The Health Roundtable4-4c_HRT1215-Session_TRENTINO_CG_WA

Reporting Hospital Acquired Complications using CHADx: Our Experience

Presenter: Kevin Trentino

Royal Perth Hospital :

Innovation Poster SessionHRT1215 – Innovation AwardsSydney 11th and 12th Oct 2012

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The Health Roundtable

KEY PROBLEM

No current automated system to report hospital acquired complications to hospital executive

Little understanding of incidence of system wide hospital acquired complications and impact on patient outcomes and hospital resources locally

In seeking assistance our search didn’t identify other implementations of CHADx at the hospital level nationally

difficult to code/implement?

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AIM OF THIS INNOVATION

Report the incidence of hospital acquired diagnoses using CHADx across all inpatient discharges presenting to Storm, Altair, Titan, Titan2, Titan3.

Investigate the association of hospital acquired diagnoses with multi-day hospital length of stay, hospital costs and emergency readmissions within 28 days

Implement systems for automated CHADx reporting

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BASELINE DATA Hospital acquired complications were present in 7% of

discharges.

Multi-day discharges crude mean LoS was significantly higher for those with hospital acquired complications

After adjustment discharges with a hospital acquired complication had almost four times the mean LoS of discharges without a hospital acquired complication

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KEY CHANGES IMPLEMENTED

Developed an abstract model for implementing the CHADx classification system

Integrated into clinical activity warehouse

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OUTCOMES SO FAR

Composite CHADx flag as a measure

in our hospital business intelligence (BI) tool: analysis services cubes.

cubes refreshed daily allow users to analyse composite CHADx rates by specialty,

DRG, ward etc… Template reports have been created to quantify

incidence of specific CHADx groups and subclasses. Dashboards (including CHADx) for Wards being tested

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LESSONS LEARNT

An automated system to report and analyse complications using the CHADx model important tool to increase the awareness of system wide hospital acquired complications

small number DRGs account for a large proportion of hospital acquired complications.

These insights will assist in designing targeted approaches to reducing hospital acquired complications, improving patient safety and reducing hospital costs.

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