Driving Precision in Neonatal Data

Evora partnered with a leading tertiary specialist hospital in Victoria, which is primarily funded through NWAU (National Weighted Activity Units) for both admitted and non-admitted services. As a long-term partner, Evora played a critical role in guiding the hospital through the complex transition from the WIES to NWAU system. This transformation involved integrating the NWAU technical specifications into the hospital's data warehouse, enabling seamless reporting and analytics by consolidating data from multiple clinical and administrative systems.

One standout achievement came during the 22/23 financial year, when Evora uncovered significant changes in NWAU calculations impacting Neonatal care—one of the hospital’s primary service streams. These changes introduced a new classification category for “Partially Qualified” babies, moving away from the traditional binary system of qualified/unqualified admissions.

Evora collaborated with a multidisciplinary team comprising Health Information Managers (HIMs), costing specialists, and Neonatal Nurse Unit Managers (NUMs) to audit over 200 neonatal admissions. This audit aimed to ensure the hospital's documentation aligned with the new classification. By comparing Electronic Medical Record (EMR) metadata and medical notes with Patient Administration System (PAS) entries, a staggering 50% variance was discovered in how these new qualifications were documented. This involved a detailed review of factors such as Care Type, Admission Status, and Qualification Status on each day.

The findings led to the development of a new, streamlined process for coders, along with the implementation of an ongoing audit schedule. Within the next audit cycle, the accuracy rate in documenting classification changes surged to 90%. The timely and precise adaptation of these changes has had far-reaching impacts, particularly in areas like:

• Quality & Safety: Correctly identifying when a Hospital-Acquired Complication (HAC) flag should be triggered based on a baby's qualification status for the day.
• Funding: Ensuring proper insurance eligibility and accurate funding based on admission status.
• Activity Data: Refining the count of patient days in acute care to support accurate reporting across critical datasets like VAED, VPDC, VCDC, and CCOPMM.

Given the hospital’s significant neonatal activity in Victoria, the accuracy of neonatal admission data is pivotal in ensuring effective reporting and decision-making across the healthcare system.

Evora’s proactive approach, combined with a commitment to accuracy and collaboration, continues to enable this health service to excel in delivering quality care, optimised funding, and impactful data-driven insights.