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Delivering Quality Through eHealth and Information Technology
Session Overview 11:45 - 11:50  Opening:     Derek Feeley 11:50 - 12:10  NHS Lanarkshire Quality Improvement Tool: Diane Campbell and Pamela Milliken 12:10 - 12:30  NHS Lothian/ Trakcare: Martin Egan/Tracey Gillies  12:30 - 12:50  NHS Lanarkshire/ ECS Dr Gregor Smith 12:50 - 13:00 Questions
BETTER EQUIPPED: USING DATA TO DRIVE HEALTHCARE IMPROVEMENT
Pamela Milliken, Head of Clinical Governance and Risk Management NHS Lanarkshire Diane Campbell, Head of Safety,  NHS Lanarkshire
QUALITY IMPROVEMENT Use of data in healthcare is changing ……… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CHALLENGES … ,[object Object],[object Object],[object Object],[object Object]
Lanarkshire Quality Improvement Portal (LanQIP) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DEVELOP LANARKSHIRE QUALITY IMPROVEMENT PORTAL
DATA ENTRY
DATA ENTRY
USING DATA FOR IMPROVEMENT
Using data for improvement   PVC Hand Hygiene
WARD SAFETY BRIEF
USING DATA TO DRIVE IMPROVEMENT
QUALITY ASSURANCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DASHBOARDS
BOARD DASHBOARD REPORT
BENEFITS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Supporting Quality with TrakCare Business Intelligence Martin J Egan Director eHealth,  NHS Lothian
Agenda ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
What is TrakCare BI ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
On Screen Reporting ,[object Object],[object Object]
Improving Efficiency
Assessing  Workloads
Meeting Targets
A&E Snapshot
Waiting Times
[object Object],[object Object],TrakCare Embedded BI
[object Object],[object Object],[object Object],[object Object],TrakCare Embedded BI
TrakCare Embedded BI
TrakCare Embedded BI
TrakCare Embedded BI
[object Object],[object Object],[object Object],[object Object],TrakCare Embedded BI
TrakCare Embedded BI
TrakCare Embedded BI
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Using e health to support improving the quality of care Ms TE Gillies NHS Lothian
Stepwise development in the use of Trak over five years ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Electronic ordering ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Handling results electronically ,[object Object],[object Object],[object Object],[object Object],[object Object]
Trak Maternity ,[object Object],[object Object],[object Object],[object Object]
Booking Questionnaire   Hyperlinks – linking to document for referral   Hyperlinks – linking to document linking to a protocol
Ethnicity Non mandatory fields – language preferred & Ethnicity  Example of new code values for Ethnicity
Alcohol brief intervention  information – HEAT Target requirement  Hyperlinks – linking to document linking to a protocol
Compliance Reports
Handling referrals
Time to process referral manually (days) Time to process referral during e triage (days) General Surgery 4.3 1.4 Vascular 4.2 1.2 Gastroenterology 3.1 1.9
 
