [common cold] (Includes all diagnosis codes beginning with J00)

J01 Acute sinusitis (Includes all diagnosis codes beginning with J01)

J02 Acute pharyngitis (Includes all diagnosis codes beginning with J02)

J03 Acute tonsillitis (Includes all diagnosis codes beginning with J03)

J04 Acute laryngitis and tracheitis (Includes all diagnosis codes beginning with J04)

J05 Acute obstructive laryngitis [croup] and epiglottitis (Includes all diagnosis codes beginning

with J05)

J06 Acute upper respiratory infections of multiple and unspecified sites (Includes all diagnosis

codes beginning with J06)

J10 Influenza due to identified influenza virus (Includes all diagnosis codes beginning with

J10)

J11 Influenza, virus not identified (Includes all diagnosis codes beginning with J11)

COPD

J44 Other chronic obstructive pulmonary disease (Includes all diagnosis codes beginning with

J44)

Cerebrovascular Diseases

I60 Subarachnoid haemorrhage (Includes all diagnosis codes beginning with I60)

I61 Intracerebral haemorrhage (Includes all diagnosis codes beginning with I61)

I62 Other nontraumatic intracranial haemorrhage (Includes all diagnosis codes beginning with

I62)

I63 Cerebral infarction (Includes all diagnosis codes beginning with I63)

I64 Stroke, not specified as haemorrhage or infarction (Includes all diagnosis codes beginning

with I64)

I65 Occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction

(Includes all diagnosis codes beginning with I65)

77

I66 Occlusion and stenosis of cerebral arteries, not resulting in cerebral infarction (Includes all

diagnosis codes beginning with I66)

I67 Other cerebrovascular diseases (Includes all diagnosis codes beginning with I67)

I68 Cerebrovascular disorders in diseases classified elsewhere (Includes all diagnosis codes

beginning with I68)

I69 Sequelae of cerebrovascular disease (Includes all diagnosis codes beginning with I69)

Appendicectomy

30572-00 Laparoscopic appendicectomy

30571-00 Appendicectomy

Asthma

J45 Asthma (Includes all diagnosis codes beginning with J45)

J46 Status asthmaticus (Includes all diagnosis codes beginning with J46)

Myocardial Infarction (MI)

I21 Acute myocardial infarction (Includes all diagnosis codes beginning with I21)

Diabetes

E10 Type 1 diabetes mellitus (Includes all diagnosis codes beginning with E10)

E11 Type 2 diabetes mellitus (Includes all diagnosis codes beginning with E11)

E13 Other specified diabetes mellitus (Includes all diagnosis codes beginning with E13)

E14 Unspecified diabetes mellitus (Includes all diagnosis codes beginning with E14)

