Volume 11 Issue 1 September 2017 Welcome to Knowledge Matters Welcome to the September edition of Knowledge Matters. Before we go any further, I must let you know that the QO team have been hanging their heads in collective shame at the length of time it’s taken us to get a new issue to press! There are no excuses, not even being busy doing marvellous analytical, webby, dashboardy stuff. Anyway, we have made up for our tardiness with an edition celebrating the launch of the new £10 note and, more specifically, Jane Austen being the first woman (aside from the Queen of course!) to appear on one of our bank notes. Inside we have the usual splendid mix of information and news. You’ll find articles from Samantha Riley on her mission to create a social movement of ‘Measurement for Improvement Champions’, the second part of Dan White’s case study on his work with the London Cancer Vanguard and a very informative article from the QO’s David Harries on StakkeR and diverging stacked bar charts. You may also recognise a familiar face within the pages. In case you hadn’t heard, Kate Cheema has returned to South, Central and West CSU as Head of Patient Safety Measurement Unit. The Quality Observatory were previously involved in the Safety Thermometer, but have now taken on responsibility for the whole process and more. Most of us are getting involved and there’s more from Kate inside about the challenges of measuring Patient Safety. As lovely as it was to see Kate return, we’ve sadly had to bid farewell to Rebecca who has just left us. In time-honoured Knowledge Matters tradition, there’s a little tribute to her inside. We’ve also got the rest of the team news including trips to the Health & Innovation Expo and the STP Behaviour Change Workshop in London. We hope you enjoy these articles - and if you think you could contribute to the next edition, please get in touch. We’d love to hear from you!
Inside This Issue : Measurement for Improvement creating a social movement
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StakkeR—diverging stacked bar charts
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Health and Care Innovation Expo
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Cancer Vanguard - automating charts to highlight outliers (part 2)
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Farewell to Rebecca
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Ask an Analyst, Team Away Day
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Patient Safety Measurement
6
Behaviour Change STP Workshop
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News
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twitter.com/SECSHAQO issuu.com/SECQO http://www.networks.nhs.uk/nhs-networks/sec-qo www.QualityObservatory.nhs.uk
2 Creating a social movement of Measurement for Improvement Champions Samantha Riley, Head of Improvement Analytics, NHS Improvement Hello Knowledge Ma ers readers. Since the last edi on of Knowledge Ma ers there have been some exci ng
developments! As some of you may know, I am reasonably ac ve on twi er. Back in April, I tweeted that I was establishing a measurement for improvement community virtual community of interest. Within a week, over 100 people had contacted me asking to be involved!!! And now there are 200 members of the community. Whilst most people are based in England, there are also members from Ireland, Scotland, New Zealand, Australia and India! I have created a Kahootz space – SPC Champions. The site is a bit basic currently – but watch this space we will be redesigning it soon to be pre0er and more user friendly. There are LOTS of useful resources available on the site which include the following: Templates for Sta s cal Process Control (SPC) charts, run charts, pareto charts and more; A range of guides developed over the past 15 years on what measurement for improvement is and how to do it; A wealth of published papers on the benefits of using control charts/dangers of two point comparisons rated as red, amber or green plus more; In addi on, a number of discussion forums have already been established and are promp ng some interes ng debate. Here are a few examples of the discussions that are taking place to whet the appe te! : -
Why 2.66? Run chart/control chart analysis at scale Reframing the measurement for improvement message SPC rules
Within the next couple of weeks I will be sending a brief ques onnaire out to members to gain an understanding of what types of people have joined the community, where they work and what their interests are. Once I understand this, I will be developing a programme of webinars and training opportuni es to cover different topics. If you would like to join the community please email me and I will send you an invite : Samantha.riley1@nhs.net You might also want to follow me on twi er to keep up with developments @samriley
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How many of you are aware of AphA – the Associa on of Professional Healthcare Analysts? h p://www.aphanalysts.org/ an organisa on
whose
AphA membership
is is
representa ve of all areas of the healthcare sector. The organisa on’s aim is to raise the profile of healthcare analysts and provide a professional
support
network,
ul mately
achieving professional registra on status for its members, and to drive up the quality and applicability of robust analy cs as an aid to evidence-based decision making in a modern health and care system. It costs only £30 a year to join and there are lots of benefits – I would really encourage you to join. Benefits are as follows: -
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Regional mee ngs – Meet with like-minded professionals to hear from guest speakers, share knowledge and develop networks
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Discounts – A end annual conference at the member rate
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Website – aphanalysts.org – keep updated with news, book events, source material within the members area
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Newsle ers – AphA members receive regular newsle ers
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On-line resources – free access to members to SAS University edi on, and a range of on-line training resources. You cannot get access to this anywhere else without buying SAS.