 
Clinical Outcomes
Using clinical outcomes ,[object Object],[object Object],[object Object]
Legitimate Clinical Variation? - General Surgery Hernia New Patients, Jul-Oct 2010 Add to WL to Treat Diagnostic Discharge to GP Follow up OPA DNA Other Outcome OutcomeRecorded % Add to WL to Treat Mr SK Kumar 62 8 11 9 12 1 103 60% Mr SJ Nixon 40 6 2 7 0 1 56 71% Ms TE Gillies 16 5 10 0 4 1 36 44% Mr B Tulloh 11 6 10 0 1 1 29 38% Others 83 24 27 6 7 4 151 55% All Consultants 212 49 60 22 24 8 375 57%
Developments into clinical practice ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Sharing information: A&E Discharge Child Protection Form
Next steps ,[object Object],[object Object],[object Object]
Medicines Reconciliation in Scheduled Care using the Emergency Care Summary  Dr Gregor Smith
Background ,[object Object],[object Object],[object Object],[object Object],[object Object]
Medicines Reconciliation “ Every time a patient is transferred from one healthcare setting to another it is essential that accurate and reliable information about the patient‟s medication is transferred at the same time. This enables healthcare professionals responsible for the care to be able to match-up the patient‟s previous medication list with their current medication list; thereby enabling timely, informed decisions about the next stage in the patient‟s medicines management journey. This process is called „Medicines Reconciliation‟ and it should be one of the basic principles of good medicines management.”  (Medicines Reconciliation: A Guide to Implementation. www.npci.org.uk )
Project Structure
Project Management  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results – Accessing ECS Did you access ECS?   Answer Options Response Percent Response Count   Yes 75.3% 305   No 24.7% 100   answered question 405   skipped question 0   Please indicate below why you could not /did not access ECS for this patient Answer Options Response Percent Response Count Patient not on any medications 20% 20 Patient refused access (Verbally) 1% 1 Patient ECS details “Opted Out” 20% 20 Other accurate source available 51% 51 No access to computer. 0% 0 ECS site down 4% 4 Other (please state reason ) 4% 4 Not able to get consent X2 Transferred from another hospital Had up to date cancer care plan available  answered question 100 skipped question 305
Results Environment  Profession Summary by Workgroup Total  %  Elderly Day Care 77  19%  Pre Assessment 135  33% Oncology 84  21% Surgical Other 109  27% 405  100% Who accessed ECS?  Answer  Options Response Percent Count Medical 0% 0 Nursing 63% 193 Pharma 37% 112 Clerical 0.0% 0 answered question 305 skipped question
ECS and Current Treatment Did the ECS reflect the current treatment?         Answer Options Nursing % Pharmacy % Total % Total Count Yes 122 65 76 66 65.5% 198 No 65 35 39 34 34.5% 104  Total   187 100 116 100     answered question 302 skipped question 3
Results – Impact of ECS
Results- Management Q8: Did the ECS change your advice re clinical management of the patient?        Answer Options Nursing % Pharmacy % Response Percent Response  Count Yes 2 9% 5 11% 10% 7 No 21 91% 39 88% 90% 60 Total   23 100.0 44 100.0   100%   answered question 67 Answer Options Nurse Pharmacy Response  Further Investigations 0 0 0 Admission 0 0 0 Referral 1 0 1 Alternative Treatment 1 3 4 Other (please state) 0 2 2* 7 * Ensure that interacting drug not taken       * Confirmation that interacting drugs are discontinued      
Acceptability ,[object Object],[object Object],[object Object],[object Object],[object Object]
Retrospective Audit of E-Referral No of episodes of care 31  Age in years (range) 56 (21 – 79) Male / Female 77% Female Number of episodes with referral paperwork and ECS available 24 Average length of time between referral and pre-assessment in days (range)  110 (20-316) Total number of discrepancies 119 Average Number of Discrepancies / Episode 5
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Will this be available in other hospitals? ,[object Object],[object Object],[object Object],[object Object]

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Delivering Quality Through eHealth and Information Technology