Hip Replacement

47522-00 Hemiarthroplasty of femur

49315-00 Partial arthroplasty of hip

49318-00 Total arthroplasty of hip, unilateral

49319-00 Total arthroplasty of hip, bilateral

UROLITHIASIS

N20.0 Calculus of kidney

N20.1 Calculus of ureter

N20.2 Calculus of kidney with calculus of ureter

N20.9 Urinary calculus, unspecified

N21.0 Calculus in bladder

N21.1 Calculus in urethra

N21.8 Other lower urinary tract calculus

N21.9 Calculus of lower urinary tract, unspecified

78

N22.0 Urinary calculus in schistosomiasis

N22.8 Calculus of urinary tract in other diseases classified elsewhere

N13.0 Hydronephrosis with ureteropelvic junction obstruction

N13.1 Hydronephrosis with ureteral stricture, not elsewhere classified

N13.2 Hydronephrosis with renal and ureteral calculus obstruction

N13.3 Other and unspecified hydronephrosis

N13.4 Hydroureter

Cellulitis

L01.0 Impetigo

L01.1 Impetiginisation of other dermatoses2

L02.0 Cutaneous abscess, furuncle and carbuncle of face

L02.1 Cutaneous abscess, furuncle and carbuncle of neck

L02.2 Cutaneous abscess, furuncle and carbuncle of trunk

L02.3 Cutaneous abscess, furuncle and carbuncle of buttock

L02.4 Cutaneous abscess, furuncle and carbuncle of limb

L02.8 Cutaneous abscess, furuncle and carbuncle of other sites

L02.9 Cutaneous abscess, furuncle and carbuncle, unspecified

L03.01 Cellulitis of finger

L03.02 Cellulitis of toe

L03.10 Cellulitis of upper limb

L03.11 Cellulitis of lower limb

L03.2 Cellulitis of face

L03.3 Cellulitis of trunk

L03.8 Cellulitis of other sites

L03.9 Cellulitis, unspecifiedL04

L04.0 Acute lymphadenitis of face, head and neck

L04.1 Acute lymphadenitis of trunk

L04.2 Acute lymphadenitis of upper limb

L04.3 Acute lymphadenitis of lower limb

L04.8 Acute lymphadenitis of other sites

L04.9 Acute lymphadenitis, unspecified

L05.0 Pilonidal cyst with abscess

L05.9 Pilonidal cyst without abscess

79

L08.0 Pyoderma

L08.1 Erythrasma

L08.8 Other specified local infections of skin and subcutaneous tissue

L08.9 Local infection of skin and subcutaneous tissue, unspecified

Abdominal Pain

R10.0 Acute abdomen

R10.1 Pain localised to upper abdomen

R10.2 Pelvic and perineal pain

R10.3 Pain localised to other parts of lower abdomen

R10.4 Other and unspecified abdominal pain

Pain in Throat and Chest Pain

R07.1 Chest pain on breathing

R07.2 Precordial pain

R07.3 Other chest pain

R07.4 Chest pain, unspecified

80

Appendix G: DRG to Specialty Mapping The following Appendix contains the mapping used to allocate HIPE DRG’s to the specialty groupings that are used in metric I2 of the Dashboard.

