A mobilisation strategy for clinicians with costing data

Sandrine Dupont ^a, Philippe Lachapelle ^a

Introduction
Quebec has detailed information on the cost of health and social services provided per patient for more than 5 years now, i.e. the cost per care pathway and services (CPSS). It was implemented nationally as a basis for the implementation of activity-based financing. The CPSS is an important lever for improving the performance of the health and social services network. However, there is a challenge for this tool to become an integral part of the analyses of clinical departments in their management of the organization of services in health and social services institutions.

The departments responsible for the production and operation of the CPSS must adopt a strategy for promoting this information to clinicians. This requires popularizing the concepts of cost of production to a clientele that is not necessarily comfortable with the interpretation and use of costing data. It is also important that this data reflects its reality to obtain their adherence.

Methods
The CHU de Québec – Université Laval has developed a two-pronged strategy for the development of the CPSS.

• Individualized meeting with clinical directors with a presentation adapted to their reality
• Continuous improvement of the CPSS in collaboration with clinicians

A dashboard presenting the data of the clientele admitted by DRG has been set up.

Results
The implementation of activity-based financing in several sectors has been a good opportunity to make clinical departments aware of the importance of knowing their costs in order to be able to compare themselves with the proposed national pricing and to benchmark with comparable institutions. A presentation of the CPSS was integrated into the project team responsible for analyzing the discrepancies between the fees and the expenditures observed.

Within this context, the improvement of the CPSS, the quality of the available data remains an issue, as does the maintenance of costing expertise for the directorate responsible for the production of the CPSS. This adds to the complexity in the mobilisation efforts towards clinicians.

Discussion/Conclusions
Promoting the use of costing data (CPSS) at all levels of governance of a health institution remains a challenge. Clinicians must take ownership of this tool and become partners to improve its quality. There is a balance to be maintained between accuracy and the effort required to produce the information. This balance depends on the ability to properly target gaps in our performance. The quality of the data and the maintenance of costing expertise are the basis for producing a CPSS useful for strategic decision-making in an institution.


^a CHU de Québec-UL, Canada

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