SEC-QO : supporting the NHS Technology Adoption Centre
Oesophageal Doppler Tools NTAC Doppler Length of Stay Benchmarking by Specialty 2009/10 HES The Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust (RDZ) Highlighted - 156 Patients Non-elective - All Specialties - South West SHA Peer Group Comparator 35 Top Decile Top Quartile Mean 30
25
20 17.6
15
15.3 13.6
10
5
RVJ
RN3
RD1
RH8
RD3
RA4
RK9
RA3
RBA RB RDZ RTE
RBZ
RNZ RA7
RA9 REF
0
South East Coast Quality Observatory is providing analytical support to the NHS Technology Adoption Centre’s (NTAC) programme of introducing innovative technology programmes. The first of these is to provide analysis to evidence the impact of Oesophageal Doppler guided fluid management during surgery. A suite of tools have been created to enable Trusts to benchmark themselves and measure improvements after adoption of the technology.
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What’s in the Toolkit? Data for the tools are sourced from the latest published Hospital Episode Statistics, currently 2009/10. All of the Trust benchmarking tools contain drop down boxes allowing you to select a number of options Specialty, as defined by the procedure groupings provided by NTAC; Elective / Non-Elective admissions; Mean / Median national average; Trust, this highlights the selected Trust the chart in red, other trusts in the peer group are highlighted in cyan; Peer group comparator, this allows you to select whether you want to view other Trusts in the selected Trust’s parent SHA or whether you want to compare against the selected Trust’s ONS peer group. NTAC Doppler Length of Stay Benchmarking by Specialty 2009/10 HES
Length of Stay
The Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust (RDZ) Highlighted - 156 Patients
25
20 17.6 15.3
15
13.6
10
5
RVJ
RN3
RD1
RH8
RA4
RD3
RK9
RA3
RBA RB RDZ RTE
RBZ
0 RA9 REF
Drop down boxes enable the user to select a speciality and provide the option to view information for elective or emergency admissions. In addition, the use can elect to view mean or median information.
RNZ RA7
The first tool in the pack is the length of stay tool, this shows mean length of stay for all Trusts in England. It is possible to select an individual Trust and select comparator information for Trusts within the same region or Trusts within the same peer group.
Non-elective - All Specialties - South West SHA Peer Group Comparator 35 Top Decile All Specialties Non-elective Mean Top Quartile ** The Royal Bournemouth & Christchurch Hospitals NHS Foundation T Mean Strategic Health Authority 30
NTAC Doppler Spell Casemix Adjusted Length of Stay Benchmarking by Specialty 2009/10 HES The Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust (RDZ) Highlighted - 114 Patients
Casemix Adjusted Length of Stay
Non-elective - General Surgery - South West SHA Peer Group Comparator 10
8
6
4
2
-2
-4
-6
RA4
RVJ
RH8 RN3
RD3 RD1
RD RB
RB
RA3
RBZ RT RK9
RN
RA9
RA7
REF
0
The second tool in the pack allows a comparison between Trusts adjusting for casemix using the length of stay by procedure for all England Trusts as a reference. The zero line represents the Trust performing as per all England Trusts based on its casemix. If a Trust is performing better than expected it’s bar shows a negative value and conversely where it is worse the bar shows a positive value. In the example to the left the highlighted Trust’s length of stay for the selected specialty is 1.5 days better than expected.
Again, information is available by speciality and admission type and enables Trusts within the region or ONS peer group Trusts to be used as comparators
Crude In-Hospital Mortality
NTAC Doppler Crude Mortality Benchmarking by Specialty 2009/10 HES Buckinghamshire Hospitals NHS Trust (RXQ) Highlighted - 755 Patients
The final benchmarking tool allows a comparison of crude in-hospital mortality rates. The same selection criteria are available as described previously.
Non-elective - All Specialties - Medium Acute Peer Group Comparator 16.0% Top Decile Top Quartile Mean 14.0%
12.0%
10.0%
8.0%
Over the coming months these tools will be refined on the basis of feedback received from users—and the tools will be regularly updated so that Trusts can see how their improvement efforts have impacted on key indicators.
6.68%
6.0% 4.77%
4.0% 3.34%
2.0%
RQ
RPA
RR7
RKE RVY RK5 RNS RBK RAS RDZ
RFR
RN5 RDD RFS
RD1 RGP
RTK
RGC
RTP RJ6
RN3 RMC RNA
RCB RNH
RJR RC9 RNL RDE
RVW RDU
RBN RAX
RW RBA
RD3
RGN RGQ
RAJ
RA2
RQ8 RCC
RWJ RD7 RA9
RAP
RJ2 RXQ
REM
0.0%
Monitoring the Improvement The tools described so far provide comparative information as a snap shot in time. An additional tool has been developed which shows progress over time for key indicators. This dashboard has been populated with data for Trusts within South East Coast. Due to limitations with regards to accessing data, it is not possible for the South East Coast Quality Observatory to populate this tool for all Trusts nationally. The Observatory has provided both the query methodology and clear instructions for use so that this tool can be rapidly adopted across the NHS so that every organisation and commissioning consortia can access this data on an ongoing basis from their local HES data or via their regional Quality Observatory. NTAC Doppler Procedures All Specialties
Elective Length of Stay Rolling Quarter Smoothing SHA Average
Trust 1
Patch 1
Trust 3
Trust 2
Patch 2
Trust 4
Trust 5
Patch 3 10
9
9
9
9
9
9
8
8
8
8
8
8
7
7
7
7
7
7
6
6
6
6
6
6
5
5
5
5
5
5
4
4
4
4
4
4
3
3
3
3
3
3
2
2
2
2
2
2
1
1
1
1
1
1
0
0
0
0
0
0
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
Trust 7
10
Trust 8
Trust 10
Trust 9
10
10
Trust 11
10
10
9
8
8
8
7
7
7
7
6
6
6
6
6
5
5
5
5
5
4
4
4
4
4
3
3
3
3
3
2
2
2
2
2
1
1
1
1
1
0
0
0
0
0
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
9
8
7
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
9
8
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
9
9
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
Trust 6
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
10
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
10
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
10
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
10
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
10
Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Oct-09 Jan-10 Apr-10 Jul-10 Oct-10 Jan-11
Rolling Quarter Smoothing Rolling 12 Month Average
The measures on the dashboard are
Admissions; Bed days; Length of stay; Crude in-hospital mortality; 30 day readmission rates.
The tool is designed to be easily updated by local analysts using SUS data extracts. For further information on this suite of tools, please e-mail simon.berry@southeastcoast.nhs.uk
Helping frontline staff innovate and improve services
Enabling
Benchmarking Networking Collaboration
Supporting
Development of Metrics Development of Skills Development of Tools
Advising
Statistical Techniques Presentation & Interpretation Data Sources & Collections Quality Observatory NHS South East Coast York House 18-20 Massetts Road Horley,Surrey, RH6 7DE Phone: 01293 778899 E-mail: Quality.Observatory@SouthEastCoast.nhs.uk Website: www.QualityObservatory.nhs.uk To contact a team member: firstname.surname@southeastcoast.nhs.uk
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