G.1 – DRG to Medical Specialty Group Mapping

Specialty DRG Code

Dermatology J60A

Dermatology J60B

Dermatology J67A

Dermatology J67B

Dermatology J68A

Dermatology J68B

Endocrinology K62A

Endocrinology K62B

Endocrinology K62C

Endocrinology K63Z

Endocrinology K64A

Endocrinology K64B

Gastroenterology G42A

Gastroenterology G42B





Gastroenterology G46C

Gastroenterology G62Z







Gastroenterology H40Z

General Medicine E60A

General Medicine E60B

General Medicine E61A

General Medicine E61B

General Medicine F63A

General Medicine F63B

General Medicine H60A

General Medicine H60B

81

General Medicine H60C

General Medicine H63A

General Medicine H63B

General Medicine J64A

General Medicine J64B

General Medicine K60A

General Medicine K60B

General Medicine K61Z

General Medicine T60A

General Medicine T60B

General Medicine T62A

General Medicine T62B

General Medicine V60A

General Medicine V60B

General Medicine X61Z

General Medicine X62A

General Medicine X62B

General Medicine X64A

General Medicine X64B

Genito-Urinary Medicine S60Z

Genito-Urinary Medicine S65A

Genito-Urinary Medicine S65B

Genito-Urinary Medicine S65C

Geriatrics/Care of the Elderly Z61Z

Geriatrics/Care of the Elderly Z64A

Haematology B62Z

Haematology Q60A

Haematology Q60B

Haematology Q60C

Haematology Q61A

Haematology Q61B

Haematology Q61C

Haematology Q62Z

Infectious Diseases B72A

Infectious Diseases B72B

Infectious Diseases B73Z

Infectious Diseases T01A

Infectious Diseases T01B

Infectious Diseases T01C





Nephrology L60A

Nephrology L60B

Nephrology L60C

Nephrology L61Z

Nephrology L63A

Nephrology L63B

82

Nephrology L63C

Nephrology L67A

Nephrology L67B

Nephrology L67C

Neurology B40Z

Neurology B41Z

Neurology B60A

Neurology B60B

Neurology B61A

Neurology B61B

Neurology B63Z

Neurology B64A

Neurology B64B

Neurology B65Z

Neurology B67A

Neurology B67B

Neurology B67C

Neurology B68A

Neurology B68B

Neurology B69A

Neurology B69B

Neurology B70A

Neurology B70B

Neurology B70C

Neurology B70D

Neurology B71A

Neurology B71B

Neurology B76A

Neurology B76B

Neurology B77Z

Neurology B81A

Neurology B81B

Oncology I65A

Oncology I65B

Oncology J62A

Oncology J62B

Oncology R01A

Oncology R01B

Oncology R02A

Oncology R02B

Oncology R03A

Oncology R03B

Oncology R04A

Oncology R04B

Oncology R60A

Oncology R60B

Oncology R60C

Oncology R61A

Oncology R61B

83

Oncology R61C

Oncology R62A

Oncology R62B

Oncology R63Z

Oncology R64Z

Radiology H41A

Radiology H41B

Radiology H42A

Radiology H42B

Radiology H42C

Respiratory Medicine E62A

Respiratory Medicine E62B

Respiratory Medicine E62C

Respiratory Medicine E63Z





Respiratory Medicine E68Z
















Rheumatology I66A

Rheumatology I66B

Rheumatology I67A

Rheumatology I67B

Rheumatology I68A

Rheumatology I68B

Rheumatology I68C

Rheumatology I69A

Rheumatology I69B

Rheumatology I69C

Rheumatology I70Z

Rheumatology I71A

Rheumatology I71B

Rheumatology I71C

Rheumatology I72A

84

Rheumatology I72B

Rheumatology I76A

Rheumatology I76B

Rheumatology I76C

G.2 – DRG to Surgical Specialty Group Mapping

Specialty DRG Code

Breast Surgery J01Z

Breast Surgery J06A

Breast Surgery J06B

Breast Surgery J07A

Breast Surgery J07B

Breast Surgery J11Z

Breast Surgery J14Z

Breast Surgery J63Z

Cardiothoracic Surgery E01A

Cardiothoracic Surgery E01B



Cardiothoracic Surgery E02C



Cardiothoracic Surgery E66C

Cardiothoracic Surgery F01A

Cardiothoracic Surgery F01B

Cardiothoracic Surgery F02Z

Cardiothoracic Surgery F03Z













Dental D40Z

Endocrinology K09Z

ENT C05Z

ENT D01Z

ENT D02A

ENT D02B

ENT D02C

ENT D03Z

ENT D05Z

85

ENT D06Z

ENT D09Z

ENT D10Z

ENT D11Z

ENT D12Z

ENT D13Z

ENT D60A

ENT D60B

ENT D61Z

ENT D62Z

ENT D63A

ENT D63B

ENT D64Z

ENT D65Z

ENT D66A

ENT D66B

ENT I15Z

ENT K02Z

ENT K05Z

ENT K06Z

ENT K08Z

General Surgery F21B

General Surgery G01A

