Non-Urgent Patients waiting more than 365 days for an initial specialist outpatient services
INDICATOR: SSA112 Previous ID: 9C7, 0023
Elective Surgery Theatre Utilisation: Operating Room Occupancy (%)
Theatre Utilisation For Elective Sessions measured as operating room occupancy (previously known as “planned surgery utilisation”) Service Agreement Type
Performance Area Status
Version number
Service Measure
Service Access and Patient Flow Final
1.1
Scope Patients treated in dedicated elective theatre sessions.
Goal Maximise the productivity of operating theatres in hospitals, reduce cancellations and improve the flow of patients through the hospital.
Desired outcome Efficient access and throughput for emergency and elective surgery patients and reduction in waiting lists.
Primary point of collection Operating Theatres
Data Collection Source/System Patient Administration System (PAS), Operating Theatre Systems, e.g.
SurgiNet, Manual Collection.
Primary data source Provided directly by LHDs and Networks to Ministry of Health.
Indicator definition The percentage of time allocated to elective theatre sessions where the operating theatre (operating room) was occupied by surgery patients receiving active treatment.
Numerator
Numerator definition The sum of ([Patient out of (operating theatre/operating room) date/time] – [Patient in (operating theatre/operating room) date/time]) for all patients treated during an elective theatre session.
Note:
• When a patient enters the operating theatre/operating room (within the Theatre suite) before the session start time, the actual session start time should be treated as the [patient in room date/time] for this indicator.
• The time spent in the theatre suite but not in the operating
theatre/operating room before the session start time is considered “out-of-session” time.
• Patient in room time commences when the patient physically enters the operating theatre/operating room assigned to the elective session. This applies even when an anaesthetic or other procedure is commenced prior to the patient entering in the operating theatre/operating room.
• Similarly, when a patient leaves the theatre operating room after the allocated session end time, the session end time should be treated as the [patient out of room date/time] for this indicator. (The time spent in the theatre after the session end time is considered “out-of-session” time.) Numerator source Operating Theatre System
Numerator availability Variable across sites Denominator
Denominator definition The time allocated to elective theatre sessions.
Denominator source Operating theatre data collection Denominator availability Variable across sites
Inclusions Elective or non elective patients treated in operating theatres during elective sessions.
Exclusions • Surgery performed outside elective surgery session.
• Periods of anaesthesia that occurred outside the operating room allocated to the session.
Targets 80%
Comments • This indicator is intended as a measure of operating theatre/operating room use during sessions routinely allocated for elective surgery only.
Activity performed outside of the operating theatre/operating room and these sessions is not included in the indicator.
• The indicator specifically relates to the time the patient is physically in the operating theatre/operating room, if the patient is anaesthetised outside the actual operating theatre/operating room, (e.g. in the anaesthetic bay/room) before the patient enters the theatre, the time is NOT counted towards utilisation of the session.
Context In order to estimate operating theatre productivity and efficiency, a number of performance indicators are required. Surgery cannot be performed without a number of support activities, which need to be viewed in combination for a true picture of utilisation to be obtained. Operating theatre/operating room,
occupancy during elective session hours is just one of a number of indicators of theatre utilisation.
Related Policies/ Programs • Clinical Services Redesign Program
• Waiting Time and Elective Surgery Policy 2012
• Operating Theatre Efficiency Guidelines (December 2014) Useable data available from Variable across site. State-wide collection commenced June 2006 Frequency of Reporting Monthly
Time lag to available data Reporting required by the 10th working day of each month, data available for previous month
Business owners System Relationships and Framework Branch
Contact - Policy Director, System Relationships and Framework Branch
Contact - Data Executive Director, Health System Information and Performance Reporting Representation
Data type Numeric
INDICATOR: SSA113, SSA114 Surgery for Children - Proportion of children (0 to 16 years) treated within their LHD of residence:
• Emergency Surgery (%) (SSA114)
• Planned Surgery (%) (SSA113) Service Agreement Type
Performance Area Status
Version number
Service Measure
Service Access and Patient Flow Final
1.1
Scope All acute admissions of Children from 0 up to 16 years of age.
