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Count Me In: To Improve Patient Care

Hunter New England Local Health District
Project Added:
4 December 2014
Last updated:
8 December 2014


Without clearly documenting non admitted patient activity, the District will never be able to fully describe the importance of clinical care provided to patients who are not formally admitted to hospital. How they help keep people healthy and in the community and how they assist in providing advice and treatment options for patients and their carers that do not revolve around physically being in a hospital.

Download a poster about this project from the Centre for Healthcare Redesign graduation, December 2014.


To accurately collect all non-admitted patient activity data at Belmont Hospital and John Hunter Children’s Hospital Oncology and Haematology Day Clinic to ensure the efficient use of resources and improve equity of access and service delivery.


By looking closely at the services we provide to patients and the resources we use to provide them, we can empower our health workforce to:

  • work together to make decisions that are best for patient care by minimising waste, repetition and delays in the patient journey
  • innovate and improve models of care to meet changing healthcare demands
  • understand the complexity of patient needs by learning about the decisions and actions we make for patients at every point in their care
  • find trends, patterns, gaps and inefficiencies in the way we deliver care for individual patients and for whole services
  • embrace innovations which make a difference to our patients. Data transparency can help health services deliver evidence based best practice care leading to improve outcomes for patients.


  • In 2013/14 HNELHD spent around $400 million on non-admitted patient activity. This represents 23% of total expense.
  • Each year HNELHD provides around 4 million patient services, which must be captured across numerous data collection systems.
  • Currently, capturing accurate activity data across data collection systems is challenging. Furthermore there was no easy way for clinicians to view data about the services they were providing.
  • In 2012 Activity Based Funding (ABF) was introduced across Australia as part of the Commonwealth Government Reforms. The activity data HNELHD collects and reports is used to assist the NSW Ministry of Health and the Independent Hospital Pricing Authority to divide funding among NSW Local Health Districts.


1. Easy to access datasets

The District has developed a suite of corporate reports using NSW Ministry of Health data. These reports contain de-identified data that can be used by clinicians, managers and researchers to make informed decisions about patient care.

2. Guidelines for establishing new clinics

A guideline has been developed which standardises the way we establish new clinics looking at issues such as clinical appropriateness, efficiency and costing structures.

3. Enhancing data capture

An enhancement to the HNE Health patient administration system has streamlined the process for creating patient appointments freeing up time for clinicians to spend in direct clinical care.

4. Knowledge sharing

A new intranet site has been developed to assist HNE Health staff learn about the importance of data collection and how to ensure data quality.

A staged approach to implementation will occur over 12 months across all 65 HNELHD facilities.

Implementation sites

  • Belmont Hospital
  • John Hunter Children’s Hospital


To date the Project has contributed to:

  • reduced waste through implementation of efficient data collection processes
  • informed local decision making on the location and types of services required for our patients
  • transparency in service funding as the District can now account for the health dollars that are spent

Lessons Learnt

  • Accurate, complete data is central to be able to make informed, quality decisions.
  • Systems and processes need to be in place to assign accountability and ensure local ownership over datasets.
  • When this occurs all staff contribute to effective decision making on key areas including; clinical need, evidence based model of care development, service evaluation, patient demand planning; conformity to facility role delineation, workforce planning and availability and consideration of resource use.
  • Success will ultimately be determined by the District’s ability to report against key measures in the NSW Service Agreement as well as the ability to monitor waitlist data for non-admitted patients.
  • This will impact on the development of effective clinical pathways and improving access to care for our patients.


Karen Kelly
Director Nursing and Midwifery
Hunter New England Local Health District
Phone: 02 4925 5363

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