  • 1. Delivering Quality Through eHealth and Information Technology
  • 2. Session Overview 11:45 - 11:50 Opening: Derek Feeley 11:50 - 12:10 NHS Lanarkshire Quality Improvement Tool: Diane Campbell and Pamela Milliken 12:10 - 12:30 NHS Lothian/ Trakcare: Martin Egan/Tracey Gillies 12:30 - 12:50 NHS Lanarkshire/ ECS Dr Gregor Smith 12:50 - 13:00 Questions
  • 3. BETTER EQUIPPED: USING DATA TO DRIVE HEALTHCARE IMPROVEMENT
  • 4. Pamela Milliken, Head of Clinical Governance and Risk Management NHS Lanarkshire Diane Campbell, Head of Safety, NHS Lanarkshire
  • 5.
  • 6.
  • 7.
  • 8. DEVELOP LANARKSHIRE QUALITY IMPROVEMENT PORTAL
  • 11. USING DATA FOR IMPROVEMENT
  • 12. Using data for improvement PVC Hand Hygiene
  • 14. USING DATA TO DRIVE IMPROVEMENT
  • 15.
  • 18.
  • 19. Supporting Quality with TrakCare Business Intelligence Martin J Egan Director eHealth, NHS Lothian
  • 20.
  • 21.
  • 22.
  • 23.
  • 29.
  • 30.
  • 34.
  • 37.
  • 38. Using e health to support improving the quality of care Ms TE Gillies NHS Lothian
  • 39.
  • 40.
  • 41.  
  • 42.  
  • 43.
  • 44.
  • 45. Booking Questionnaire Hyperlinks – linking to document for referral Hyperlinks – linking to document linking to a protocol
  • 46. Ethnicity Non mandatory fields – language preferred & Ethnicity Example of new code values for Ethnicity
  • 47. Alcohol brief intervention information – HEAT Target requirement Hyperlinks – linking to document linking to a protocol
  • 50. Time to process referral manually (days) Time to process referral during e triage (days) General Surgery 4.3 1.4 Vascular 4.2 1.2 Gastroenterology 3.1 1.9
  • 51.  
  • 52.  
  • 54.
  • 55. Legitimate Clinical Variation? - General Surgery Hernia New Patients, Jul-Oct 2010 Add to WL to Treat Diagnostic Discharge to GP Follow up OPA DNA Other Outcome OutcomeRecorded % Add to WL to Treat Mr SK Kumar 62 8 11 9 12 1 103 60% Mr SJ Nixon 40 6 2 7 0 1 56 71% Ms TE Gillies 16 5 10 0 4 1 36 44% Mr B Tulloh 11 6 10 0 1 1 29 38% Others 83 24 27 6 7 4 151 55% All Consultants 212 49 60 22 24 8 375 57%
  • 56.
  • 57.  
  • 58.  
  • 59. Sharing information: A&E Discharge Child Protection Form
  • 60.
  • 61. Medicines Reconciliation in Scheduled Care using the Emergency Care Summary Dr Gregor Smith
  • 62.
  • 63. Medicines Reconciliation “ Every time a patient is transferred from one healthcare setting to another it is essential that accurate and reliable information about the patient‟s medication is transferred at the same time. This enables healthcare professionals responsible for the care to be able to match-up the patient‟s previous medication list with their current medication list; thereby enabling timely, informed decisions about the next stage in the patient‟s medicines management journey. This process is called „Medicines Reconciliation‟ and it should be one of the basic principles of good medicines management.” (Medicines Reconciliation: A Guide to Implementation. www.npci.org.uk )
  • 65.
  • 66. Results – Accessing ECS Did you access ECS?   Answer Options Response Percent Response Count   Yes 75.3% 305   No 24.7% 100   answered question 405   skipped question 0   Please indicate below why you could not /did not access ECS for this patient Answer Options Response Percent Response Count Patient not on any medications 20% 20 Patient refused access (Verbally) 1% 1 Patient ECS details “Opted Out” 20% 20 Other accurate source available 51% 51 No access to computer. 0% 0 ECS site down 4% 4 Other (please state reason ) 4% 4 Not able to get consent X2 Transferred from another hospital Had up to date cancer care plan available answered question 100 skipped question 305
  • 67. Results Environment Profession Summary by Workgroup Total % Elderly Day Care 77 19% Pre Assessment 135 33% Oncology 84 21% Surgical Other 109 27% 405 100% Who accessed ECS? Answer Options Response Percent Count Medical 0% 0 Nursing 63% 193 Pharma 37% 112 Clerical 0.0% 0 answered question 305 skipped question
  • 68. ECS and Current Treatment Did the ECS reflect the current treatment?         Answer Options Nursing % Pharmacy % Total % Total Count Yes 122 65 76 66 65.5% 198 No 65 35 39 34 34.5% 104 Total   187 100 116 100     answered question 302 skipped question 3
  • 70. Results- Management Q8: Did the ECS change your advice re clinical management of the patient?       Answer Options Nursing % Pharmacy % Response Percent Response Count Yes 2 9% 5 11% 10% 7 No 21 91% 39 88% 90% 60 Total   23 100.0 44 100.0   100%   answered question 67 Answer Options Nurse Pharmacy Response Further Investigations 0 0 0 Admission 0 0 0 Referral 1 0 1 Alternative Treatment 1 3 4 Other (please state) 0 2 2* 7 * Ensure that interacting drug not taken       * Confirmation that interacting drugs are discontinued      
  • 71.
  • 72. Retrospective Audit of E-Referral No of episodes of care 31 Age in years (range) 56 (21 – 79) Male / Female 77% Female Number of episodes with referral paperwork and ECS available 24 Average length of time between referral and pre-assessment in days (range) 110 (20-316) Total number of discrepancies 119 Average Number of Discrepancies / Episode 5
  • 73.
  • 74.

Hinweis der Redaktion

  1. Order Item is displayed, enter username & password
  2. Returned to the Ward, the Order Icon is displayed on Floor Plan, hovering over Icon shows which Order(s) have been placed
  3. Click the Look-Up to display the Mannequin and Select the Category & Option
  4. General Surgery Operation Note
  5. Selecting Yes will access the Questionnaire