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Workshops – AphA members to receive priority booking at technical workshops
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Awards – work and talent recognised via annual awards I presented at the AphA north conference – it was a great event with approximately 80 analysts working in a range of NHS organisa ons. There was a huge amount of interest and energy around driving the measurement for improvement agenda. And I came away with a huge amount of feedback (in the form of many post it notes) on what support and resources NHS Improvement and other bodies could provide. Over the coming weeks I will be carefully considering where I should focus my efforts to best support analysts to be able to provide analysis which best supports improvement. So watch this space!
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4 Cancer Vanguard Project – automating charts to highlight outliers Part 2 by Daniel White – Senior Information Analyst
This continues the case study on automating charts to highlight outliers. Staggering the Incidence and Mortality data
The structure below enables the Incidence and Mortality rates for each CCG to be displayed correctly in the chart. Each of the columns has the data pulled from another source tab in the sheet automa cally. This enables the data set to automa cally update in the event that the CCG list changes for a new cancer data set. Columns and rows have been labelled for ease of explana on:
Key features of the layout are as follows: Column A: In order to ensure that the CCG name does not appear twice along the horizontal axis (once each for incidence and mortality), column A is used for axis labelling. By staggering the CCG names every three rows the chart displays the incidence rate, then mortality rate above the CCG name, then leaves a blank space before the pair of values. This displays the Incidence and Mortality Rate values as a pair, then leaves a space on the chart, as the customer requested. There is a formula used to repeat the CCG heading on every third row which is detailed in the next sec on. Column B: Incidence and mortality rates are posi oned on adjacent rows. In order to allow the lookup formula to func on correctly, the CCG name is repeated on each row where a lookup is required. A formula is used to repeat the CCG heading on the second and third rows which is detailed in the next sec on. Columns C and G: These sta c values are pulled from the Incidence and mortality rates tabs. They are used to generate flat trend lines on the chart. Columns D and H/Rows 2 and 3: The incident and mortality rates are extracted from the appropriate source tab by using a VLOOKUP func on against the CCG name in Column B. The lookup is embedded within an IF() formula that only triggers the lookup for every third row. Columns E,F,I,J/Rows 2 and 3: The incident and mortality red/green overlays are posi oned on adjacent rows. They are extracted from the appropriate source tab by using a VLOOKUP func on against the CCG name in Column B. The lookup is embedded within an IF() formula that only triggers the lookup for every third row. Creating the lookup formulas
In order to carry out the lookup once on every third row only, the MOD and ROW formulas can be used: =IF(MOD(ROW(),3)=1, < VLOOKUP formula > ),"") The formula above selects the row number on the sheet and applies a MOD func on to that number with a divisor of 3. If the result is 1, the VLOOKUP func on is carried out, otherwise an empty cell is returned. For the mortality rate lookup the results need to be displayed on the adjacent row below, so the result of the MOD func on needs to be changed to 2.
