Le#ng  the  Data  Speak  –  Surgical  Dashboards  as  the  Driver  of  Opera;ng  Theatre  Efficiency    MaAhew  Hadfield,  Director  Periopera;ve  Services,  Ballarat  Health  Services      

Surgery  Services      6  Opera;ng  Theatre  2  Procedure  Rooms  1  Cardiovascular  Suite    General  Surgery  ENT  Orthopaedic    Vascular  Obstetrics  Gynaecology  Urology  Endoscopy    24  Hour  Service  

Procedures  per  Year  

In  developing  a  suite  of  reports  we  endeavoured  to  have  a  number  of  reports  that  would  address  each  of  the  goals  

•  Prior  to  2013  there  was  limited  access  to  useful  reports  for  Periopera;ve  Services  and  in  general  these  were  ini;ated  by  request  and  took  ;me.

•  Late  in  2012  Ballarat  Health  Service  made  a  commitment  to  develop  a  Series  of  Dashboards  for  Clinical  Streams  

•  This  presenta;on  describes  where  the  Dashboard(s)  for  Periopera;ve  Services  is  today  

Where  we  have  come  from…………………….  

In  developing  reports  we  used  the  following  principle    For  a  fact  to  be  simple  it  must    •  Inform  

•  MaAer  

•  Deserve  a  Response  

When  any  of  these  quali;es  are  missing,  data  remains  as  noise      Stephen  Few  

Consultant  Principal  Procedures  

Date  Range  Consultant  

Drill  Down  

Consultant  Principal  Procedures  

Procedure Name Indications ED - Balloon Time

Coronary + LV STEMICoronary Angio STEMICoronary + LV NSTEMIAorto-bifemoral AngioFistuloplastyPICC

Cardiovascular  Suite  Daily  Ac;vity  

We  are  very  excited  with  this  report  as  it  links  three  so`ware  systems  

     

Unit  of  Ac;vity    

Contact  Hours    =  Lab  Arrival      -­‐  Lab  Dept  Time  

- One contact hour equivalent to one WIES -  One Session has the potential to generate 4 WIES

Data

Note  increasing  ac;vity  and  decreased  variance  –  this  indirectly  reflects  beAer  session  u;lisa;on  

Daily  Theatre  List   Contact  Hours  per  Theatre  per  Day  

Dr Name Leave Type From Date To Date Current Date Days Approved Days Used Days Remaining Year Month Week Number

DAVID COOK ANNUAL LEAVE 01/07/2015 09/08/2015 7/30/2015 39 -29 10 2015 Jul-15 27RUTH BOLLARD ANNUAL LEAVE 10/07/2015 10/08/2015 7/30/2015 31 -20 11 2015 Jul-15 28RUTH BOLLARD-STANDARD

ANNUAL LEAVE 10/07/2015 09/08/2015 7/30/2015 30 -2010 2015 Jul-15 28

KARIN ANNERTZ LEAVE WITHOUT PAY

20/07/2015 02/08/2015 7/30/2015 13 -103 2015 Jul-15 30

NIALL MCCONCHIE

CONFERENCE 26/07/2015 30/07/2015 7/30/2015 4 -40 2015 Jul-15 30

CHANTELLE STUBNA

ANNUAL LEAVE 27/07/2015 16/08/2015 7/30/2015 20 -317 2015 Jul-15 31

SUSIE FOX ANNUAL LEAVE 29/07/2015 29/07/2015 7/30/2015 0 -1 -1 2015 Jul-15 31IRUKA KUMARAGE

ANNUAL LEAVE 29/07/2015 29/07/2015 7/30/2015 0 -1-1 2015 Jul-15 31

JOHN DILLON ANNUAL LEAVE 06/08/2015 06/08/2015 7/30/2015 0 7 7 2015 Aug-15 32ANDREW LOWE ANNUAL LEAVE 08/08/2015 16/08/2015 7/30/2015 8 9 17 2015 Aug-15 32JOHN DILLON ANNUAL LEAVE 10/08/2015 13/08/2015 7/30/2015 3 11 14 2015 Aug-15 33BRUCE STEWART ANNUAL LEAVE 10/08/2015 17/08/2015 7/30/2015 7 11

