Transcript Outline of Changes Proposed

Critical Care Minimum
Data Set
(CCMDS)
Sheila Reynolds
Quality and Audit Sister
Critical Care Department
Sheffield Teaching Hospitals Foundation Trust
Development of the CCMDS
 Change in funding of critical care
 ACP dataset inadequate
 CCMDS developed by clinicians with DoH
 ICS
 BACCN
 ICNARC
 Independent Health Sector
Purpose of the CCMDS
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Gives an overall picture of critical care patients
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Sensitive enough to support the development of Health
Care Resource Groups (HRG)
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Critical Care HRGs will be based on total number of
organs supported
Where is CCMDS collected?
Designated Critical Care beds
 Level 2 beds only
 Level 3 beds only
 Flexible beds (mix of level 2 and 3 beds)
 Temporary use of non critical care beds
What is a designated bed?
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Not defined in CCMDS
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Refer to DoH Guidelines on Admission and Discharge to
ICU and HDU 1996
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Local commissioning groups and networks can use this
as a template to help decide if a bed can be designated
What areas are included?
 Adult critical care beds
 General ICU
 HDU and Surgical HDU
 Post Operative Surgical Unit
 Cardiac ICU and PCU
 Neurosurgical and Neuromedical ICU/HDU
 Specialist units meeting criteria (if agreed by commissioners)
 Obstetric HDU
 Respiratory Support Units
 Adults receiving critical care in temporary locations whilst waiting for a
critical care bed for 4 or more hours (Recovery/PACU)
 Children can be counted if they are being treated in an adult bed
 Burns Critical Care Units and Spinal Critical Care Units excluded (2008/09)
 Outreach Services are NOT included
The CCMDS data items
7 items
Demographic links to PAS
8 items
Admission
10 items
Organ Support
9 items
Outcome and discharge
34 in total
(14 mandatory = HRG subset)
Demographic data
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NHS number
Hospital number
Site code of treatment
Code of GP practice
Treatment function code (consultant specialty)
Date of birth
Postcode
Admission and Discharge data
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Admission source and location
Admission type
Discharge status
Discharge destination and location
Discharge ready date and time
Actual discharge date and time
Daily Organ Support
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Advanced Respiratory Support
Basic Respiratory Support
Advanced Cardiovascular Support
Basic Cardiovascular Support
Renal Support
Neurological Support
Gastro-intestinal Support
Dermatological Support
Liver Support
Level of Care
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Number of level 2 and level 3 days
(using ICS Levels of Care)
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Level of care is based on clinical interpretation
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Top up to level 2 if no organs supported
The HRG Subset (14 items)
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Local identifier
Critical Care start date
Unit function code
Advanced Respiratory Support
Basic Respiratory Support
Advanced Cardiovascular Support
Basic Cardiovascular Support
Renal Support
Neurological Support
Dermatological Support
Liver Support
Critical Care level 2 days
Critical Care level 3 days
Critical Care discharge date
Nurses Role in CCMDS
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Record at midnight and on discharge on every patient
Record accurate admission and discharge data
Collect accurate Organ Support Data
 Use the highest level of support received in the
previous 24 hours
Assess level of care especially if there are no organs
supported
HDU and ITU locations are separate episodes of care in
non-combined units
Audit Staff role
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Collect data each day
Chase up missing data
Validate data
Correctly interpret the admission/discharge information
Input into NTCCN database
Liaise with clinical staff to assign a level of care
Understand the definitions
Challenge inaccurate data
Support input into PAS
Ensuring data quality
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Keep abreast of changes
Regular training of nursing and audit staff
Understand definitions
Comply with rules and definitions
Do not substitute personal rules and definitions
Challenge data inaccuracy as soon as possible
Regular audit (at least 1 in 5 of all admissions)
Common errors
Discharge day missing
 Missing patients
 Missing organ support
 Incorrect interpretation of organ support
 Highest level of organ support omitted
 Missing level of care top up
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Remember !
Every patient counts
Every organ counts
Every day counts
Any questions?