Transcript 3. Welcome to this E4E and QIPP Safe Care Measurement webex

Did you know that every year in England there are…
74,689
patients with catheters & infection
13,945 patient falls (with harm)
50,552 patients with pressure ulcers
(category III&IV) like these
Get Staffing
Right
Deliver Care
Safer Nursing
Care Tool
(AUKUH)
HURST
PANDA
Birth Rate+
E Rostering
Productive Care
Safety Express
High Impact
Actions
Essence of
Care
NW Care
Indicators
Measure
Impact
Patient
Experience
Productive Care
Safety Express
High Impact
Actions
Real-time
Monitoring
Experience
Based Design
Single Sex
Accommodatio
n
Patient Stories
Nurse
Sensitive
Outcome
Measures
Staff
Experience
High Impact
Actions
Real-time
Monitoring
Health and
Well Being
People often say the NHS is data rich…….
……..they’re not joking!
– Reduce
• Identify what reporting requirements you have to meet
and whether this covers what you want to collect
– Reuse
• Think about the overlaps, what can be collected once
and reused in another collection mechanism
– Recycle
• All data is useful. Use what you have already collected
in retrospective reporting
– Consider triangulating different data sources to
give a broader picture
– If you’re going to undertake a new data collection
start by carefully considering what you need to
answer your question
– Design a collection tool that minimises burden
and maximises data quality (i.e. keep it simple!)
Has anyone on the call succeeded in using
data to show improvement?
Or have you made some brilliant
improvements which you are struggling to
show in your data?
Administrative
Point of Care
Case Note Review
Incident Reporting
Pressure
Ulcers
HES at 0.3%
(underreported)
No category
Prevalence
Safety Thermometer 8%
Category II – IV
Prevalence and incidence
Data over time each
month
Global Trigger Tool ??
Local audit carried out
yearly by the TVNs –
3% incidence
Category III – IV
40 on NRLS
(underreported?)
Falls
No admin data
Safety Cross completed
each month – no data
over time
Safety Thermometer –
variation 0 – 2.5%
Global Trigger Tool??
Falls reported through
NRLS
35 falls reported last year
Catheters
& UTIs
No admin data
VTE
HES at 1% patients with
VTE
UNIFY 85% risk assessed
Safety Thermometer 16% Yearly audit of catheters
catheters, 2% catheter and
UTI
Safety Thermometer
68% risk assessed
66% prophylaxis
2% new VTE
Global Trigger Tool??
Diagnosed with VTE
0.2%
No data
New VTEs after surgery
reported in NRLS
3 reported last year
Administrative
Point of Care
Case Note Review
Incident Reporting
Pressure
Ulcers
HES at 0.3%
(underreported)
No category
Prevalence
Safety Thermometer 8%
Category II – IV
Prevalence and incidence
Data over time each
month
Global Trigger Tool ??
Local audit carried out
yearly by the TVNs –
3% incidence
Category III – IV
40 on NRLS
(underreported?)
Falls
No admin data
Safety Cross completed
each month – no data
over time
Safety Thermometer –
variation 0 – 2.5%
Global Trigger Tool ??
Falls reported through
NRLS
35 falls reported last year
Catheters
& UTIs
No admin data
VTE
HES at 1% patients with
VTE
UNIFY 85% risk assessed
Safety Thermometer 16% Yearly audit of catheters
catheters, 2% catheter and
UTI
Safety Thermometer
68% risk assessed
66% prophylaxis
2% new VTE
Global Trigger Tool Diagnosed with VTE
0.2%
No data
New VTEs after surgery
reported in NRLS
3 reported last year
Administrative
Point of Care
Case Note Review
Incident Reporting
Pressure
Ulcers
HES at 0.3%
(underreported)
No category
Prevalence
Safety Thermometer 8%
Category II – IV
Prevalence and incidence
Data over time each
month
Global Trigger Tool ??
Local audit carried out
yearly by the TVNs –
3% incidence
Category III – IV
40 on NRLS
(underreported?)
Falls
No admin data
Safety Cross completed
each month – no data
over time
Safety Thermometer –
variation 0 – 2.5%
Global Trigger Tool ??
