The Quality Observatory

What High Quality Care for All said: We will ask each SHA to establish a formal Quality Observatory, building on existing analytical arrangements, to:  Enable local benchmarking  Support the development of metrics  Help frontline staff innovate and improve services Expectation that each Quality Observatory will:  Make information available through portals such as NHS Evidence and NHS Choices

Some Core Principles Structure:  No centrally prescribed model – but, regardless of whether a virtual network or centralised service, must have a clear point of access / “front door”  Should seek to build on, rather than duplicate, existing infrastructure and the work of existing institutions / networks e.g. PHO’s, Regional Audit Teams, Cancer Registries etc  Should be effectively networked with each other and with national organisations e.g. Information Centre, to avoid duplication and share best practice  Should cover all sectors of health and social care Governance:  Should be accountable to the SHA  Should have a clearly defined process for setting a work programme that is responsive to clinical priorities / local & regional strategies, involving all stakeholders e.g. patients, public, clinical staff, providers and commissioners  Should form an integral part of overall SHA strategy for quality assurance and improvement Functions (General)  Promote and support the development of quality indicators as a tool for quality improvement; and  Provide support to clinical leaders to act on the information and achieve quality improvements

Quality Infrastructure New Director of Innovation –Service Improvement –Innovation –Quality Observatory Quality Board established –Recently revised to incorporate QIP agenda (Quality, Innovation, Productivity) Enhancing Quality Programme –Similar to Advancing Quality (NHS North West)

The Quality Observatory Team of 12 – built on SHA Knowledge Management Team Provision of benchmarking –Over 40 tools and products developed Skills development –Analytical –Measurement and interpretation Data quality improvement World Class Commissioning support Developing meaningful clinical metrics

Who are we? Samantha Riley Head of the Quality Observatory Simon Berry Specialist Information Analyst Peter Nyaga Support Analyst Katherine Cheema Specialist Information Analyst Adam Cook Specialist Information Analyst Kiran Cheema Workforce Analyst Aleksandra Bujnicka Workforce Support Analyst David Harries Health Analyst Rebecca Owen Performance and Planning Analyst Nia Naibheman Performance Analyst Charlene Atcherley-Steers Performance Analyst Vacant PA and Admin Support

Structure & Governance National Quality Board South East Coast Quality Board South East Coast Quality Observatory Other potential contributors Thames Cancer Registry Library and Knowledge Services ….? PRIMARY ACCESS POINT TO THE QUALITY OBSERVATORY Directorates Service Specifications Quarterly Reviews Including ad hoc query review No standard model being prescribed South East Coast is one of the first to establish a Quality Observatory Key difference to others – we will provide an analytical service to the SHA itself

Examples of our work Clinical Metrics Development Programme –Joint programme with the NHS Information Centre –Dementia –Stroke Safer Smarter Nursing Metrics Quality Dashboard Focus –Utilising existing data –Presentation –Measurement for improvement –Combining data to ‘tell a story’

BADS* Tool – Trust dashboard *British Association of Day Surgery

Specialty view – comparison with others

PCT Spend - dementia Apparent disinvestment

QOF register - dementia Utilised NAO prevalence model Comparison with numbers on dementia registers

Acute Admissions

Monitoring Tool

Stroke metrics Mortality % Patients with MRI/CT Length of stay –Average –Run chart Cost of activity Discharge destination Selected sentinel audit indicators Viewable by hospital site View for all patients or patients less than 75 Identifies specialist units on site

Stroke dashboard A Hospital

Safer, Smarter Nursing Health community wide (benchmarking) –Pressure damage –HCAI –Drug administration errors –Falls –Complaints Bespoke local service –Including elements of productive ward

Trust Monitoring

Enhanced presentation

Overview of latest position

Comparative information

Quality Dashboard MRSA and C-Diff rates Risk adjusted mortality Unplanned readmissions Rate of complications of medical & surgical care Rate of drugs, medicaments & biological substances causing adverse events Incidence of catheter associated UTIs Incidence of pressure ulcers Hip fracture repairs within 48 hours Patient satisfaction

Quality Dashboard

Work in progress Commissioner based dashboards –Stroke –Dementia Practice level diabetes dashboard Cardiac Dashboard Maternity Dashboard Nursing metrics - community Systems to identify early warning signs SUI monitoring suite Agreement on regional monitoring measures Evidencing and spreading innovation

nww.sec.nhs.uk/knowledge nww.sec.nhs.uk/qualityobservatory

Contact details nww.sec.nhs.uk/knowledge –Register as a user Samantha Riley –