NTAC Doppler leaflet

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.

Turn over to find out more…...

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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

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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

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10

Trust 11

10

10

9

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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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