Statement of Priorities - 2017-18 Agreement between the Minister for Health and Austin Health - health.vic
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Statement of Priorities 2017-18 Agreement between the Minister for Health and Austin Health.
To receive this publication in an accessible format phone 9096 1309, using the National Relay Service 13 36 77 if required, or email ryan.heath@dhhs.vic.gov.au. Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne. © State of Victoria, Department of Health and Human Services, November 2017. ISSN 2206-7507 Available at https://www2.health.vic.gov.au/hospitals-and-health-services/funding-performance- accountability/statement-of-priorities Austin Health Statement of Priorities 2017-18 ii
Contents Background .......................................................................................................................................... 4 Strategic priorities ................................................................................................................................ 5 Government commitments ...................................................................................................................... 5 Part A: Strategic overview ................................................................................................................... 6 Mission statement .................................................................................................................................. 6 Service profile ........................................................................................................................................ 6 Strategic planning................................................................................................................................... 7 Strategic priorities................................................................................................................................... 7 Part B: Performance Priorities ........................................................................................................... 13 Part C: Activity and funding............................................................................................................... 17 Part D: Commonwealth funding contribution ................................................................................... 19 Accountability and funding requirements......................................................................................... 20 Austin Health Statement of Priorities 2017-18 iii
Background Statements of Priorities are key accountability agreements between Government and Victorian publicly funded health, mental health and ambulance services. The content and process for preparation and agreement of the annual Statement of Priorities is consistent with sections 65ZFA, 65ZFB and section 26 of the Health Services Act 1988. Statements of Priorities are consistent with the health services’ strategic plans and aligned to government policy directions and priorities. The annual agreements support the delivery of, or substantial progress towards the key shared objectives of quality and safety, good governance and leadership, access and timeliness, and financial sustainability. A Statement of Priorities consists of four parts: • Part A provides an overview of the service profile, strategic priorities and deliverables the health service will achieve in the year ahead. • Part B lists the performance priorities and agreed targets. • Part C lists funding and associated activity. • Part D forms the service agreement between each health service and the state of Victoria for the purposes of the National Health Reform Agreement. Performance expectations and mechanisms used by the Department of Health and Human Services to monitor and manage performance are described in the Victorian Health Service Performance Monitoring Framework 2017-18. High standards of governance, transparency and accountability are essential. In this context, the Victorian Government commits to publish Statements of Priorities by 1 November each year and place more data about the performance of our health system into the public domain. Austin Health Statement of Priorities 2017-18 Page 4
Strategic priorities The Victorian Government is responsible for ensuring that a wide range of health services are delivered to the Victorian community. The Department of Health and Human Services (the department) develops policy, funds and regulates health services and activities that promote and protect the health of Victorians. Through the department, the government funds more than 500 organisations to provide various health services to Victorians. Government commitments The Victorian Budget 2017–18 provides an extra $1.67 billion over four years for health, mental health and aged care services across Victoria, including: • $1.3 billion over four years from 2017-18 to respond to growing patient demand across Victoria. • $325.7 million over four years for mental health and investment in forensic mental health services. • $319.8 million over four years from 2017-18 to provide additional elective surgery funding. • $215.1 million over five years from 2016–17 to implement the recommendations of Targeting zero to put patient safety first. • Building on the investment of $526 million in November 2016, a further $26.5 million will help ambulances respond to every emergency even sooner. To support this investment, the Andrews Labor Government is funding capital projects worth $428.5 million across Victoria. This investment will support the implementation of Health 2040: advancing health, access and care - which presents a clear vision for the health and wellbeing of Victorians and for the Victorian healthcare system. Austin Health Statement of Priorities 2017-18 Page 5
