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WWL Finance and Musculoskeletal Teams win HSJ Award

Newsdate: 21 September 2011

WWL Finance Department and Musculoskeletal (MSK) Division were celebrating last week as they won the ‘Efficiency in Financial Services’ category of the inaugural Health Service Journal (HSJ) Efficiency Awards. Claire Jacobson (Head of Strategic Financial Planning and Development), Nick Jones (Deputy General Manager MSK) Kelly Knowles (Costing Accountant) and Professor Raj Murali (Orthopaedic Consultant).

The awards identify and reward the organisations that have delivered tangible improvements in healthcare efficiency and cost savings (while maintaining the highest levels of patient care).
Alastair McLellan, Editor of HSJ, commented on the evening:  “We have been massively encouraged...by the success of the first year of the awards. We received over 320 entries and shortlisted 84 of them.
There are 70 NHS, private and third sector organisations represented in this room tonight. Every one of them has demonstrated a commitment to achieving efficiency which should inspire the rest of the service. Every one of them should be very proud of what they achieved. Everyone deserves congratulations.”

The Service Line Management project was carried out collaboratively between Finance and Musculoskeletal clinical teams working using the Service Line Reporting tool to understand clinical practices and move a service line from loss to profit making.

Primary total prosthetic replacement of hip joint is the most common procedure performed at Wrightington Hospital.  The MSK Division operate on over 10,000 patients per annum from all across the UK, delivering excellent clinical outcomes.  However, in service line reporting terms we were showing a loss of £1 million per annum.  This procedure is the most common carried out in the division and should have been profitable.

The project team used Service Line Reporting to analyse all areas of the procedure to determine where cost savings can be made. This involved looking at the following areas:

  • Is there a consultant variation, i.e. are some consultants carrying out the procedure at a higher cost than others
  • Is the loss linked to Length of Stay (LOS)
  • Is the loss linked to Anaesthetist
  • Is the loss linked to time in theatres
  • Does site affect time in theatres
  • How does time in recovery affect the loss
  • Is the loss linked to prosthesis
  • Is the loss linked to radiology
  • Does admission day affect LOS
  • Does procedure day affect LOS
  • Is the loss linked to pre-op bed days
  • Number of discharges per day
  • Coding opportunities

The overall conclusions were that radiology, anaesthetics, theatre time, recovery time, length of stay and pre-op bed days are all having an effect on the losses being made for this procedure. An action plan was developed to determine how practices can change in order to make cost savings in these areas and Key Performance Indicators were agreed to measure the progress.

This initiative was the first of its kind and is unique to WWL.  This framework will be rolled out to other Musculo-skeletal procedures e.g. primary knee and will result in further efficiency savings and improvements to quality of care and patient experience for the division

Maintaining excellent outcomes and the highest quality of care has been at the forefront of this project. The procedure pathway has been standardised to ensure that patients receive the best quality care and experience, e.g. no unnecessary radiology/pathology tests and being discharged when medically fit.

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