General Surgery G01B





General Surgery G03C










General Surgery G09Z





General Surgery G43Z






86







General Surgery H01A

General Surgery H01B



General Surgery H02C



General Surgery H06Z











General Surgery J09Z

General Surgery J65A

General Surgery J65B

General Surgery K03Z

General Surgery K04Z

General Surgery L02A

General Surgery L02B

General Surgery Q01Z

General Surgery W03Z

General Surgery X63B

General Surgery Z40Z

Neurosurgery B01Z

Neurosurgery B02A

Neurosurgery B02B

Neurosurgery B02C

Neurosurgery B03A

Neurosurgery B03B

Neurosurgery B07A

Neurosurgery B07B

Neurosurgery B66A

Neurosurgery B66B

Neurosurgery B78A

Neurosurgery B78B

Neurosurgery B79Z

Neurosurgery B80Z

87

Neurosurgery I06Z

Neurosurgery I09A

Neurosurgery I09B

Neurosurgery I10A

Neurosurgery I10B

Neurosurgery W01Z

Orthopaedics W04Z

Orthopaedics W60Z

Ophthalmology C01Z

Ophthalmology C02Z

Ophthalmology C03Z

Ophthalmology C04Z

Ophthalmology C10Z

Ophthalmology C11Z

Ophthalmology C12Z

Ophthalmology C13Z

Ophthalmology C14Z

Ophthalmology C15A

Ophthalmology C15B

Ophthalmology C16A

Ophthalmology C16B

Ophthalmology C60A

Ophthalmology C60B

Ophthalmology C61Z

Ophthalmology C62Z

Ophthalmology C63A

Ophthalmology C63B

Oral & Maxillofacial Surgery D04A

Oral & Maxillofacial Surgery D04B

Oral & Maxillofacial Surgery D14Z

Oral & Maxillofacial Surgery D67A

Oral & Maxillofacial Surgery D67B

Oral & Maxillofacial Surgery I17Z

Other F21A

Other Q02A

Other Q02B

Other T61A

Other T61B

Other Z01A

Other Z01B

Plastic Surgery I02A

Plastic Surgery I02B

Plastic Surgery J08A

Plastic Surgery J08B

Plastic Surgery J10Z



Plastic Surgery J12C


88


Plastic Surgery K07Z

Plastic Surgery X02Z

Plastic Surgery X07A

Plastic Surgery X07B

Plastic Surgery Y01Z

Plastic Surgery Y02A

Plastic Surgery Y02B




Plastic Surgery Y62A

Plastic Surgery Y62B

Rehabilitation Medicine W61Z

Transplant Surgery A01Z




Transplant Surgery A08A

Transplant Surgery A08B

Transplant Surgery A09A

Transplant Surgery A09B

Vascular Surgery B04A

Vascular Surgery B04B

Vascular Surgery F11A

Vascular Surgery F11B

Vascular Surgery F13Z



Vascular Surgery F14C





Vascular Surgery I07Z

Vascular Surgery I14Z

Vascular Surgery K01Z

G.3 – DRG to Paediatrics Specialty Group Mapping

Specialty DRG Code

Neonatology P01Z

Neonatology P02Z

Neonatology P03Z

Neonatology P04Z

Neonatology P05Z

Neonatology P06A

Neonatology P06B

Neonatology P60A

89

Neonatology P60B

Neonatology P61Z

Neonatology P62Z

Neonatology P63Z

Neonatology P64Z

Neonatology P65A

Neonatology P65B

Neonatology P65C

Neonatology P65D

Neonatology P66A

Neonatology P66B

Neonatology P66C

Neonatology P66D

Neonatology P67A

Neonatology P67B

Neonatology P67C

Neonatology P67D

Other 963Z

Paediatric Critical Care A40Z

Paediatric Critical Care A41A

Paediatric Critical Care A41B

Paediatric Medicine B75Z

Paediatric Medicine E70A

Paediatric Medicine E70B

Paediatric Medicine E72Z

Paediatric Medicine G68A

Paediatric Medicine G68B

Paediatric Medicine G69Z

Paediatric Surgery G06Z

Paediatric Surgery G10Z

G.4 – DRG to Obstetrics Specialty Group Mapping

Specialty DRG Code Obstetrics O01A

Obstetrics O01B

Obstetrics O01C

Obstetrics O02A

Obstetrics O02B

Obstetrics O03Z

Obstetrics O04Z

Obstetrics O05Z

Obstetrics O60A

Obstetrics O60B

Obstetrics O60C

Obstetrics O61Z

Obstetrics O63Z

Obstetrics O64A

Obstetrics O64B

90

Obstetrics O66A

Obstetrics O66B

G.5 – DRG to Gynaecology Specialty Group Mapping

Specialty DRG Code Gynaecology N01Z

Gynaecology N02A

Gynaecology N02B

Gynaecology N03A

Gynaecology N03B

Gynaecology N04Z

Gynaecology N05A

Gynaecology N05B

Gynaecology N06Z

Gynaecology N07Z

Gynaecology N08Z

Gynaecology N09Z

Gynaecology N10Z

Gynaecology N11A

Gynaecology N11B

Gynaecology N60A

Gynaecology N60B

Gynaecology N61Z

Gynaecology N62A

Gynaecology N62B