Part A: Strategic overview Mission statement Vision Changing healthcare for the better through world class research, education and exceptional patient care. Values Our values guide our behaviour • Integrity - we exercise honesty, candour and sincerity • Accountability - we are transparent, responsible and answerable • Respect - we treat others with dignity, consideration, equality and value • Excellence - we continually strive for excellence Purpose Austin Health is a major provider of tertiary health services, health professional education and research in the northeast of Melbourne. Service profile Austin Health is a long established major academic public health service providing healthcare, health professional education and health research. Located in north east Melbourne, it provides a comprehensive range of acute, sub- acute, mental health, specialist clinics and outreach services to our local community. Austin Health is also the state-wide provider of a range of specialist services, some of which include: • The Victorian Spinal Cord Service • The Victorian Respiratory Support Service • The Victorian Liver Transplant Service • The state-wide Acquired Brain Injury Unit • The Psychological Trauma Recovery Service Austin Health is also renowned for its specialist work in cancer, neurology, endocrinology, mental health, infectious diseases, rehabilitation, sleep medicine, intensive care, emergency medicine and a range of other specialties. As part of a broader healthcare system, Austin Health works closely with other healthcare providers to collectively delivery a comprehensive and accessible mix of services. Austin Health is one of Victoria’s largest healthcare providers, employing over 8,000 people over several locations, including Austin Hospital, Heidelberg Repatriation Hospital (HRH), the Royal Talbot Rehabilitation Centre (RTRC) and the Olivia Newton John Cancer W ellness & Research Centre. Austin Health is an internationally recognised leader in clinical teaching and training, and is affiliated with 16 universities and 4 TAFEs. W e have a significant research commitment through Austin LifeSciences which brings together over 800 researchers and several leading research institutes: • The Clinical Departments of the University of Melbourne • The Florey Institute of Neurosciences and Mental Health • Olivia Newton-John Cancer Research Institute Austin Health Statement of Priorities 2017-18 Page 6
• Institute for Breathing and Sleep
• Parent-Infant Research Institute
• Spinal Research Institute
Our Strategic Improvement Plan has identified the following priority areas of focus to continue through
2017-18 to support achievement of our strategic priorities, address enterprise risks and support the delivery of
safe high quality patient care.
• Deliver a more consistent, structured approach to safety and quality that improves reliability and
outcomes.
• Models of care to improve care management and outcomes, particularly for patients with multiple or
complex chronic conditions.
• Partnerships with community health services, General Practitioners through the Primary Health Networks
and other providers to more effectively integrate care.
• To develop a more focused research strategy, uplifting the reputation of the precinct and positioning it to
have a greater impact.
• Develop infrastructure strategy to support reliable clinical service provision;
• Increase our capability and skills for innovation.
• Demand and flow management to ensure patients’ needs are met in a timely way, and in the most
appropriate location.
• Information systems and technology to support decision-making.
Strategic planning
The Austin Health Strategic Plan for 2013-2017 can be read at http://www.austin.org.au. A new Strategic
Plan is currently under development, and will focus on key priority areas that support better care, better
access and better health.
Strategic priorities
In 2017-18 Austin Health will contribute to the achieve ment of the Victorian Government’s co mmitments
by:
Goals Strategies Health Service Deliverables
Better Health Better Health Work with community and primary
A system geared to Reduce statewide risks health partners through Better Health
prevention as much as North East Melbourne to build healthy
treatment neighbourhoods by delivering care that
Build healthy neighborhoods supports people with complex needs
to live well. This activity will align with
Everyone understands the National Strategic Framework for
their own health and risks Help people to stay healthy Chronic Conditions and encompass
preparation for HealthLinks: Chronic
Care implementation, which will
Illness is detected and Target health gaps include:
managed early - Identifying the priority focus
by conducting
50 interviews with
Healthy neighborhoods clients / carers,
and communities General
encourage healthy lifestyles Practitioners
community and
Austin Health Statement of Priorities 2017-18 Page 7Goals Strategies Health Service Deliverables
hospital based staff
A workshop to
review results of
the interviews and
identify priorities.
- Development of an internal
business case to support the
establishment of an identified
model to commence HealthLinks
at Austin Health in 2018/19.
Develop a Primary Care Strategy to
establish Austin Health’s role in
supporting and integrating with primary
care providers to improve the health
outcomes and experiences of people
in our community with chronic and
complex needs. Commence
implementation of year one initiatives.
Implement a telehealth service in
partnership with Bendigo Health to
support and improve the health of
patients of two of our state-wide
services- the Victorian Spinal Cord
Service and the Victorian Respiratory
Support Service.