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Creating the chart data series
The chart type used was a standard Clustered Column chart, with the data series added in layers and set to overlap with no gap to achieve the required look. References to the sample data table above will be made for clarity. Incidence and Mortality rates The incidence data is found in Column D and mortality in Column H. In order to ensure that the rates display in the correct posi on, it is essen al that the “series values” both start at Row 1, despite this being an empty row. This ensures that the rates are staggered correctly and hence display in adjacent columns. Incidence Red/Green Overlays The incidence red and green overlay data is found in Columns E and F. As with the rate data, it is essen al that the “series values” both start at Row 1, to ensure that the overlays align correctly with the values that they are intended to highlight. To create the overlay effect, select each overlay data series in turn, then select, “Format selec on”: Set “Fill” to “No Fill”. Set “Border Colour” to “Solid line”, and set the colour to red or green as appropriate. Set “Border Styles/Width” to 1.5pt. Creating dynamically updating titles and text boxes
It was desirable to include a dynamically upda ng tle for the charts, as well as overall Incidence and mortality rates for each of the four regions. By crea ng dynamic cap ons, charts would update automa cally whenever the source data was changed. This feature is not supported in Excel, but fortunately there is a workaround: Create the text that you wish to use as a cap on elsewhere in the sheet. This can be constructed using CONCATENATE() func ons and references to cell values. Create a text box within the boundary of the chart where you wish to display the cap on Select the text box, then click in the formula bar and enter a reference to the cell where the cap on text is stored. Repeat this process for each cap on that you wish to include This process can also be used to create a dynamically upda ng chart tle. The tle cap on was created using the following formula, which was stored in a separate “Lookups” tab: =CONCATENATE("Graph showing the incidence and mortality age-standardised rates of "&CancerType_Selected&" cancer ("&ICD10_Code_Selected&") in females, by London and Greater Manchester CCG: "&YearsGroup2) The variables, <CancerType_Selected>, <ICD10_Code_Selected> and <YearsGroup2> refer to named ranges within the document. These will dynamically update whenever the source data is changed. If you would like to know any more about this, please contact Dan White, Senior Informa on Analyst in the Development and Modelling Analy cs Team at South, Central and West CSU - daniel.white@nhs.net
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Patient Safety Measurement - Simples? Kate Cheema, Head of Patient Safety Measurement Unit Back in 2008 Professor Charles Vincent and colleagues asked the question ‘is healthcare getting safer’? The short answer was that we don’t know, and this in part was down to simply not having a systematic approach to measures. Simply put, measurement wasn’t high enough on the agenda and often put in the ‘too difficult’ box.
Regular readers of Knowledge Matters will know that this is a problem - if we’re not measuring effectively then how do we know that our efforts are actually leading to an improvement? We could all be wasting our time!
Back in the mists of time an effort was made to systematise the reporting of patient safety incidents; the national reporting and learning system (NRLS) is a significant database where incidents are reported centrally. Great, I hear you cry, all our problems are solved! But we know that whilst the learning from incident reports and the holistic review of themes at organisation level are invaluable, when the data from these reports is taken at a national or regional level it is less useful. We know, for example, from structured case note reviews that incident reporting captures only about half of the incidents that actually happened.
So what we think is going to be a simple ‘count the problems’ approach becomes much more complex; in fact the measurement of safety has vexed many of the 15 patient safety collaboratives across England since their inception in 2014.
This challenge has led NHS Improvement (who look after this sort of thing) to commission a central Patient Safety Measurement Unit (PSMU). South Central and West are delivering this unit on behalf of NHS Improvement and have been mobilising throughout recent months. Fair to say this is going to be a challenge but at the same time enormously exciting! We’ve also taken on the NHS Safety Thermometer (all five of them!) and are focussing on getting the processes around collection and publication slick and recently launched the shiny new Safety Thermometer website!
Bringing together multiple sets of data, ensuring we are effectively and meaningfully interpreting the information and communicating that successfully is the bedrock of the PSMU. We’re working with national and local workstreams to best assess their impact on the lives of patients and staff.
If you’d like to learn more about the PSMU or the measurement of safety generally, please do get in touch with me! K.cheema@nhs.net
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Vincent, Aylin, Dean Franklin, Holmes, Iskander, Jacklin and Moorthy (2008), Is health care getting safer?, BMJ, 337, 1205-1207
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StakkeR David Harries, Development Analyst Stacked bar charts have a bad reputation. One of the criticisms often levelled at stacked bar charts are that they are hard to interpret. Whilst doing a quick search before starting this article for the newsletter I stumbled on a quote attributed to the Economist (although I failed to find the aforementioned original source) that described stacked bar charts as follows ‘Lthey are so bad at conveying information that they are a great way to hide a bad number amongst good ones’!
Whilst there are plenty of examples of bad practice when it comes to using stacked bar charts to visual data this is usually down to their inappropriate use e.g. when used for trends over time when a line chart would be better. The example below taken from European Environment Agency’s handy guide to ’Chart dos and don’ts’1 on how bad stacked bar charts can be in certain cases illustrates this very point using the following charts to display Household Types over time from US Census Bureau.
Whereas this is by no means the worst example of their use I’ve seen, you would have to agree that the line chart more clearly highlights the decline of household category “Married Couples with Children” as well as more clearly showing the trends in the other categories as well.