Goal Greater certainty concerning the amount of activity to be performed in a year.
Desired outcome To improve and monitor the proportion of children receiving appropriate planned surgery within the LHD of residence. To document, monitor and increase capacity to undertake emergency surgery for children within the LHD of residence.
Primary point of collection Patient Medical Record
Data Collection Source/System Hospital PAS systems, Admitted Patient Data Collection, Primary data source for analysis HIE
Indicator definition The percentage of LHD resident aged 0 to 16 years who had a surgical procedure and that surgery was performed at a facility in their LHD of residence. Reported by:
• Emergency: Urgency of admission “1” = Emergency
• Planned: Urgency of Admission = “2”, “3”, “4” or “5”
Numerator
Numerator definition Number of surgeries undertaken at LHD of residence where:
• The count is based on patient stays (ie formal admission to formal discharge) not episode
• Surgical DRGs are assigned based on the first episode of care and recorded using AN-DRG surgical partition, version 5.2 AN-DRGs
Numerator source HIE
Numerator availability Coded data available 2 months after the end of the period of measurement.
Denominator
Denominator definition Total number of surgeries for LHD residents x 100 Denominator source HIE
Denominator availability Coded data available 2 months after the end of the period of measurement.
Inclusions • Acute episodes (care type 1 or 5)
• Episode end date within the period
• All facilities performing surgery
• All children aged 0 to 16 years (cutoff is the child’s 16th birthday)
• LHD of residence of the patient is based on the SLA of the patient and the December 2010 boundaries
Exclusions • Children 16 years and older
• interstate patients/interstates hospitals
• Justice Health / Forensic Mental Health Network patients Targets
Target N/A
Context
Related Policies/ Programs “Surgery for Children in Metropolitan Sydney – Strategic Framework”
Useable data available from 2001 Frequency of Reporting Monthly Time lag to available data 6 – 7 weeks
Business owners NSW Kids and Families
Contact - Policy Director, NSW Kids and Families
Contact - Data Executive Director, Health System Information and Performance Reporting
Representation
Data type Numeric
Form Number, presented as a percentage (%)
Representational layout NNN.N
Minimum size 3
Maximum size 4
Data domain
Date effective July 2013
Related National Indicator N/A
Service Agreement Type Performance Area Status
Version number
Service Measure
Service Access and Patient Flow Final
1.0
Scope Acute admitted patients, all public hospitals
Goal To monitor and manage Health Services
Desired outcome High quality patient outcomes and effective service management Primary point of collection Patient Medical Record
Data Collection Source/System Hospital PAS system, Admitted Patient Data Collection Primary data source for
analysis HIE/IQ server.
Indicator definition The average number of patient days for admitted patient episodes during the reporting period. Patients admitted and separated on the same day are excluded.
ALOS_episodes = sum of episode_length_of_stay / Number of episodes
Average length of episode stay (ALOS) is computed by dividing the total number of in-patient hospital days , in all hospitals, counted from the date of admission to the date of discharge by the total number of discharges (including deaths) in all hospitals during a given period. A hospital day (or bed-day or in-patient day) is a day, during which a person admitted as an in-in-patient, is confined to a bed and stays overnight in a hospital.
Numerator
Numerator definition Sum of all patients episode length of stay in the period.
Episode_length_of_stay is the difference from episode_end_date , episode_start_date minus leave_days
• Where length of stay of a patient measured in days
• The calculation is inclusive of records with admission and separation dates.
• Total contracted days are included in the length of stay.
• All leave days are not included in length of stay calculation.
Numerator source HIE (Facility and Episode Table)
Numerator availability Fed to HIE weekly but data entry into source systems may not be up-to-date.
Denominator
Denominator definition The total number of completed patient episodes in the reporting period.
INDICATOR; SSA116