Develop an optimal care pathway for
patients in our region with lung cancer,
focusing on the identification and
implementation of strategies that will
achieve improved timeframes in the
patient pathway for referral, detection
and management of lung cancer.
Better Access Better Access Refresh the site master plan at the
Care is always there when Plan and invest Austin and Heidelberg Repatriation
people need it Hospitals with a view to developing a
plan for future investment to provide
More access to care in the Unlock innovation
better access and care. Commence
home and community
the development of a feasibility study
for operating theatre redevelopment
Provide easier access
at Austin Hospital.
People are connected to
the full range of care and
Ensure fair access Using the results of an organisation
support they need
wide innovation audit that will be
undertaken in early 2017-18, identify
There is equal access to goals and exploration activities to
care define the Austin Health approach to
innovation.
Austin Health Statement of Priorities 2017-18 Page 8Goals Strategies Health Service Deliverables
Surgical Access:
- Implement the actions from the
Day Of Surgery Admission
(DOSA) project to reduce the
number of day of surgery
cancellations for patients being
admitted for elective surgery.
- Review the referral and triage
process for patients referred for
colonoscopy to ensure
consistency of patient
management and equity of
access.
- Undertake a feasibility study for
the development of a model for
nurse led procedural sedation in
endoscopy.
Specialist Clinics Access:
- Participate in the Better Care
Victoria Specialist Clinics
partnership and commit to
support sustainable and
continuous improvement in
Specialist Clinic services,
focusing on improving access to
our Specialist Clinics within a
clinically appropriate timeframe.
- Implement telehealth functionality
that enables our medical staff to
consult with patients in their
homes in 6 Specialist Clinics
Infectious Disease
Allergy Clinic
Epilepsy
Liver Transplant
Endocrinology
Hepatology
Genetics.
Emergency Department access:
- Collaborate on a project with the
Victorian Department of Premier
and Cabinet that focuses on
linking consumer behaviour
change to achieving the diversion
of suitable Category 4 and 5
patients from the Emergency
Department (ED) to more
appropriate health care settings
and improving access for patients
requiring emergency care.
- Using a co-design approach,
review and redesign the triage
Austin Health Statement of Priorities 2017-18 Page 9Goals Strategies Health Service Deliverables
process to improve triage and
seen times for patients presenting
to ED, focusing on workflows, the
model of care, the physical triage
space and IT system support
constraints.
- Implement a proof of concept
statistical process control system
in ED to better understand ED flow
and 4-hour length of stay
performance, in light of recent
capital works.
Indigenous Health:
- Continue to implement strategies
to strengthen our capacity to
deliver culturally appropriate care
to our Aboriginal and Torres Strait
Island patients, and connect them
to the full range of care and
support available, by
Undertaking focused
training with staff who
register patients
presenting to ED and
other common hospital
entry points to maximise
patient self-identification
and improve
opportunities for
Aboriginal patients to
access the Aboriginal
Health Program
Providing reminder calls
and SMSs to Aboriginal
patients with Specialist
Clinic appointments, and
undertaking targeted
audits on this patient
group to understand the
barriers that are
preventing them from
accessing care.
- Collaborate with regional health
services, in the first instance,
Kyneton Hospital and Goulburn
Valley Health, to provide their
communities with improved
access to a high quality,
contemporary pathology service.
Austin Health Statement of Priorities 2017-18 Page 10Goals Strategies Health Service Deliverables
Better Care Better Care Undertake a gap analysis to quantify
Target zero avoidable harm Put quality first the issues and identify opportunities for
improvement in the identification and
reporting of patient safety concerns.
Join up care
Healthcare that focusses
on outcomes
To develop a more consistent and
Partner with patients
structured approach to improving
Patients and carers are outcomes and reducing harm, Austin
Strengthen the workforce Health will design a training framework
active partners in care
for up to 25 nominated staff to be
Embed evidence trained as local 'experts' in the science
Care fits together around of clinical practice improvement.
people’s needs
Ensure equal care Through the Choosing Wisely project,
demonstrate sustained reduction in
key over-ordered diagnostics where
evidence shows they may provide no
benefit, by achieving a 15% reduction
in the ordering of:
- Urine cultures
- Coagulation profiles
- C Reactive Protein.