However, this doesn’t mean that stacked bar charts should be dismissed out of hand. Having been working a fair bit on survey data recently, I certainly found that diverging stacked bar charts can offer one of the best options for the display of ordinal or Likert-type data that is often collected in surveys, audits and other types of assessment. In their paper published by the Journal of Statistical Software, Heiberger and Robbins2 actually recommend using diverging stacked bar charts as the primary graphical display technique for visualizing Likert, semantic differential, rating scale data, and population pyramids.
So the type of data that shows the spread of negative and positive values, such as Poor to Excellent ratings or Strongly Disagree to Strongly Agree statements are well suited to this type of chart as since they align to each other around the midpoint, they handle some of the criticism of regular stacked bar charts, which is that it is difficult to compare values of the categories in the middle of the stack that do not start from the axis.
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StakkeR
(continued)
Stacked bar charts are, if anything, too easy to create in Microsoft Excel, diverging stacked bar charts on the other hand definitely less so without a great deal of experimenting with formatting, adding dummy series and hiding of cells etc. If you want to try it out then I recommend checking out http://peltiertech.com/diverging-stacked-barcharts/ for more details. Whilst Excel isnâ&#x20AC;&#x2122;t the most flexible or powerful graphics package, there are other software applications that can more easily produce these graphics. In R for example there are various packages available to the user to create these graphics with perhaps one of the easiest approaches using the HH package compiled by the same Heiberger and Robbins referenced above.
If you are unfamiliar with R*, it is a programmable environment that uses command-line scripting designed specifically for statistical computing and graphics, where packages are collections of reusable R functions, data, and compiled code in a well-defined format. The directory where packages are stored is called the library. A standard core set of packages are included with the installation of R, with more than 10,000 additional packages available to download and install at the Comprehensive R Archive Network (CRAN). This means that it is possible to expand the types of analyses you can do in R, and with so many to choose from there is usually an R package available for pretty much every eventuality. Below is an example of a diverging stacked bar chart drawn with the likertMosaic function using demo data contained in the HH package which took all of a couple of minutes to load and run in R. Reusing the example provided in the package it is very straightforward to re-code and apply the R functions to your own data. LikertMosaic plot of survey responses to a question on job satisfaction using demo data included with the HH package.
Another approach is to use the likert package built around ggplot2, the most popular of R packages (based on total number of downloads) for creating graphics. In this example the diverging stacked bars are shown for questions 18 grouped by organisation with additional histograms on the right to show response counts.
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Both examples help illustrate why using diverging stacked bar charts provide a much more intuitive way of presenting this type of data, where you centre around the neutral value, with the less-than-neutral values plotted to the left and the more-than-neutral to the right. Good use is made of diverging colour schemes based on two different hues so that they diverge from a shared light colour toward dark colours of different hues at each extreme. At a glance, you can easily compare different questions, or the same question split over another variable.
As you can see diverging stacked bar charts can be created without much difficulty in R and when used appropriately this type of graph can offer an effective way to communicate a summary of ordinal or Likert-type data collected in surveys, audits and other types of assessment.
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Chart dos and donâ&#x20AC;&#x2122;ts â&#x20AC;&#x201D; European Environment Agency https://www.eea.europa.eu/data-and-maps/daviz/learn-more/chart-dosand-donts#toc-16
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Richard M. Heiberger, Naomi B. Robbins (2014)., "Design of Diverging Stacked Bar Charts for Likert Scales and Other Applications", Journal of Statistical Software, 57(5), 1--32, http://www.jstatsoft.org/v57/i05/
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R Training
The Quality Observatory can offer introductory training on using R. Contact qoteam.scwcsu@nhs.net address to register interest.
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Farewell to Rebecca It was with very heavy hearts that we had to say goodbye to Rebecca last week. Rebecca has been with the QO just a few months shy of 10 years, making her truly one of the longest-serving members of the team. In her time with us she has produced many fantastic and innovative pieces of work on things such as cancer care and prevention and many others. She also managed the Performance Reporting team back in the days when we were a part of South East Coast SHA, and more recently our fabulous Support Services team. Her leaving is especially poignant for Kate, whose maternity leave was covered by Rebecca both times (including at a previous organisation). Rebeccaâ&#x20AC;&#x2122;s daughter has just started school so she plans to spend a wee while relaxing at home and making the most of having the house to herself! It really is the end of an era for the Quality Observatory weâ&#x20AC;&#x2122;re going to miss Rebecca enormously! To that end, our resident poet, Adam, has composed a farewell to her in his own inimitable way.....