G.6 – DRG to Trauma and Orthopaedic Specialty Group Mapping

Specialty DRG Code

Trauma & Orthopaedics B05Z

Trauma & Orthopaedics B06A

Trauma & Orthopaedics B06B

Trauma & Orthopaedics I01Z


Trauma & Orthopaedics I08A

Trauma & Orthopaedics I08B




Trauma & Orthopaedics I12C






91






























Trauma & Orthopaedics W02Z






Trauma & Orthopaedics X04A

Trauma & Orthopaedics X04B

Trauma & Orthopaedics X05Z





92

Trauma & Orthopaedics X60C

G.7 – DRG to Cardiology Specialty Group Mapping

Specialty DRG Code

Cardiology E64Z

Cardiology F10Z

Cardiology F12Z

Cardiology F15Z

Cardiology F16Z

Cardiology F17Z

Cardiology F18Z

Cardiology F19Z

Cardiology F42A

Cardiology F42B

Cardiology F61Z

Cardiology F66A

Cardiology F66B

Cardiology F67A

Cardiology F67B

Cardiology F68Z

Cardiology F69A

Cardiology F69B

Cardiology F72A

Cardiology F72B

Cardiology F75A

Cardiology F75B

Cardiology F75C

Cardiology F41A

Cardiology F41B

Cardiology F60A

Cardiology F60B

Cardiology F60C

Cardiology F70A

Cardiology F70B

Cardiology F71A

Cardiology F71B

Cardiology F74Z

Cardiology F62A

Cardiology F62B

Cardiology F73A

93

Cardiology F73B

G.8 – DRG to Urology Specialty Group Mapping

Specialty DRG Code

Urology 903Z

Urology L03A

Urology L03B

Urology L04A

Urology L04B

Urology L04C

Urology L05A

Urology L05B

Urology L06A

Urology L06B

Urology L07A

Urology L07B

Urology L08A

Urology L08B

Urology L09A

Urology L09B

Urology L09C

Urology L40Z

Urology L41Z

Urology L42Z

Urology L62A

Urology L62B

Urology L64Z

Urology L65A

Urology L65B

Urology L66Z

Urology M01Z

Urology M02A

Urology M02B

Urology M03A

Urology M03B

Urology M04A

Urology M04B

Urology M05Z

Urology M06A

Urology M06B

94

Urology M40Z

Urology M61A

Urology M61B

Urology M62A

Urology M62B

Urology M63Z

Urology M64Z

G.9 – DRG to Gastroenterology Specialty Group Mapping

Specialty DRG Code









Gastroenterology H40Z





Gastroenterology G46C


95

Appendix H: Definition of Terms

The following Appendix contains a list of definitions applicable to the metrics contained in the HealthStat hospital dashboard.

Absenteeism: All unscheduled absence of staff from work in hours. This is to exclude the following types of planned or approved leave (annual leave, public holidays, maternity leave, paternity leave, compassionate leave, study leave, special leave and any other statutory leave – e.g. jury duty). It is also to be classified into the following groups:

Uncertified absence – consecutive absence in duration of zero to three days. Certified absence – consecutive absence in duration of zero days to six

months. If an absence has duration of three to six months and the certification has not been processed then this should still count as a certified absence.

Long-term absence – consecutive absence in duration of six months or more.

Agency Staff: All staff that are employed by the hospital on a temporary basis and do not appear as part of the hospital WTE head count

Appendectomy: A surgical procedure which involves the removal of the appendix

Asthma: A chronic respiratory disease, usually of allergic origin, characterized by inflammation and narrowing of the bronchi which results in wheezing and breathing difficulties

Average Length of Stay (ALOS): The average number of patient days for an admitted patient episode

Average Length of Stay Variance: A measure of the difference between the actual length of stay and the expected length of stay taking into consideration the complexity of the procedure and the age of the patient

Basket of 24: A grouping of 24 procedures commonly undertaken as Day Cases. These procedures are further detailed in Appendix E

Cardiology: The branch of medicine that deals with medical problems relating to the heart. Further information on the sub-specialty groups and DRGs that form this specialty group within HealthStat are listed in Appendix F.