Develop and commence implementation
of the Austin Health digital strategy.
In response to patient experience data,
improve the patient experience
through:
- The establishment of a working
group of staff and consumers to
review patient discharge
information during the transition of
care
- Implementation and evaluation of a
new revitalised menu for inpatient
meals.
Better Care Mandatory actions against Develop and evaluate a standardised
the ‘Target zero avoidable package for frontline managers to
harm’ goal: Develop and support them to deliver consistent
implement a plan to educate education to their staff on:
- Obligations to report patient safety
staff about obligations to
concerns
report patient safety
concerns. - Systems and processes that exist
to report patient safety concerns.
The results of these interventions will
be reported to and monitored by the
Austin Health Executive with a 6-
monthly statement of incident reporting
Austin Health Statement of Priorities 2017-18 Page 11Goals Strategies Health Service Deliverables
by professional group.
In partnership with Use the principles of co-design to
consumers, identify 3 priority partner with patients and their families
improvement areas using to improve the patient experience and
Victorian Healthcare the care we provide by scoping and
Experience Survey data and developing an implementation plan for
establish an improvement the following four co-design projects:
plan for each. These should - Health Independence Program
be reviewed every 6 months (HIP) Specialist Clinics review:
to reflect new areas for Exploring stakeholder experience
improvement in patient of the model of care in HIP
experience. Specialist Clinics
- ED to HIP pathway review:
Ensuring patients are referred to
HIP at the right time in their journey
- Our Patients’ Expectations toolkit:
Sharing and responding to
feedback on the Our Patient’s
Experience toolkit developed by
the Community Advisory
Committee
- Consumer led rehabilitation: Better
understanding the discharge
experience to improve the care that
we provide to rehabilitation patients
in the Mellor Unit.
Austin Health Statement of Priorities 2017-18 Page 12Part B: Performance Priorities
The Victorian Health Services Performance monitoring framework outlines the Government’s approach
to overseeing the performance of Victorian health services.
Changes to the key performance measures in 2017-18 strengthen the focus on high quality and safe
care, organisational culture, patient experience and access and timeliness in line with Ministerial and
departmental priorities.
Further information is available at https://www2.health.vic.gov.au/hospitals-and-health-services/funding-
performance-accountability/performance-monitoring
High quality and safe care
Key performance indicator Target
Accreditation
Accreditation against the National Safety and Quality Health Service Standards Full compliance
Compliance with the Commonwealth’s Aged Care Accreditation Standards Full compliance
Infection prevention and control
Compliance with the Hand Hygiene Australia program 80%
Percentage of healthcare workers immunised for influenza 75%
Patient experience
Victorian Healthcare Experience Survey – percentage of positive patient experience 95% positive
responses experience
Victorian Healthcare Experience Survey – percentage of very positive responses to 75% very positive
questions on discharge care experience
Victorian Healthcare Experience Survey – patients perception of cleanliness 70%
Healthcare associated infections (HAI’s)
Number of patients with surgical site infection No outliers
Number of patients with ICU central-line-associated bloodstream infection (CLABSI) Nil
Rate of patients with SAB1 per occupied bed day ≤ 1/10,000
Adverse events
Number of sentinel events Nil
Mortality – number of deaths in low mortality DRGs2 Nil
Mental Health
Percentage of adult acute mental health inpatients who are readmitted within 28 days of 14%
discharge
Rate of seclusion events relating to a mental health acute admission – all age groups ≤ 15/1,000
1
SAB is Staphylococcus Aureus Bacteraemia
2
DRG is Diagnosis Related Group
Austin Health Statement of Priorities 2017-18 Page 13Key performance indicator Target
Rate of seclusion events relating to a child and adolescent acute mental health ≤ 15/1,000
admission
Rate of seclusion events relating to an adult acute mental health admission ≤ 15/1,000
Percentage of child and adolescent acute mental health inpatients who have a post- 75%
