VAHI’s Health Data Integrity (HDI) program ensures the integrity of performance and activity data reported by health services to the Department of Health and Human Services.
As part of the program, VAHI recently undertook an analysis of patient data reported to the Elective Surgery Information System (ESIS), specifically looking at the time elapsed (interval) between the clinical registration date and administrative registration date.
The results indicate opportunities for improvement, particularly for the accuracy of data reported to ESIS and the adherence to the Elective Surgery Access Policy.
The clinical registration date refers to the date of the clinical assessment where it was agreed that surgery for a patient was required, and the relevant referral paperwork for surgery was completed by the clinician.
The administrative registration date refers to the date that the health service first entered the patient on the elective surgery waiting list.
All referrals for elective surgery must be accepted or rejected within three working days of the health service receiving the completed and signed referral/consent form.
Following VAHI’s internal analysis, we wrote to 23 ESIS health services seeking information for two interval types:
- Where there were zero delays between the clinical registration date and administrative registration date.
- Where the interval was greater than 28 days.
VAHI asked for general comments and specific details for 10 sample records and responses were received from all 23 health services.
Where there were zero delays for the interval between the clinical registration date and administrative registration date, some health services commented that this was achieved mostly through efficient booking office processes and some said it was via electronic medical record functionality.
For episodes where there was a greater than 28-day delay, some health services commented that there were referral delays and process errors. The results of these delays were also dependent upon location (metropolitan or rural) and setting (for example public verses private rooms).
However, for both intervals there were widespread self-reported data entry errors, which impacts the accuracy of data reported to ESIS and the adherence to the Elective Surgery Access Policy.
Findings and the future
The findings also demonstrated that for some referrals, significant delays may be due to factors outside of the control of the health service.
To recognise this, a change to ESIS has been proposed to include a field called ‘Referral accepted date’. This will enable health services to record the date on which a completed referral is accepted by the health service. If accepted in the annual change process, this new field will also provide greater intelligence when measuring waiting list activities for both the health service and the Department of Health and Human Services.
VAHI will continue to monitor the interval between clinical registration date and administrative registration date through its HDI program.
For more information, please contact David Debono, Manager, Data Integrity, via email@example.com