The research paper will based on the attached Case 15: Australian Surgery Indicator Makes the Front
*You are only using the one case you selected to write your analysis throughout the entire paper.
*You then have to apply four of the seven policy analysis below to the case you selected.
Here are the seven policy analysis:
Policy Analysis Process of Identification & Definition
Policy Analysis Process of Health Technology Assessment
Policy Analysis Process of Evidence-Based Medicine
Policy Analysis Process of Evaluation of Political Feasibility
Policy Analysis Process of Evaluation of Economic Viability
Policy Analysis Process of Analysis of Values
Implementation Strategy and Planning
*Following this analysis, describe how the three processes you didn’t select could be applied to the
case, and provide a rationale (reason) for their application.
* All seven processes will be used in your paper, but fully analyzing the application of four. Doing so
helps to ensure that you’re meeting a key element of the assignment directions, which is to include
“all applicable information from previous weeks.”
*The paper is to be at least 8 pages in length, including title and reference pages; include the name of
the case you selected in the title of the paper; have a conclusion, summarizing the key points of your
health policy analysis, and must begin with an introductory paragraph, describing the topics to be
covered in your paper.
*You are also to use section headings throughout your paper.
*The paper must include a minimum of 8 scholarly resources. At least one from textbook (McLaughlin
and McLaughlin (2014) textbook).
Please read the Case below and address the following questions in minimum of 250 words
1. Do the conclusions you draw from the case justify the headline? Why or why not?
2. Discuss the indications found in Table 15-1 and their effect on the health care organizations
efficiency in elective surgery.
3. Evaluate the avoidable rate of canceled surgeries and develop an implementation plan to
overcome the concerns.
4. Develop a mini policy to address the issues between the doctors and the organization.
Australian Surgery Indicator Makes the Front Page
The front page of the Sydney Morning Herald of February 28, 2011, carried an exclusive headlined,
“Thousands Hit as Hospitals Cancel Surgery” (Wallace, 2011). It cited public records from NSW Health,
the ministry responsible for monitoring New South Wales’ state health system. The records indicated
that same-day surgery cancellations were “occurring regularly at three times the accepted standard.”
Many patients showed up at public hospitals operated by area health services expecting to go into the
operating room, only to be sent home after fasting and having blood samples sent to the lab. In many
instances, surgeries were canceled because the hospitals did not have beds waiting for the patients after
their surgeries. The article noted that the ministry’s “Surgery Dashboard,” a monthly snapshot of key
performance indicators, sets a target of less than 2% for surgery cancellations. This is a stretch or
“aspirational” goal, and some NSW hospitals were not meeting the previous standard of less than 5%.
The Surgical Service Taskforce developed the dashboard, and NSW Health incorporated it into its PreProcedure Preparation Toolkit, a guideline issued by the ministry’s Health Service Performance Improve
ment Branch. Table 15-1 lists the key performance indicators for both state and local levels. The
guideline indicators and targets were reviewed in November 2012, and the canceled surgeries target
remained unchanged. The reporter interviewed the chair of the local Australian Medical Association
problem was worse than indicated, because patients who wanted surgery but were never booked were
not counted. He observed that the benchmark percentage was “ambitious but clearly double or triple
that figure is unacceptable.” He called a ministry plan to add 400 public hospital beds per year
The deputy director-general of NSW Health told the reporter that 40–45% of the cancellations were for
“patient reasons,” such as the patient not showing up or being ill on the day of surgery. He also noted
that there were multiple reasons why hospitals could not accommodate surgery patients—when trauma
patients unexpectedly tied up ICU beds, for example, or when necessary supplies and equipment were
not avail- able. He noted that when the benchmark had been less than 5% nearly all the hospitals had
met it, so it was raised to an “aspirational” level of less than 2% in 2007.
Data extracted from the monthly reports by the newspaper indicated that some hospitals were usually
failing to meet the less than 5% target and few had come close to the less than 2% level on a consistent
basis. The same-day cancellation rate for six of the nine local hospitals was around 4%. This suggests
that almost 9,000 same-day surgeries are canceled in New South Wales each year. The deputy observed
that a cancellation rate of 4–5% was typical of other Australian states and that 91% of elective surgeries
were “completed on time.”
Table 15-1 Key Surgical Performance Indicators
Booked patient cancellations on the day of surgery for any reason
Patients canceled due to medical conditions (included above)
Suggested for Local Level
Patients through the pre-procedure preparation process
Percentage of patients processed by:
General preadmission clinic
Multidisciplinary preadmission clinic
Average time spent by patient in preadmission clinic
General (anesthetist and nurse)
Patients who “do not attend” on the day of surgery
Target locally determined
Source: Data from: NSW Department of Health, Guideline: Pre-Procedure Preparation Toolkit,
Document GL-2007_018, 02-Nov-2007, p. 18. Accessed December 9, 2013, at
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