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Rebecca Goodbye to Rebecca, Goodbye Weâ&#x20AC;&#x2122;ll all do our best to get by, Now you're gone we're bereft Of your knowledge and skills, oh so deft. Goodbye to Rebecca Goodbye Almost ten years since you started, But alas now you've departed. Leaving with your expertise Of PTLs and flex and freeze, and all the things you charted And every year on planning round Performance queen you were crowned. Cancer data - you know your stuff, But that is not enough, You've more skills to expound
Rebecca we will miss you so, And we want you just to know, That your humour, warmth and grace Has left us with an empty space
Ready for a challenge that is new
In the heart of the QO
You headed up the helpdesk crew With FFT and Primary Care
With you around we were blessed
And CAS Alerts to share
Forget about the rest,
You always knew just what to do
And just for Rebecca, Another glass of Prosecca, A toast to one of the best!
Welcome back Kate! On a much happier note, you may or may not be aware that we recently welcomed back Kate Cheema to the Horley office - hurrah! Kate has returned to head up the new Patient Safety Measurement Unit for South, Central and West CSU, and she has written all about this on page 6. If you want to learn more about it you can contact Kate on k.cheema@nhs.net
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Behaviour Change STP Workshop Dani Collier, Specialist Information Analyst Back in June a few of us headed to London to attend a workshop at the Imperial War museum regarding behaviour change within the South East STP (Sustainability and Transformation Plan) areas. This event was organised by Public Health England, Public Health Action, NHS England and Health Education England. Before attending, I thought the workshop would be about changing our own behaviours within the NHS. It soon became apparent that there is much work going on to help engage the public in taking more responsibility for their own health, and decreasing reliance on already struggling services. With NHS and Social care struggling with funding, staffing, huge caseloads and large waiting lists we all need to play a part in helping change the way in which we look after ourselves and support others to do the same. We heard from Sharon Boundy on how social marketing can be used to cost effectively communicate change. Across the Berkshire system, which falls across not just one but two STPs (Buckinghamshire, Oxfordshire and Berkshire West STP and Frimley STP), they are piloting Shared Care records for their staff. This will enable health and social care providers to find out information they need to know about the person without the patient/service user having to explain everything time and time again. Staff registered with a Berkshire GP have been given wearable technology. The benefits to this will be improved health, fitness and wellbeing of staff, reduced sickness and help re-enforce public health promotion. Also procured for this pilot is an app which will record the information and help analyse this across the system. Some information will even alert GPs if there is an issue with a user’s information, although the aim of the app is to keep people healthy and not increase GPs workloads! There was a lot of talk about changing the way in which we can help others by changing the way we try and fix problems. Instead of trying to fix people when things have gone wrong, usually spending little money over long term, we need to try and get the message across to people to get help now before it is too late. Public Health Action saw this and spent money on television campaigns called ‘SmokeFree South West’. This included some hard hitting adverts with real people, real stories and the real devastating effects smoking has on people and their families. The adverts cost around 5 pence per person but the benefits can be so much greater in the long run.
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NICE have also published some modelling tools on smoking, alcohol, physical activity, social and emotional wellbeing; and children, young people and pregnant women for public health commissioners and decision makers to help improve health and wellbeing. Itâ&#x20AC;&#x2122;s not just the NHS and Local Authority that are attempting to change the ways in which we behave. There are many apps, websites and a whole range of technology that can help us improve our health from Fitness wearables, food/meal apps, health and exercise apps. I myself have successfully used a mobile app to quit smoking and also recommend sleep/meditation app to help drift off on a night. I look forwarded to the future which will hopefully be happier and healthier with the aid of all this technology. I will leave you with a few links and names of apps which I personally have found great! Social Marketing to Communicate Change - https://www.youtube.com/watch? v=qxwSHjNOAuY&feature=youtu.be NICE Return on investment tools - https://www.nice.org.uk/about/what-we-do/into-practice/return-oninvestment-tools Smoke Free South West - http://www.smokefreesouthwest.org.uk/ Android and iOS Apps MyFitnessPal By MyFitnessPal.com iSleep Easy Sleep Meditations by Meditation Oasis Get Rich or Die Smoking by Tobias Gruber Twilight by Urbandroid Team
