Audit Name: Avoidable Days Audit™

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Purpose of the audit

The Avoidable Days Audit™is a service offering developed to identify the causes of issues that drive avoidable days of care (days of care beyond medical necessity) derived from 4 key areas:

• Challenges in placing patients efficiently
• Challenges in organizing and prioritizing care
• Challenges in defining appropriate DRG upon admission
• Challenges in administering consistent plans of care

As well as improving patient satisfaction the audit (and recommendations derived from the audit) is intended to improve:

• Length of Stay
• Labor dependence (the amount of labor needed to care for current patient volumes)
• Rates of avoidable infection
• Throughput
• Occurrence of denials
• Work-burden on physician and ancillary staff
• Physician satisfaction

Audit Methodology

During the Avoidable Days Audit, Workforce Prescriptions (WRX) examines over 30 unique sources of delays in care/discharge, their frequency and their impact on both length-of-stay and overall financial performance including:

• Delays due to wait times for consults
• Delays due to wait times for ordered procedures
• Delays due to wait times for signed discharge orders
• Delays due to wait times for placement to LTC/SN facilities
• Delays due to the provision of unnecessary care
• Delays due to wait times for beds/internal transfers

The Avoidable Days Audit™gathers 3 kinds of data encompassing over 1,000 distinct data-points:

• Quantitative data (through online data requests)
• Qualitative data (through onsite interviews)
• Statistically driven data (through 2 online surveys)

WRX then compares all the datasets to differentiate between correlations and root causes. We only report back on issues that have a minimum of 3 points of data redundancy. This eliminates, "chasing after cultural ghosts" and saves time in implementation.

Audit Process

A standard Avoidable Days Audit™ consists of 7 distinct steps:

1. Initial data request including on-line surveys (Quantitative Information Gathering) managed through WRX client portal.
2. Clarification calls with CLIENT project lead and appropriate departments
3. 2 man days on-site visit for additional information gathering (Qualitative Information Gathering)
4. Perform initial recapture analysis (Quantitative Analysis)
5. Clarification call of preliminary findings with key stakeholders(Qualitative Analysis)
6. Initial presentation of reports by phone to key stakeholders (Scaling & Tuning Conversation)*
7. Final 1 day on-site meeting to present findings and recommendations to different constituencies

A standard Avoidable Days Audit™ requires 7-9 weeks:

1. 2-3 weeks for initial data exchange
2. Followed by 1 day onsite to perform interviews, introduce the data portal and launch surveys.
3. The survey period typically requires 3-4 weeks
4. Followed by 10 days of off-site analytics
5. A "preview call" is scheduled for 4-5 weeks after the onsite day
6. A final presentation of findings & introduction to implementation meeting occurs within 2 weeks of the preview call

Audit Outputs

A Avoidable Days Audit™ results in the production of 2 reports:

• The State of the Union report that details identifies root causes and contributing factors to both avoidable hours & avoidable days of care.
• The Implementation Strategy report that provides actionable recommendations for creating change sensitive progress against organizational goals.

WRX follows the philosophy of, "Staying in the game" with customers. We build detailed implementation plans based on our assessment of your organizations change readiness and current systems. We create a customized roadmap built from lessons learned during implementations in over 150 other facilities. We charge a minimal 1 time fee for implementation and continue to work with a customer for a period of up to 12 months to ensure the success of both firms (although standard implementation time is 90 days).

Audit Guarantee

WRX guarantees that it will identify a minimum of $1,000,000 in annual recapture opportunities.