Martin Morse 30th May 2008

Workload Modelling Tool

MORSE Analytics British Museum 12th June 2008 1

How can Read Codes be used to model “workload”?

• Provide benchmark analysis of workload within the practice over time Seasonal variations (e.g. flu vaccinations) Balance of workload across resources, e.g. GPs, nurses Impact of implementing specific programmes • Provide benchmark analysis of workload against other practices Why do some practices do things differently?

What was the impact of a programme implementation on a practice?

• Support future workload planning for a practice Provide scenario generation, enabling “what if” analysis for alternative workload plans Analyse and make cases for employing additional resources, or shifting resource workloads within the practice / to other providers MORSE Analytics British Museum 12th June 2008 2

What might practices gain from workload modelling?

• A better understanding of work delivered within the practice Who is doing what work for which patients, conditions and services?

How is my practice doing compared with other practices?

• An ability to evaluate the impact on workload of implementing specific programmes • An ability to evaluate options for actively managing future practice workload through Shifting workload within the practice Providing additional or reducing resources within the practice Establishing partnerships with other organisations, such as specialists, mental health teams, pharmacists, patient groups MORSE Analytics British Museum 12th June 2008 3

How this might be done in practice: “Workload Modelling Tool”

• The following slides demonstrate a concept for a tool that supports Workload Modelling To present what might be possible using read code data • It contains a number of sections Practice Information Importing Read Code Data Grouping Read Codes Data and Workload Analysis Workload Planning MORSE Analytics British Museum 12th June 2008 4

Practice information: Gathering information about available resources

Workload Modelling Tool Practice Information

Practice Name Practice Number Practice Population Clinicians Dr. Green Dr. Brown Dr. White Hilary Thornton Lesley Pearce Osmington Health Centre B86017 10,400 GP GP GP Nurse Practitioner Practice Nurse Hours per week 40 25 18 40 30 Use links to add, edit and delete clinical resources for this practice

Add new Edit Delete

MORSE Analytics British Museum 12th June 2008 5

Importing data: Obtaining the feeds from read code analysis

Workload Modelling Tool Import Data

Data currently imported for this practice B86017 - September 2007 B86017 - October 2007 B86017 - November 2007 B86017 - December 2007

Import data Delete data

Link to selecting data from Workbooks A, B and C for this practice MORSE Analytics British Museum 12th June 2008 6

•

Grouping read codes: How to define how a unit of “workload” can be measured

To make analysis easier, read codes are aggregated into simple groups. This enables groups which may have been coded slightly differently across practices to be compared Groups of read codes set up by this practice

Workload Modelling Tool Read Code Groups

Imported definitions of read code groups, for comparing across practices Read code groups

My Groups

All read codes Respiratory (all clinicians, all patients) Diabetes (all clinicians, all patients) Preventative Procedures (all clinicians, all patients) Musculoskeletal (all clinicians, all patients) Respiratory (GP) Respiratory (nurse)

Imported Groups

PCT Defined Preventative Procedures PCT Defined Musculoskeletal Links to add, edit and import read code group definitions

Add new Import groups Edit Export Groups Delete

MORSE Analytics British Museum 12th June 2008 7

•

Data analysis: Viewing practice performance

Simple graphs and tables of read code group data for the practice Trends over time, or compared with other practices

Workload Modelling Tool Data Analysis

Read Code Group Relative to Musculoskeletal (all) All read codes

Musculoskeletal ( N…) Read Codes as % of all Read Codes: September - December 2007

10% 9% 8% 7% 6% 5% 4% 3% 2% 1% 0% September October November E82074 B86017 PCT Average P81137 December Musculoskeletal (all) All read codes %

Compare with…

PCT Average Sep-07 1,360 25,706 5.3% 5.3% Oct-07 713 15,016 4.7% 5.0% Nov-07 672 9,484 7.1% 4.2% Dec-07 619 9,310 6.6% 4.2% Select the read code group(s) to analyse Select comparison groups MORSE Analytics British Museum 12th June 2008 8

How can read codes be translated into measurable workload?