Casemix: A method of quantifying hospital workload by describing the complexity and resource-intensity of the services provided. This differs from a simple count of total patients treated or total bed days used

Cataracts: An eye disease that involves clouding or yellowing of the eye lens that leads to blurred vision

96

CATH Labs: An abbreviation of Cardiovascular Catheter Laboratory – A minimally invasive procedure which involves inserting one or more catheters into the coronary arteries under X-ray guidance for diagnostic or treatment purposes

Cerebrovascular Diseases: A group of brain dysfunctions related to a disease of the blood vessels supplying the brain

Chronic Obstructive Pulmonary Disease (COPD): A long-term respiratory condition that results in blocked air flow in the lungs

Computed Tomography (CT): A scan which produces highly detailed 3-D pictures of parts of the body, using an X-ray machine linked to a computer to interpret and display the images

Day Case: A patient who is admitted to hospital on an elective basis for care and/or treatment which does not require the use of a hospital bed overnight and who is discharged as scheduled

Diabetes: A disease in which the body does not properly control the amount of sugar in the blood

Discharge planning: The active planning of discharge and post-discharge services for in-patients

DRG: Diagnosis Related Group is a system used to classify hospital cases into one of approximately 500 groups. DRG’s are assigned based upon diagnosis, procedures, sex, age and the presence of complications or comorbidities

ED to Acute Admission Wait Time: The waiting time for a patient to be admitted into an acute bed from the ED (Emergency Department) from the point in time where it has been decided that such an admission is required. Note that these figures are based upon a daily ED census at 2pm

Elective treatment: A planned or non-emergency admission or procedure that has been arranged in advance. This differs from emergency treatment that is unplanned and urgently required

Encounter: A contact between a patient and the health care system to receive an episode of treatment

Gastroenterology: The branch of medicine that deals with medical problems of the gastrointestinal tract, including the stomach, intestines and associated organs. Further information on the sub-specialty groups and DRGs that form this specialty group within HealthStat are listed in Appendix F

General Medicine: The branches of medicine that deal with non-surgical techniques. Further information on the sub-specialty groups and DRGs that form this specialty group within HealthStat are listed in Appendix F

General Surgery: The branch of surgery which focuses on procedures of the abdominal organs/covers a wide variety of surgical procedures. Further information

97

on the sub-specialty groups and DRGs that form this specialty group within HealthStat are listed in Appendix F

Gynaecology: The branch of medicine that deals with medical problems of women, in particular health of the female reproductive system. Further information on the sub-specialty groups and DRGs that form this specialty group within HealthStat are listed in Appendix F

Hip replacement: A surgical procedure in which the hip joint is replaced by a prosthetic implant

Hospital in-patient enquiry (HIPE): A health information system that collates data about each in-patient and day care hospital discharge, including diagnostic and treatment information and length of stay

Inappropriate occupancy: The occupancy of an acute bed by a patient deemed not to be in need of acute care at the time of assessment

Inguinal Hernia: Protrusion of the abdominal viscera through the inguinal canal

In-patient: A person admitted to hospital for treatment or investigation who stays for at least one night in the hospital

Insourced Activity: Activity that is undertaken by the hospital on behalf of an external third party

Internal Activity: Activity that is undertaken by the hospital in the hospital as part of its standard delivery of care for patients under the care of that hospital

Interventional: An abbreviation of Interventional Radiology – a minimally invasive procedure using image guidance for diagnostic or treatment purposes

Investigative Scope: A collection of investigative procedures including Laparascopy, Arthroscopy and Hysteroscopy

Magnetic resonance imaging (MRI): Primarily used in medical imaging to visualize the structure and function of the body. It provides detailed images of the body in any plane. MR has much greater soft tissue contrast than computed tomography (CT) making it especially useful in neurological, musculoskeletal, cardiovascular, and oncological imaging

Mammography: The process of using low-dose X-rays to examine the human breast. It is used to look for different types of tumors and cysts

Myocardial Infarction: The destruction of heart tissue resulting from obstruction of the blood supply to the heart muscle

New Patient: A patient that is being seen for the first time for that episode of care

98

NTPF (National Treatment Purchase Fund): A government agency funded by the Department of Health and Children to reduce waiting times for public patients awaiting surgery on public hospital waiting lists

NEMU (National Employment Monitoring Unit): A unit of the HSE’s National Human Resources Directorate, responsible for administration of HSE employment numbers

