“INTERVENTIONAL DAY UNIT” – A SOUTH WESTERN SYDNEY LOCAL HEALTH DISTRICT (SWSLHD) OUTPATIENT SERVICE INITIATIVE. REDESIGNING RENAL SERVICE DELIVERY

J.K. WONG1, I DE GUZMAN1, A MAKRIS1, T.S. SPICER1, M LI DONNI1

1Liverpool Hospital, SWSLHD, Sydney, Australia

Aim: Examine the impact and cost-benefit of implementation of this model of care which commenced a four bedded/chair area within the Satellite dialysis unit, operating three days a week. Existing management and administration services were utilised. Funding was provided through capturing of billing opportunities and generation of revenue.

Background: Many renal patients require day only procedures or treatment including: biopsies, access procedures including insertion of Tenckhoff catheters and tunneled vascular catheters requiring pre and post procedural care, and salt, iron and chemotherapeutic infusions. With general hospital ambulatory services increasingly difficult to access, and increasing demand from renal patients in the South-Western Sydney Local Health District (SWSLHD) resulting in delayed diagnostic and therapeutic interventions an interventional day unit was developed.

Methods: Retrospective review of episodes of care and funds generated from October 2015-October 2016 in the interventional day unit

Results: From the introduction of the service, 432 outpatient procedures and treatments were performed in the first year, and an additional 41 procedures were conducted on “inpatients” which could not be billed. The revenue generated was greater than the service cost. Revenue exceeded $104,000. The cost of the workforce was $95,663.36 – a net gain of over $8,000. At least 163 inpatient admissions were avoided by this implementation, a further cost saving to the health service.

Conclusions: The renal interventional day unit has been innovative in providing service delivery to renal outpatients in the SWSLHD. This self-funded initiative incorporated existing services successfully and provided expeditious, specialized care and services and access to treatment. Additionally, the avoidance of unnecessary admissions and/or delayed discharges and streamlining patient journey into dialysis pathways was achieved.

About ANZSN

The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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