• If read codes could be translated into metrics for workload in the practice...

E.g. “H1A.. read code = average 10 minutes nurse time” • ...then analysis could support resource planning Monitoring of resources required for seasonal variations (e.g. Flu vaccinations) More effective resource management through transferring roles, increasing or decreasing resource levels MORSE Analytics British Museum 12th June 2008 9

Workload analysis: Translating read codes into activity

Workload Modelling Tool Workload Analysis

Read Code Group Weekly hours spent on

GP

Musculoskeletal (all) All read codes %

Nurse Practitioner

Musculoskeletal (all) All read codes %

Practice Nurse

Musculoskeletal (all) All read codes % Musculoskeletal (all) Sep-07 5 83 6.0% Sep-07 2 40 5.0% Sep-07 2 30 6.7% Oct-07 4 83 4.8% Oct-07 1 40 2.5% Oct-07 0 30 0.0% Nov-07 5 83 6.0% Nov-07 1 40 2.5% Nov-07 0 30 0.0% Dec-07 5 83 6.0% Dec-07 1 40 2.5% Dec-07 0 30 0.0% 10 8 6 4 2 0 Sep-07 Oct-07 Nov-07 GP Nurse Practitioner Practice Nurse Dec-07 In this example, Musculoskeletal read code data has been translated into weekly hours by clinician type MORSE Analytics British Museum 12th June 2008 10

Workload planning: Constructing scenarios for evaluation

Planning levels of workload by type of work

Workload Modelling Tool Workload Planning

Scenario name

Manage scenarios… Weekly hours

Respiratory Diabetes Preventative Procedures Musculoskeletal Other

TOTAL Select groups… Compare with… Weekly hours

Respiratory Diabetes Preventative Procedures Musculoskeletal Other

TOTAL

Considering resources required to deliver work Planned workload for February 2008 GP

Dr. Green

3.5

0.5

20.0

2.1

13.9

40.0

GP

Dr. Brown

1.0

0.5

12.0

1.9

9.6

25.0

GP

Dr. White

1.0

0.5

8.0

2.0

6.5

18.0

Nurse Practitioner

Hilary Thornton

4.0

2.0

25.0

1.0

8.0

40.0

Practice Nurse

Lesley Pearce

4.0

2.0

15.0

Add new resource…

9.0

30.0

[ACTUAL READ CODE DATA FOR JANUARY 2008]

Select scenario or actual data…

GP

Dr. Green

3.4

-0.1

0.6

+0.1

17.6

-2.4

2.2

+0.1

14.1

+0.2

35.7

-4.3

GP

Dr. Brown

0.9

-0.1

0.5

-0.0

11.8

-0.2

1.7

-0.2

8.0

-1.6

22.6

-2.4

GP

Dr. White

0.9

-0.1

0.5

+0.0

7.5

-0.5

2.2

+0.2

7.5

+1.0

18.3

+0.3

Nurse Practitioner

Hilary Thornton

3.9

-0.1

2.1

+0.1

28.9

+3.9

0.8

-0.2

6.2

-1.8

45.9

+5.9

Practice Nurse

Lesley Pearce

3.4

-0.6

2.2

+0.2

14.2

-0.8

0.0

+0.0

7.5

-1.5

26.1

-3.9

Compare plans with read code data or alternative plans MORSE Analytics British Museum 12th June 2008 11

Topics for consideration

• What analysis of read codes is most useful on a regular basis for practices?

Monitoring consistency of key chapters within the practice?

Monitoring impact of changes in practice read code use, e.g. Recruitment of practice nurse?

Comparability with performance of other practices?

• Can read codes be used as a proxy for workload?

Is it possible to know the workload value of a read code?

• In what ways might read code tracking be useful in workload planning?

Monitoring of seasonal events to predict workload requirements?

Monitoring impact on workload of changes in practice?

Justification of changes in resourcing levels, both increasing and decreasing?

MORSE Analytics British Museum 12th June 2008 12