Milliman Care Guidelines—delivering new models of care with exceptional results

In July 2003 Mater Private Hospital successfully trialled a three month pilot study based on the Milliman Care Guidelines.

Milliman, a United States company, had researched and developed the care guidelines using international best practice for approximately 60% of DRGs. The guidelines incorporated pre-admission hospital contact and encouraged an optimal hospital length of stay (LOS) with strong home care support where appropriate.

From this first pilot group of patients for total knee replacement (TKR) and total hip replacement (THR), the comparative results (as below) confirmed the guidelines improved patient outcomes, reduced length of stay and facilitated standardised care.

Results of the 2003 trial:

• improved patient outcomes/satisfaction
• 90% of patients contacted at pre admission
• decreased nursing documentation by 44%
• increased variance recording to 100%
• reduced LOS
• TKR decreased by 17%
• THR decreased by 27%.

Following these impressive findings, the Exceptional Models of Care at Mater (EMC@M) Program was established to implement the Milliman Care Guidelines into most specialties within all of Mater hospitals.

Giselle Caron, Team Leader EMC@M, said the evidence based guidelines take a different approach to care and focus on achieving recovery milestones and not LOS.

“Each time we have applied the Milliman Care Guidelines to a carepath, the results have consistently shown a reduction of LOS, improved patient outcomes and increased patient satisfaction,” Ms Caron said.

“By engaging the patient and the family early and providing ongoing education throughout the continuum of care, it helps with the recovery process and reassures the patient they are receiving the best possible care before, during and after their hospital stay.”