Quality Improvement in Imaging Services in Scotland Margaret Sherwood Assistant General Manager NHS Greater Glasgow & Clyde

Overview  Define quality in Healthcare setting  Previous Quality measurements in Imaging  Data collection  Proposed QI subgroup 3 year work programme

What is Quality? Within healthcare, there is no universally accepted definition of ‘quality’. However the US Institute of Medicine (IoM), has identified six dimensions through which quality is expressed.  Safety  Effectiveness  Patient centred  Timeliness  Efficiency  Equity

What is Quality Improvement?  Improving the safety of our service  Becoming more effective through providing services based on scientific knowledge and which produce a clear benefit  Being patient centred through providing care that is respectful and responsive to individuals’ needs and values  Timeliness through reducing unnecessary waits and delays  Avoiding waste and providing an efficient service  Equitable through providing care that does not vary in quality

Quality Outcome Indicators for Imaging in NHS Scotland  No imaging equivalent to SMR datasets  Pilot imaging dataset 80’s/90’s?  ISD costbook activity data  Diagnostic Waiting Times  Audit Scotland Report 2008  Benchmarking project – 2008  NHS Efficiency and Productivity Programme - Report of the Diagnostics Steering Group 2009  MDICN – 2012

MDICN Minimum Dataset  Minimum dataset agreed in 2010  Demand - the number of patient referrals to each modality – all patients being recorded in RIS  Activity - the number of patient events by modality – all patients being recorded in RIS  Demand and Activity broken down by referring specialty  Modality sub-group data collection  Provided comparable data across NHS Scotland

SCIN Data Collection   Minimum dataset agreed as a good baseline   Recognised additional workload for RIS managers   Recognised gap in timelines   Cumbersome Data pushed rather than automatic pull from data source   PACS database suggested as alternative – but Exam rather than attendance based Other activity on system, eg. Digitised old films etc.

The Way Forward Dr Raj Burgul

Real time RIS Data   Demo at SCIN Quality Improvement Sub group   Uses real time data   Currently used for Carestream RIS in NHS FV   NSS Datamart   Dashboard   Trial arranged for CRIS in NHS GG&C

QI Subgroup 3 year Work Programme Year 1Year 2Year 3  MDICN Minimum Data Set  DNA Rates  KPIs for Imaging  In-patient Turnaround Times.  Dose Assessment & Optimisation  Demand Management  Workforce Issues  Urgency Codes  Cost Book Optimisation  Weighting Factors for Complexity

In Summary 3 year work programme for QI group -  Safety – Dose assessment and optimisation  Effectiveness – Demand management  Patient centred – Inpatient turnaround, staffing  Timeliness – Measured waiting times  Efficiency - DNA rates, Cost book analysis  Equity – Urgency codes, KPIs