Training practitioners in activity-based funding best practice

The provision of hospital and healthcare services occurs in one of the most complex organisational structures, which, while embracing continuing change in clinical practice, has concomitantly resisted change in the management functions of those services. The introduction of activity-based funding (ABF) has provided a significant challenge to healthcare management teams, which, faced with continuing budget restrictions and spiralling healthcare provision costs, have been forced to reconsider the design of healthcare management systems. The basis for ABF is the management of activity in the most efficient manner possible across the entire organisation. This requires a whole team approach that extends beyond the clinical service delivery team. Healthcare funding models are complex and there are few (if any) people in the organisation who have a full understanding of the entire patient journey through the system and who can conceptually relate that information to the design and implementation of that funding model. Clearly, in addition to a whole team approach to the challenges of health reform, organisations must invest in education and training. Using an ABF best practice model, this paper discusses how we can better educate the whole team, build skills required in each specialty domain and how we can work together in the identification of opportunities for improvement, from their initial analysis, through to practice change planning, implementation and monitoring.