18 2015 Aug-15 33

Doctor  Leave  Report  

Emergency  Theatre  Booking  System  &  Time  to  Surgery  

UR Op Date Anaes Time

Surgeon ED Date ED Time

Theatre Hrs

ETBS Booking Confirmed

ED-Theatre

Hrs

Admission Unit

471468 22/07/2015 18:40 Robert FORSYTH - STANDARD

20/07/2015 12:39 0.83 21/07/2015 08:12 54.02 UROLOGY

471415 23/07/2015 15:10 SCOTT JOSEPH MASON 18/07/2015 11:55 1.15 19/07/2015 08:17 123.25 ORTHOPAEDIC128899 23/07/2015 22:05 JOHN DILLON 15/07/2015 06:54 0.78 22/07/2015 20:32 207.18 ORTHOPAEDIC419988 24/07/2015 13:55 EMERGENY -THEATRE 19/07/2015 10:02 2.58 21/07/2015 22:27 123.88 ORTHOPAEDIC471416 24/07/2015 20:27 KONTOKU SHIMOKAWA 18/07/2015 12:01 2.80 22/07/2015 13:40 152.43 GENERAL SURGERY128899 26/07/2015 09:30 ANURUBAN AMBIKAIPALAN 15/07/2015 06:54 1.17 25/07/2015 12:35 266.60 ORTHOPAEDIC238353 28/07/2015 12:55 RICHARD MCMULLIN 25/07/2015 08:07 1.00 27/07/2015 16:43 76.80 ONCOLOGY172080 28/07/2015 16:28 TOM FISHER - STANDARD 25/07/2015 04:20 0.48 28/07/2015 15:17 84.13 GENERAL SURGERY276554 28/07/2015 21:21 DANIEL WONG 26/07/2015 10:22 0.90 28/07/2015 09:01 58.98 GENERAL SURGERY

Emergency  Theatre  Booking  System  &  Time  to  Surgery  

It  is  the  ED  Time  to  Surgery  that  is  looked  at  and  if  >48  hours  it  is  reviewed  

Polypectomy  Rate    Rate  to  be  calculated  from  Principal  Procedure                                                                                      32093-­‐00  ____________________________________________  32084-­‐00+32084-­‐01+32090-­‐00+32090-­‐01+32093-­‐00  

Calcula;on  of  Polypectomy  Rate  

Polypectomy  Rates  

Readmission  Report  March  3rd  –  March  13th  

Discriminators  •  Number  of  days  •  Unit  •  Procedure  code  •  DRG  Code  

 

Click  and  it  expands  

Readmission  Report  March  3rd  –  March  13th  

Provides  details  of  Procedure/Diagnosis  associated  with  the  

admission  

Readmission  within  30  Days  Report    March  3rd  -­‐    

Time  Line  Report  

On-­‐the-­‐Day  Cancella;ons  

See  next  slide  

First  Case  Start  Times  

Contact  Hours  Busy  >250  –  Quiet  <200  

From  this  report  you  can  work  out  the  session  u;lisa;on  for  a  year  

All  Sessions  excluding  Emergency  Theatre  and  A`er  Hours  

15  %  of  our  allocated  sessions  are  cancelled  for  leave  and  other  reasons  

By  Surgeon

Proc  Count Avg  Surg  Dur  (Mins) Avg  The  Dur  (Mins)   Avg  LoS  (Days) Est  LoSP ro c ed ur a l i s t   1 26 119 180 7.17 2.96P ro c ed ur a l i s t   2 62 108 162 4.31 3.08P ro c ed ur a l i s t   3 44 85 127 6.87 5.32P ro c ed ur a l i s t   4 30 112 161 3.96 3.23P ro c ed ur a l i s t   5 27 104 157 4.37 3.56P ro c ed ur a l i s t   6 22 109 157 3.55 2.68Total 225 105 157 5.63 3.54

49318-­‐00Total  arthroplasty  of  hip  unilateral

Top  20  Procedure  DurationsWhen  you  drill  down  you  will  

find  one  pa;ent  who  developed  an  infec;on  with  an  extended  

length  of  stay  

In  Summary    Ballarat  Health  Service  has  developed  a  range  of  Dashboard  Reports  which  provide  relevant  and  ;mely  informa;on  rela;on  to  the  ac;vity  of  Periopera;ve  Services.    The  reports  are  accessed  daily,  weekly  and  monthly  with  the  data  used  in  local  workplace  area  to  the  Board.  It  has  helped  enormously  in  suppor;ng  business  cases  and  aArac;ng  funding