Falls reported through
NRLS
35 falls reported last year
Catheters
& UTIs
No admin data
VTE
HES at 1% patients with
VTE
UNIFY 85% risk assessed
Safety Thermometer 16% Yearly audit of catheters
catheters, 2% catheter and
UTI
Safety Thermometer
68% risk assessed
66% prophylaxis
2% new VTE
Global Trigger Tool Diagnosed with VTE
0.2%
No data
New VTEs after surgery
reported in NRLS
3 reported last year
Administrative
Point of Care
Case Note Review
Incident Reporting
Pressure
Ulcers
HES at 0.3%
(underreported)
No category
Prevalence
Safety Thermometer 8%
Category II – IV
Prevalence and incidence
Data over time each
month
Global Trigger Tool ??
Local audit carried out
yearly by the TVNs –
3% incidence
Category III – IV
40 on NRLS
(underreported?)
Falls
No admin data
Safety Cross completed
each month – no data
over time
Safety Thermometer –
variation 0 – 2.5%
Global Trigger Tool ??
Falls reported through
NRLS
35 falls reported last year
Catheters
& UTIs
No admin data
VTE
HES at 1% patients with
VTE
UNIFY 85% risk assessed
Safety Thermometer 16% Yearly audit of catheters
catheters, 2% catheter and
UTI
Safety Thermometer
68% risk assessed
66% prophylaxis
2% new VTE
Global Trigger Tool Diagnosed with VTE
0.2%
No data
New VTEs after surgery
reported in NRLS
3 reported last year
Judgement
Research
Improvement!!
• View data over time
• View different data
sources side by side
• Look for similarities and
understand the reasons for
differences; don’t be afraid
of uncertainty
– Plot as you go; set up a spreadsheet to help you
– The more the better; try to measure as often as possible
– Print and scribble; annotate your charts to add context and
additional qualitative information
– Display your charts for all to see
– Assess trends, not absolute numbers
– Use run chart or SPC methods to help detect a change
– Embrace your analytical resource……
Julie Jones, Patient Safety
Lead, Birmingham
Community Health Care
NHS Trust
www.ihi.org for advanced measurement for
improvement
Safety Thermometer Results
Dashboard
Show national benchmark
Step 1: select SHA
LONDON SHA
AllAll
Pressure ulcers
Step 2: select organisation
WEST MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST
Total
falls
Total
falls
Falls
20%
18%
Total number of patients at selected
organisation surveyed to date:
Catheters
7%
30%
6%
25%
16%
5%
14%
12%
20%
4%
15%
10%
3%
8%
10%
6%
2%
5%
4%
1%
2%
0%
Sep-11
Aug-11
Jul-11
Jun-11
May-11
Apr-11
Mar-11
Feb-11
Jan-11
Dec-10
Nov-10
% patients with catheter AND UTI
100%
4%
90%
% patients with catheter
Harm free care
Patients with a new VTE
100%
Oct-10
Sep-11
Aug-11
Jul-11
Jun-11
May-11
Apr-11
Mar-11
Feb-11
Jan-11
Dec-10
Nov-10
Oct-10
Sep-10
Sep-11
Aug-11
Jul-11
Jun-11
May-11
Apr-11
Mar-11
Feb-11
Jan-11
Dec-10
Nov-10
Oct-10
Sep-10
VTE
Sep-10
0%
0%
90%
4%
80%
80%
3%
70%
60%
3%
60%
50%
2%
70%
50%
40%
40%
2%
30%
30%
20%
1%
10%
1%
20%
10%
Sep-11
Aug-11
Jul-11
Jun-11
1 Harm
May-11
Apr-11
Mar-11
Feb-11
Jan-11
No Harms
Dec-10
Nov-10
Oct-10
Sep-11
Aug-11
Jul-11
Jun-11
May-11
Apr-11
Mar-11
Feb-11
Jan-11
Dec-10
Nov-10
Oct-10
% patients given prophylaxis
0%
Sep-10
Sep-11
Aug-11
Jul-11
Jun-11
May-11
Apr-11
Mar-11
Feb-11
Jan-11
Dec-10
Nov-10
Oct-10
Sep-10
% patients assessed
0%
Sep-10
0%
2 Harms
1069
Has anyone on the call succeeded in using
data to show improvement?
Or have you made some brilliant
improvements which you are struggling to
show in your data?
Are there any gaps in the data you collect?
Go to: www.harmfreecare.org