Neuro: An abbreviation of Neuro-radiology – focuses on diseases relating to the nerves or nervous system

Nuclear medicine: A branch of medicine and medical imaging that uses the nuclear properties of matter in diagnosis and therapy

Obstetrics: The specialty that deals with the care of a woman and her offspring during pregnancy, delivery and the period shortly after birth. Further information on the sub-specialty groups and DRGs that form this specialty group within HealthStat are listed in Appendix F

Occupational Therapy: The treatment of physical functions to aid development of physical skills based on engagement in activities of daily life

OPD: Out-patient Department

Ophthalmology: The branch of medicine which deals with the diseases and surgery of the visual pathways, including the eye, brain, and areas surrounding the eye, such as the lacrimal system and eyelids

Otolaryngology: The branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head & neck disorders. Commonly referred to as ENT

Out-patient: A patient who attends a hospital clinic for treatment and is not admitted to the hospital

Outsourced Activity: Activity that is undertaken by an external third party on behalf of the hospital

Paediatrics: The branch of medicine that deals with the medical care of infants, children, and adolescents. Further information on the sub-specialty groups and DRGs that form this specialty group within HealthStat are listed in Appendix F

PMU (Performance Monitoring Unit): A unit of the HSE’s National Hospitals Office Directorate, responsible for collection and reporting of the hospital Monthly Data Return (MDR) and other performance information

Positron emission tomography (PET): A nuclear medicine medical imaging technique which produces a three-dimensional image or map of functional processes in the body. The system detects pairs of gamma rays emitted indirectly by a positron-emitting radioisotope, which is introduced into the body on a metabolically active

99

molecule. Images of metabolic activity in space are then reconstructed by computer analysis, often in modern scanners aided by results from a CT X-ray scan performed on the patient at the same time, in the same machine

PTR (Patient Treatment Register): A register for publishing in-patient and day-case hospital waiting lists maintained by NTPF

Physiotherapy: The treatment of disorders of movement or function by methods such as exercise, manipulation, heat or ultrasound

Radiographer: A professional trained to operate equipment concerned with the production and detection of radiation

Radiologist: A doctor who uses radioactive substances and X-rays in the treatment of diseases

Return Patient: A patient that has already been seen as part of that episode of care

Routine Appointment: A request for an appointment that is not identified/assessed as being of priority. It should reflect the longest wait time

Tonsillectomy: A surgical procedure which involves the removal of the tonsils

Trauma and Orthopaedics: The branch of surgery concerned with traumatic injuries and acute, chronic, and overuse injuries and other disorders of the musculoskeletal system. Further information on the sub-specialty groups and DRGs that form this specialty group within HealthStat are listed in Appendix F

Ultrasound: Cyclic sound pressure with a frequency greater than the upper limit of human hearing. Medical sonography (ultrasonography) is an ultrasound-based diagnostic medical imaging technique used to visualize muscles, tendons, and many internal organs, their size, structure and any pathological lesions with real time tomographic images. It is also used to visualize a fetus during routine and emergency prenatal care

Urgent Appointment: A request for an appointment that is identified/assessed as being of priority. It should reflect the shortest wait time

Urology: The branch of medicine that deals with medical conditions of the male and female urinary system, including the kidneys, bladder, and adrenal gland and the reproductive system of males. Further information on the sub-specialty groups and DRGs that form this specialty group within HealthStat are listed in Appendix F

Varicose Veins: A widened, twisted, visible vein which result from a weakness in the valves of the veins

Wait Time: The time in calendar days from the day in which the request for an appointment is received, to the day in which that appointment is scheduled

100

Whole-time equivalent numbers (WTE): A measure of the number of people working in an organisation which takes into account the number of hours worked by both full and part-time staff and expresses this in terms of the number of people working full-time that it would take to carry out the same work. In its simplest form two part-time workers are deemed to be equivalent to one whole-time equivalent

X-ray: A form of electromagnetic radiation with a wavelength in the range of 10 to 0.01 nanometers, corresponding to frequencies in the range 30 PHz to 30 EHz. They are primarily used for diagnostic radiography and crystallography.

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