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Health and Care Innovation Expo 2017 Annette Whitfield, Specialist Information Analyst Relatively new to the NHS, I took the opportunity to attend the Health and Care Innovation Expo in September along with Dani and Becki. On my way to Manchester, I had thoughts of filling my bag with clever little health themed pens and squeezy stress ball ‘desk fodder’. More importantly, the two days offered a variety of sessions on health and social care innovations and developments in support of transitioning the NHS Five Year Forward View (FYFV) into reality. With my earmarked events guide (I could have used the Mobile App), I darted between the main stage, the theatres, pop up university and zones. Spoilt for choice, I focused on collaborations across sectors, and sessions demonstrating strategy turned into practical roll out to counter any strategic gaps in the NHS. The ‘Digital innovation in the future NHS’ presented by Tara Donnelly, Chief Executive of theHealth Innovation Network showcased the AHSN’s stewardship expertise with the ATLAS of Solutions in Healthcare and the system enabler project, the NHS Innovation Accelerator. Although a brief 45 minute tour of the substantial array of products deployed at ‘pace and scale’, the session was a great signpost to the case studies demonstrating the benefits of the tools and clearly related how they address the FYFV gaps. Not only this, with an eye to fostering more effective business partnerships, we were introduced to the DigitalHealth.London Accelerator programme aimed at improving and speeding up SME businesses’ ability to deliver innovation and technology to patients. The AHSN’s myCOPD system is one example of linking technology to the key themes of the Behaviour Change STP workshop (see Dani’s article on page 12) which would also underpin one of the New Care Model’s objectives of reducing pressure on A&E departments. The system enables patients to self-
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15 manage their condition, report their symptoms scores to clinicians, access reminders and educational material and follow tailored Pulmonary Rehabilitation (PR) exercise courses. The patient now has an accessible online system and is empowered to have greater influence over their care, which is expected to reduce A&E incidents and clinician interventions. Not to forget the costs and potential savings, the AHSN state on their website that chronic obstructive pulmonary disease (COPD) is ‘the second most common cause of hospital admissions with direct NHS healthcare costs of £800 million’. Should 90 CCGs adopt this system with a 60-80% patient uptake in the coming year, the projected savings for the NHS on PR alone is estimated at £12.9m per year. Now... that may not be a big shiny red bus promising £350m a week and I doubt we should hang up our keyboards and wait for the conceivable £100m a week the Nuffield Trust think-tank suggest the government could allocate after Brexit, but this is just one solution from the 100 or more exhibitors who presented over 200 hours of content at Expo 2017. In simplistic terms, I recommend going to Expo 2018 if you are looking to join the dots between technology, change agents, practical outcomes and benefits aligned to NHS strategic plans. And the freebies are good too! For a slightly classier overview, do check out ‘Digital Health News at Expo 2017: App and tech roundup’. Or see the links below for the actual Expo 2017 slides, transcripts, videos and a summary pack of the main messages – useful for team meetings or away days (or Knowledge Matters)!
The gift that just keeps giving (Expo Resources & Reviews)
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Camera Function with IF Statement by Becki Ehren Application: Microsoft Excel A colleague and I recently came across a simple trick using the ‘Camera’ function in Excel, and as this was completely new to me I thought I would share with you how I did it!
Solution: Complexity 1/5 It can be a really good idea to include some images within a dashboard to help with the appeal of the work, or to make it easier to understand. Sometimes you want images to be interchangeable or to only appear when specific selections are made. A lot of people struggle with VBA writing or adjusting the formulas to get what they want, so here is a straight forward way of using an IF statement instead: Firstly, add the Camera function to your Ribbon in Excel. If you add this to your ‘Tool tabs’ then it will appear at the top of the page in Excel, alongside the save, undo and redo buttons etc. As an example, I will use a star to show how the formula works. Firstly type the number 1 in cell A2. Now insert a blue star and place it over cell B2 (this can be any other cell, but I’ll stick with B2 for this example). Now add a red star over C2. Click in the cell where your blue star is located (B2), making sure you select the actual cell and not the image. Once you have clicked on B2, click the camera button that you added to your ribbon earlier. The cell will then show as if it has been copied. Click on the cell (or place in your dashboard) where you want the changeable image to now appear, and the blue star will be pasted. Next, go to the ribbon and click on formulas, name manager, and ‘new’. Insert a named range called Star, and use the formula ‘=IF(A2=1,B2,C2)’. This formula is saying that if A2 equals to 1, then show the star that is in B2, if not then show the star that is in E2. Now click on the pasted picture and you will see in the formula box that it says ‘=$B$2’. Delete this out, and write ‘=Star’. The above can be used for many different things in Excel, but one of the best uses I have come across is when you make a selection in a drop down, and the legend on a chart updates using a specific picture. This can be useful when there are a lot of different elements to a chart that aren’t all needed at one time. To keep this tidy, I would add the formulas and additional pictures on a separate tab and keep it hidden to avoid confusion.