discharge follow-up within seven days
Percentage of adult acute mental health inpatients who have a post-discharge follow-up 75%
within seven days
Continuing Care
Functional independence gain from an episode of GEM3 admission to discharge relative ≥ 0.39
to length of stay
Functional independence gain from an episode of rehabilitation admission to discharge ≥ 0.645
relative to length of stay
Strong governance, leadership and culture
Key performance indicator Target
Organisational culture
People matter survey - percentage of staff with an overall positive response to safety and 80%
culture questions
People matter survey – percentage of staff with a positive response to the question, “I am 80%
encouraged by my colleagues to report any patient safety concerns I may have”
People matter survey – percentage of staff with a positive response to the question, 80%
“Patient care errors are handled appropriately in my work area”
People matter survey – percentage of staff with a positive response to the question, “My 80%
suggestions about patient safety would be acted upon if I expressed them to my
manager”
People matter survey – percentage of staff with a positive response to the question, “The 80%
culture in my work area makes it easy to learn from the errors of others”
People matter survey – percentage of staff with a positive response to the question, 80%
“Management is driving us to be a safety-centred organisation”
People matter survey – percentage of staff with a positive response to the question, “This 80%
health service does a good job of training new and existing staff”
People matter survey – percentage of staff with a positive response to the question, 80%
“Trainees in my discipline are adequately supervised”
People matter survey – percentage of staff with a positive response to the question, “I 80%
would recommend a friend or relative to be treated as a patient here”
3
GEM is Geriatric Evaluation and Management
Austin Health Statement of Priorities 2017-18 Page 14Timely access to care
Key performance indicator Target
Emergency care
Percentage of patients transferred from ambulance to emergency department within 40 90%
minutes
Percentage of Triage Category 1 emergency patients seen immediately 100%
Percentage of Triage Category 1 to 5 emergency patients seen within clinically 80%
recommended time
Percentage of emergency patients with a length of stay in the emergency department of 81%
less than four hours
Number of patients with a length of stay in the emergency department greater than 24 0
hours
Elective surgery
Percentage of urgency category 1 elective surgery patients admitted within 30 days 100%
Percentage of urgency category 1,2 and 3 elective surgery patients admitted within 94%
clinically recommended time
Percentage of patients on the waiting list who have waited longer than clinically 5% or 15%
recommended time for their respective triage category proportional
improvement from
prior year
Number of patients on the elective surgery waiting list4 2,340
Number of hospital initiated postponements per 100 scheduled elective surgery ≤ 8 /100
admissions
Number of patients admitted from the elective surgery waiting list 12,590
Specialist clinics
Percentage of urgent patients referred by a GP or external specialist who attended a first 100%
appointment within 30 days
Percentage of routine patients referred by GP or external specialist who attended a first 90%
appointment within 365 days
Effective financial management
Key performance indicator Target
Finance
Operating result ($m) 0.00
Average number of days to paying trade creditors 60 days
Average number of days to receiving patient fee debtors 60 days
4
the target shown is the number of patients on the elective surgery waiting list as at 30 June 2018
Austin Health Statement of Priorities 2017-18 Page 15Key performance indicator Target
5
Public and Private WIES activity performance to target 100%
Adjusted current asset ratio 0.7 or 3%
improvement from
health service base
target
Number of days of available cash 14 days
5
WIES is a Weighted Inlier Equivalent Separation
