Clinical quality indicators: progress update

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Clinical quality indicators progress update

• Jim Chalmers Lindsay Mathie
• Information Services Division, NHS National
  Services Scotland

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Overview

• What is the project about
• Approach to deriving indicators
• Suggested indicators
• Examples

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What is it about?

• Investment in Childrens Specialist Services
• Is it working?
• How can we tell?
• What does good look like
• Need to measure relevant outcomes
• National Delivery Plan for Children and Young
  Peoples Specialist Services in Scotland
• 71. There is, therefore, a need to be able to
  identify, gather and analyse a number of key
  clinical or service outcome measures that would
  allow an accurate and timely understanding of
  progress across the spectrum of specialist
  childrens services.

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Relevant Indicators

• Multiple dimensions of health care quality
• safe, effective, efficient, patient-centred,
  timely, equitable
• Exploit currently collected data where possible
• Develop data collection/analysis without
  excessive costs

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Approach

• Following Institute of Healthcare Improvement
  model and proposed Healthcare Quality Strategy
  for Scotland
• Catalogue existing indicators
• Engage with exemplar MCNs and Steering Group for
  further suggested indicators
• Feed back to clinical leads
• Compare indicators to dimensions specified by
  Association of Public Health Observatories
• Importance, relevance, validity, possibility,
  meaningfulness, implications

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Examples of Indicators in Practice
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EF06 Compliance with Standards Protocols

• Cincinnati Children's Hospital
• Use of evidence Based Guidelines
• July - September 2009 92 compliance.
  (Percentage of condition specific evidence-based
  guidelines followed in the emergency department
  and on inpatient units)
• 1996- 2007 Resulted in
• Fewer hospital admissions (12-71 decrease)
• Shorter average length of stay (12-37 decrease)

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EQ02 How far the patient has to travel

• As an example the project group looked at Access
  to General Surgery of Childhood
• Looked at
• Estimated travel times
• Length of stay by travel time

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Table 1 Mean Length of Stay by Estimated Travel
Time1 Elective Admissions to General Surgery of
Childhood, 2008/09
Estimate Travel Time1 Mean length of stay (days) Number of admissions
0 30 minutes 2.3 1,315
30 60 minutes 2.8 577
60 90 minutes 4.6 141
90 180 minutes 4.9 183