Case Study: Bridging the Gap
How an in-depth analysis helped create a much-needed palliative care ward
Overview
A regional hospital was planning to establish a dedicated palliative care inpatient ward. But first, the hospital needed to understand the likely need for this service to estimate the number of beds required.
At the time, there were no dedicated palliative care beds in the region. This meant no single dataset could be analysed to identify the level of community need for the new ward.
The hospital needed insight into the current demand for inpatient palliative care and how this may change in the future. It also had to know staffing requirements and the number and type of beds required.
Comprehensive data collection and analysis were crucial for a robust case to plan this new ward. So, the hospital engaged the Guardian Actuarial team.
Key Issue
Analysis to understand the current and future needs for designated palliative care beds, including an estimate of beds required and the consideration of admission criteria.
What was required to solve the problem?
Data discovery across all sources, including de-identified organisation-level data and publicly available sources. This enabled a robust and complex analysis to establish need and provide a foundation of data for the business case.
Our Process
Initial session: Understanding the problem
We met with Jenny*, the director leading the development of the new ward. She helped us understand what data was available and what we would need to find. She also connected us with key staff members currently delivering palliative care services who would also be involved in the new ward.
Collect and review data: Clarifying need
Analysis of quantitative data is best done with a single, clean dataset. However, in this situation (as is often the case when planning for a new service), a single dataset of people needing the palliative care service did not exist. To complete the analysis, we collected multiple datasets and used research to inform assumptions when data did not exist.
We examined:
Publicly available population and deaths data, including population projections
De-identified community palliative care services data
De-identified hospital deaths data
Research on palliative care services and inpatient needs for various population groups and sizes
Validate initial findings and agree on assumptions: Working with staff
The Guardian Actuarial team specialises in data analysis and modelling for health and human services providers. However, we know from experience that we can provide the most robust analysis when we agree on assumptions and validate our findings with practitioners closely involved in the planning and delivery of these services.
In this case, we worked with palliative care team members to understand any nuances in the de-identified hospital data. We also reviewed and agreed on assumptions about ward occupancy and expected patient throughput based on current hospital practice, expected admission practices, and Australian and international research and practice.
Actuarial modelling: Calculating estimates
Once the data had been reviewed and assumptions about expected ward occupancy and patient throughput had been agreed upon, we calculated bed number estimates for now and into the future.
Additionally, we used scenario analysis to estimate bed numbers for several possible scenarios, depending on the ward’s admission criteria and actual usage.
Our analysis of the combined data also provided some interesting insights, including the large number of patients dying in the emergency department. This provided further evidence to support the need for a dedicated inpatient ward.
Reporting: Presenting solutions
We provided Jenny and her team with an independent report outlining our estimates for the number of beds needed on the new palliative care ward. Our report included all the data we had reviewed and analysed, all assumptions used in the modelling, and all research sources.
The hospital used our independent report to create a plan for the ward, which is now officially open to the community.
Finding a community need
Jenny and her specialist staff knew that their patients would use dedicated palliative care inpatient beds if they were available. However, there was no readily accessible data to estimate the number of beds required to service the region.
We reviewed the hospital’s de-identified dataset and supplemented this with publicly available data and research. This was validated by professional judgement, giving a clear picture of the community’s need for the ward.
Our independent report outlined estimates under several scenarios, which were used to support the planning of the ward.
This ward is now operational and supports people in the region needing inpatient palliative care services.
From
A lack of information to estimate the number of beds required, despite there being a clear need for the service.
To
Well-informed and researched estimates that addressed all areas of consideration.
*Names have been changed to protect client confidentiality.