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Transformation Analytics & Health Economics Away Day! The QO are a part of South Central & West CSU’s rather large Transformation Analytics and Health Economics team and a couple of weeks ago, we all descended on Reading for our team away day. Firstly we took time to review just some of our wonderful achievements over the last year and then Sarah Scobie, our great leader, talked us through how we must adapt in order to better support our STPs, and particularly as they seek to evolve into Accountable Care Systems (we hope to write more about this next time). We also heard about Technology Enabled Change and some of the technology initiatives that are being used across the patch to benefit patients and the overall health economy. There was a very interesting piece about population analytics along with a presentation of the CSU’s new Integrated Population Analytics (IPA) system which looks set to take population health management and risk stratification to the next level. Sarah presented the SCW Customer and Service Delivery Model and explained how, in order to be more responsive to customers’ needs, we must look at how we can work in a more flexible way. The day also included ’speed dating’ with the various managers, an interactive quiz which tested our knowledge of the SCW patch and finished with a Belbin exercise that highlighted how each of us behaves within a team; the roles we tend to play and the strengths that we contribute. All in all a fun-filled day packed with informative stuff, and the QO were even forgiven for turning up late (we blame the M25!).
QO Team Do Update! Since our last edition, the Quality Observatory have taken part in a couple of rather splendid events, all in the name of good old team building! Firstly, in June we went down to Brighton for a bit of seaside action, starting with a game of crazy golf on the seafront. There was a minor dispute over who actually won, however there was no doubt that Dani had managed to lose yet again! Afterwards we all sat on the beach for a bit - well it seemed rude not to - and Tao got to see the English Channel for the very first time. Quite a big moment for anyone, I’m sure you’ll agree. While she was admiring that, some bright individual was busy filling Becki’s handbag with pebbles. Just to make sure Tao got the full British seaside experience, we took a wander along the pier - as you do - took silly photos and enjoyed the last traces of Brighton sunshine. In September we went bowling just down the road in Crawley. It was a big win for the ladies with Sophie, Nikki and Rebecca finishing 1st, 2nd and 3rd respectively. Some might argue though that Kiran was the actual winner since he didn’t use the bumpers! Yeah, whatever. Once we’d finished arguing about that one, we headed off to Turtle Bay for some rather lovely Caribbean food.
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NEWS Improved emergency care data to support commissioning From October 2017 a new, improved level of data will be submitted by trusts on urgent and emergency care to enable better commissioning. The Emergency Care Data Set (ECDS) will be particularly important in understanding how and why people access urgent and emergency care over the winter, so we can help improve planning to reduce pressure in the system. The ECDS Information Standard Notice (ISN) has been published by NHS Digital. For further information please visit their website: https://digital.nhs.uk/ecds
STPs: linking organisations If you’ve struggled to link a CCG to the correct STP, or to the correct Cancer Alliance etc, the ONS have several lookup files on their website which can be downloaded. There are quite a few really useful ones and, among others, they include the following: • Clinical Commissioning Groups to STPs (April 2017) Lookup in England • LSOA (2011) to Clinical Commissioning Groups to Sustainability and Transformation Partnerships (April 2017) Lookup in England • Clinical Commissioning Groups to STPs to Cancer Alliances and National Cancer Vanguards (April 2017) Lookup in England • LSOA (2011) to Clinical Commissioning Group to STP to Cancer Alliances and National Cancer Vanguards (April 2017) Lookup in England • Clinical Commissioning Groups (April 2017) Names and Codes in England • Lower Layer Super Output Area to Clinical Commissioning Group to Local Authority District (April 2017) Lookup in England To access them, click on the link below and copy the name above into the search box. http://geoportal.statistics.gov.uk
