Transcript National Data Relating to Children

Clinical quality indicators:
progress update
Jim Chalmers & Lindsay Mathie
Information Services Division, NHS National Services
Scotland
Overview
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What is the project about
Approach to deriving indicators
Suggested indicators
Examples
What is it about?
• Investment in Children’s Specialist Services
– Is it working?
– How can we tell?
• What does “good” look like
• Need to measure relevant outcomes
• National Delivery Plan for Children and Young
People’s Specialist Services in Scotland:
– “71. There is, therefore, a need to be able to identify,
gather and analyse a number of key clinical or
service outcome measures that would allow an
accurate and timely understanding of progress
across the spectrum of specialist children’s
services.”
Relevant Indicators
• Multiple dimensions of health care
quality
– safe, effective, efficient, patient-centred,
timely, equitable
• Exploit currently collected data where
possible
• Develop data collection/analysis without
excessive costs
Approach
• Following Institute of Healthcare Improvement
model and proposed Healthcare Quality Strategy
for Scotland
– Catalogue existing indicators
– Engage with exemplar MCNs and Steering Group
for further suggested indicators
– Feed back to clinical leads
– Compare indicators to dimensions specified by
Association of Public Health Observatories
• Importance, relevance, validity, possibility,
meaningfulness, implications
Examples of Indicators
in Practice
EF06 Compliance with Standards &
Protocols
– Cincinnati Children's Hospital
– Use of evidence Based Guidelines
• July - September 2009 – 92% compliance.
(Percentage of condition specific evidencebased guidelines followed in the emergency
department and on inpatient units)
– 1996- 2007 Resulted in
• Fewer hospital admissions (12-71% decrease)
• Shorter average length of stay (12-37% decrease)
EQ02 How far the patient has to travel
• As an example the project group looked
at Access to General Surgery of
Childhood
• Looked at
– Estimated travel times
– Length of stay by travel time
Table 1:
Mean Length of Stay by Estimated Travel Time1
Elective Admissions to General Surgery of Childhood,
2008/09
Estimate Travel Time1
Mean length of stay (days)
Number of admissions
0 – 30 minutes
2.3
1,315
30 – 60 minutes
2.8
577
60 – 90 minutes
4.6
141
90 – 180 minutes
4.9
183