Austin Health Statement of Priorities 2017-18 Page 16Part C: Activity and funding The performance and financial framework within which state government-funded organisations operate is described in ‘Volume 2: Health operations 2017-18 of the Department of Health and Human Services Policy and funding guidelines 2017. The Policy and funding guidelines are available at https://www2.health.vic.gov.au/about/policy-and- funding-guidelines Further information about the Department of Health and Human Services' approach to funding and price setting for specific clinical activities, and funding policy changes is also available at https://www2.health.vic.gov.au/hospitals-and-health-services/funding-performance-accountability/pricing- funding-framework/funding-policy Funding type Activity Budget ($'000) Acute Admitted WIES Public 65,484 $309,871 WIES Private 17,509 $62,056 WIES DVA 1,136 $5,681 WIES TAC 617 $2,590 Other Admitted $9,310 Acute Non-Admitted Emergency Services $30,283 Genetic services $2,836 Home Enteral Nutrition 1,293 $270 Home Renal Dialysis 67 $3,751 Radiotherapy WAUs Public 65,563 $15,211 Radiotherapy WAUs DVA 752 $216 Specialist Clinics - Public 166,910 $40,952 Specialist Clinics - DVA $2,918 Other non-admitted $2,516 Total Perinatal Nutrition 105 $807 Subacute & Non-Acute Admitted Subacute WIES - Rehabilitation Public 1,485 $15,448 Subacute WIES - Rehabilitation Private 473 $4,580 Subacute WIES - GEM Public 1,158 $12,041 Subacute WIES - GEM Private 367 $3,554 Subacute WIES - Palliative Care Public 291 $3,029 Subacute WIES - Palliative Care Private 91 $882 Subacute WIES - DVA 135 $1,701 Transition Care - Bed days 7,665 $1,165 Transition Care - Home days 10,585 $593 Subacute Admitted Other $7,218 Subacute Non-Admitted Health Independence Program - Public 72,031 $16,365 Austin Health Statement of Priorities 2017-18 Page 17
Health Independence Program - DVA $14 Victorian Artificial Limb Program $883 Subacute Non-Admitted Other $8,279 Subacute & Non-Acute Other Other specified funding $344 Aged Care Aged Care Assessment Service $1,106 Residential Aged Care $0 Mental Health and Drug Services Mental Health Ambulatory 58,052 $23,101 Mental Health Inpatient - Available bed days 39,083 $26,629 Mental Health Inpatient - Secure Unit 9,131 $5,132 Mental Health Service System Capacity $553 Mental Health Subacute 16,437 $7,382 Mental Health Other $15 Drug Services 140 $1,647 Primary Health Community Health Other $7 Other NFC - Transplants - Paediatric Liver 7 $2,141 Health Workforce 290 $13,464 Other specified funding $10,001 Total Funding $656,538 Austin Health Statement of Priorities 2017-18 Page 18
Part D: Commonwealth funding contribution
The Victorian health system has faced a number of changes to Commonwealth funding since
2012–13. The changes to the funding arrangements announced in the 2014–15 Commonwealth
Budget will continue to be applicable for the period 1 July 2017 to 30 June 2018 with funding
continued to be linked to actual activity levels.
The Commonwealth funding contribution outlined the 2017–18 Commonwealth Budget was based on
estimates and has since been updated by the Administrator of the National Health Funding Pool,
based on latest activity estimates from States and Territories. However, given that final funding
amounts are based on actual activity, there may be adjustments to funding throughout the year as a
result of reconciliations and other factors outlined below.
Period: 1 July 2017 – 30 June 2018
Service category Estimated Total funding ($)
National
Weighted Activity
Units (NWAU17)
Activity based Acute admitted services 88,865.80 560,141,692
funding
Admitted mental health services 5,930.54
Admitted subacute services 10,154.98
Emergency services 11,603.55
Non-admitted services 41,751.21
Block Funding Non-admitted mental health services - 50,478,961
Teaching, training and research
Other non-admitted services
Other Funding - 42,153,266
Total 158,306.07 652,773,919
Note:
• Estimated National Weighted Activity Unit may be amended by the Department following the
finalisation of the 2016–17 reconciliation by the Administrator of the National Health Funding Pool.
• Activity loadings are included in the Estimated National Weighted Activity Units (i.e. Paediatric,
Indigenous, Remoteness, Intensive Care Unit, Private Patient Service Adjustment, and Private
Patient Accommodation Adjustment).
• In situations where a change is required to Part D, changes to the agreement will be actioned
through an exchange of letters between the Department and the Health Service Chief Executive
Officer.
Ambulance Victoria and Dental Health Services Victoria do not receive a Commonwealth funding
contribution under the National Health Reform Agreement. Dental Health Services Victoria receives
Commonwealth funding through the National Partnership Agreement.
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