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Bronze Quality Improvement Training Yorks and Humber AHSN Improvement Academy have some free Quality Improvement online training – http://www.improvementacademy.org/training-and -events/bronze-quality-improvement-training.html It’s not just about analytics but all aspects of QI. Consultations across Yorkshire and Humber and discussions with their regional Quality Improvement Training Advisory Group highlighted wide variation and gaps in the provision of foundation Quality Improvement training across our NHS organisations. As a result they developed an e-learning Bronze training programme which includes a broad spectrum of foundation knowledge, from an introduction to the concepts of quality improvement and the Model for Improvement, to more detailed descriptions of some of the tools for improvement and how they can be used. This Bronze training can be used on a ‘stand-alone’ basis, or as entry to more advanced training. For example, in Yorkshire and Humber the Improvement Academy offers ‘silver training for individuals’ and ‘silver training for teams’. You can find out more about Silver training by visiting http:// www.improvementacademy.org/training-and-events/ silver-quality-improvement-training.html (trainees from outside the Yorkshire and Humber area should consult your local training or improvement team to see what opportunities are available in your area). Content of the Bronze Training: A key objective of the training is to help participants understand how and why everyone has a role to play and can contribute to Quality Improvement in their work area. Module 1: Introduction to Quality Improvement Training Module 2: Quality Improvement in Yorkshire and Humber Module 3: How can I improve patient care? Module 4: Your Model for Improvement
www.QualityObservatory.nhs.uk
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NEWS New starters
Team Birthdays
Introducing our newest team members; Brendan
As you might expect, we’ve had several birthdays in the team since the last issue of Knowledge Matters! Annette, Rebecca, Kiran, Sophie, Trishna, Becki and Nikki have all had birthdays over the last few months, and all indeed have benefited from the usual generosity of the Quality Observatory team (as evidenced in the pictures below!)
and Stephen: Hi, I’m Brendan. I joined SCW nearly 5 years ago as a Senior GIS Analyst before moving onto GIS Team leader and more recently GIS Technical Specialist. Throughout this time my primary role has been leading on the technical aspects of the team and development of various tools including GP Map, GP Finder and MapBuilder. I’m looking forward to moving across to the Quality Observatory where I will continue much as before but with a primary focus on (and hopefully learning a lot more about) web and software development. I will be based at South Plaza in Bristol and continue to work closely with the GIS Team.
My name is Stephen Ayoola; I am a Web Developer/Analyst with the Quality observatory. I recently progressed from the Digital Transformation team in Reading and have worked in various fields including Desktop Support Engineer, IT Project Manager, Data Analyst and CIS Support Analyst at Kent Community Health foundation Trust. I’ve completed a B.Sc. in Software Engineering and a Master’s degree in Network and Security where I honed my skills in programming, software architecture, infrastructure services, traffic and performance analysis, web and application development and building interactive web sites. My hobbies include swimming, cycling and playing ping pong.
www.QualityObservatory.nhs.uk
qoteam.scwcsu@nhs.net
Team Timehop! It’s always interesting to reflect on how far we’ve come, and looking back through old issues of Knowledge Matters this is what we were doing around this time in previous years: 1 year ago: we were winning more awards (Nutritional Resource of the Year for our BAPEN tool!), took a look at the Primary Care Web Tool , welcomed KJ to the team and sent Charlene off on maternity leave 4 years ago: was our Doctor Who themed edition where we had a look at Virtual Wards and the latest goings on with the Friends and Family Test, Charlene got married and we said goodbye to Fats 5 years ago: Rebecca gave birth to her daughter, Rosie, we introduced everyone to our new South of England Respiratory Dashboard and Health Visitors Dashboard, and delved into effective clinical analysis 9 years ago: David launched his Clinical Quality Dashboard, Adam looked at developing clinical metrics for dementia and stroke, and Kiran had just abseiled Guy’s Hospital Tower!
STPs and ACSs!
Fascinating Facts
You'll have heard, I'm sure, of things called STPs
Did you know that we humans share 98.4% of our DNA with a chimpL. L. and 70% with a slug!?
Local partnerships of skills and expertise, Designed to bring the best of care to all communities
There's something new, just appeared, called an ACS Joined up local thinking, striving for success, That sounds the same - I hope it's not a mess
The answer is, so I'm told, one of evolution STPs become ACSs as part of the solution This is just the next stage of the healthcare revolution.
Sophie’s joke of the day... Someone stole my laptop the other day, and I’d just installed Microsoft Office! I will get it back, you have my Word L.!
Knowledge matters is the newsletter of NHS Quality Observatory. To discuss any items raised in this publication, for further information or to be added to our distribution list, please contact us. Hosted by: South, Central & West Commissioning Support Unit E-mail: qoteam.scwcsu@nhs.net