National Health Information: Better Data, Better Decisions March 1st, 2017

1. A Game of Trust….. Reliable data for
national clinical audit
Marina Cronin

2. A Game of Trust….. Reliable data for
national clinical audit
Launch of HIQA
Information management standards for
national health and social care data
collections
01 March 2017

3. • Established in 2012
• HSE QID Funded
• Based in RCSI
• Produce hospital and
national level reports ,
recommendations for
improvement
• Inform & escalate outliers
within HSE Accountability
Framework
• Promote use of national
clinical audit data
• Set governance standards
for NOCA audits – meetings,
data protection/ security,
data set, data quality, PIA,
reporting
• Design, implement &
manage new national audit
• Training programmes
• Research studies
• Sharing of learnings
arising from national
audits
About NOCA

4. Current Audit Portfolio
# Audit
National
Report
Public
Hospitals
Live 2017 2018 2019
1
National Audit of Hospital Mortality
(NAHM)
2016 44 44
2 Major Trauma Audit (MTA) 2016 26 26
3 Irish Hip Fracture Database (IHFD) 2013 16 16
4 NPEC Severe Maternal Morbidity 2011 19 19
5 NPEC Perinatal Mortality 2008 19 19
6 NPEC- Vermont Oxford Network 2016 2016 19
7 Intensive Care Unit Audit (ICU) NA 22 7 6 6 3
8
Irish National Orthopedic Register
(INOR)*
NA 12 1 4 7
4
*Phase 2 Private Hospitals

5. National Clinical Audit
5
‘a cyclical process
that aims to improve
patient care and
outcomes by
systematic,
structured review
and evaluation of
clinical care against
explicit clinical
standards on a
national basis.’
(NCEC)
National
clinical
audit -A
dashboard
of clinical
care
Good Data
driving
Good
Decisions

6. In God we trust, all others bring data.
W. Edwards Deming
A Game of Trust….. Reliable data for national
clinical audit

7. NOCA
Governance
National Clinical
Effectiveness
Committee
Legislation & National
Guidelines e.g DP, Consent
Best Practice Clinical Standards

8. NOCA Governance Approach
8
DESIGN
DESIGN
Audit Aim & Objectives
Clinical Standards
Methodology &
Methods
Data set & dictionary
Identify Data Sources
Data protection
National Governance
Structure
IMPLEMENTATION
Local Governance Structures
Local resources
Testing
Training
Data validation
On going support
MANAGEMENT
Data Quality
Outlier Management
Governance: National
Audit Annual Review
Audit Annual Plan
Share learnings
NOCA Board Approval
Annual Reports
NOCA AUDIT OUTPUTS
Quarterly Hospital
Reports
Annual National Report
– Key findings &
recommendations
Key recommendations
to system

9. • Person centred
• Leadership, Governance
& Management
• Use of Information
• Information
Governance
• Workforce
• Use of resources
9
HIQA Standards for National Health and
Social Care Data Collections
NOCA
JOURNEY
OF
IMPROVEMENT
IN DATA
QUALITY

10. Theme 1: Person-centred

11. Theme 1: Person-centred

12. Theme 2: Governance, Leadership and
Management
National
Perinatal
Epidemiology
Centre (NPEC)
Prof Richard
Greene
NOCA GOVERNANCE BOARD
Intensive Care
Audit (ICU)
PICANet
Dr R.Dwyer
Dr M.Healy
National Audit
Hospital
Mortality
(NAHM)
Dr B.Creedon
Irish National
Orthopaedic
Register (INOR)
Mr P.Kenny
Mr D.Moore
Mr J.Cashman
Irish Hip
Fracture
Database
(IHFD)
Mr C.Hurson
Dr E.Ahern
Major Trauma
Audit (MTA)
Dr C Deasy
NOCA Executive Director Clinical Director
NOCA Operational Support

13. 13
Theme 3: Use of Information
DESIGN
COMPLIANCE WITH
AGREED
DEFINITIONS:
COMPARABILITY
HL7 Message
Standard: INOR, ICU.
SNOMED: ICU
ICD10AM: NAHM,
INOR, IHFD, MTA
DATA QUALITY
Data Quality Frameworks
Data Dictionary
Collaboration with Key
stakeholders
Training
DATA ACCESS
Access to data in
accessible and
usable format for
patients and
clinicians
DISSEMINATES &
REPORTS
INFORMATION
Hospital Level
National
Patient & Public

14. Theme 4: Information Governance
• Appointed Data Protection Officer and FOI Administrator
• Access logs: DP, FOI, Research, Service Evaluation
• PIAs - Audits in active implementation; INOR, ICU
• Deloitte Data Protection review
• INOR infrastructure setup 2 Data centres: Full disaster
recovery and business continuity

15. Security AAA Standards adhered in the
development of INOR security features
AuthorisationAuthentication Accounting
Role based access setup

16. Theme 5: Workforce
Hospital audit staff
NOCA staff
Education
National
Collaborations –
NCEC, HPO,
In house
Training &
Updates
Evaluation
of Training
Sharing of
Learning
Annual
Audit
Review
International
Collaboration-
TARN, ICNARC,
FFN, ISAR, HQIP
Continuous
Improvement

17. Theme 6: Use of Resources
Governance
3rd party
Vendor
Agreements
Security testing
Data Security -
Industry
Standard
products
Testing
Applications
go through
rigorous
testing
NOCA
Audit

18. NOCA
Governance
National Clinical
Effectiveness
Committee
Legislation & National
Guidelines e.g DP, Consent
Best Practice Clinical Standards
HIQA Information management standards for
national health and social care data collections

19. • Making National Clinical Audit happen;
Hospitals, Audit Collaborators,
• Making this presentation happen-NOCA
Colleagues; Brid Moran, Collette Tully, Aisling
Connolly, Kenny Franks, Dee Burke, Mary
Baggot
• To you
19
Acknowledgments