Are we Doing to Many Procedures? (Example Tonsillectomy) Explore Discovery Are we Doing to Many Procedures? (Example Tonsillectomy) This presentation is my opportunity to highlight some of the feedback that we within the wrap-around team have been receiving from HB about what Discovery Developments would make Discovery a more useful tool for users. It is based on the type of work that wrap-around has done with Health Boards in order to support their use of Discovery and encompasses suggested additional content and new visualisations. If there is support from the wider Discovery Audience to develop these Discovery enhancements then we as a Discovery team will begin developing them.

Methodology Go to Discovery Dashboard ‘Consultant Team Dashboard’ and Procedure Diagnosis Search tab (Discovery Level 2) Type in ‘Key word’ in procedure search box to identify Procedure Chapter and Sub Chapter Go to Procedures tab in this Dashboard Filter on ‘OPCS Chapter’ identified via procedure search, Dashboard renders to show all procedures, initially set for Elective IP Activity, user selects desired procedure Episode type can be changed by clicking on dashboard panel. Hovering over bar identifies further information User can then compare selected activity to Scotland and identify consultant activity

Consultant Team Dashboard Procedure/Diagnosis Search Tab:- Click for link Type in ‘Tonsi’ in procedure search box. Then click ‘Enter’ on keyboard This identifies all of the procedures with this key word in the procedure code and description. It also identifies associated diagnosis’ for patients who had this procedure. Also identifies the OPCS 4 procedure chapter and sub chapter, which is useful for when other dashboards are analysed. A monthly trend in activity is also shown

Consultant Team Dashboard Procedure Tab Filter on ‘OPCS Chapter’ for Mouth, Dashboard renders to show all procedures (initially set for Elective IP) for the Mouth Chapter. 2. Click on F34:- Excision of Tonsil. Dashboard renders to show activity for this procedure. 3. You can now see that this HB undertook 750 procedures out of 4,480 in Scotland (17% of total activity). Depending on size of HB a judgement can be made on if HB are doing to many procedures.

Consultant Team Dashboard:-Procedure Tab Other Interesting Information:- F34 Procedure Only 11/750 procedures done as a Day case (1%) V 1,181/4480 for Scotland( 26%) 2. Trend Graph shows that month on month this HB is undertaking fewer of these operations 3. Shows Activity information by consultant for selected procedures. 4. This dashboard is dynamic so selections made on one panel are reflected in the other panels. Holding down ctrl while you click on different areas of the graph will allow the user to multi-select procedures/episode types

Other Potentially Useful Dashboards BADS:- Discovery Level 2:- Click for Link Selected BADS Procedure of Tonsillectomy 2. Potential Improvement Graph compares activity undertaken as a day case V BADs Target (Suggested % of activity that should be day case) 3. Shows activity information for the selected location and selected BADs Procedure and a peer rate comparison (user can expand table to show monthly activity) 4. Shows monthly trend Information for % BADs by Month V Peer BADs performance. Note Check Metadata for BADs to identify what procedure codes are included in each BADs procedure.

Other Potentially Useful Dashboards Cross Boundary Flow:- Discovery Level 2:- Click for Link For Tonsillectomies are we operating on other HB Patients? Go to CBF Dashboard Level 2 Treatment OPCS4 tab:- Choose Your Board of Treatment and then Exclude your Board of Residence from 2nd Drop Down Box. This renders the Dashboard to show other HB patients you are operating on 2. Chart shows numbers by HB of Residence and which Hospital they are treated in. 2nd Bar Graph shows patients GP practice 3. Shows activity information for the OPCS Chapter. Clicking on a section here renders all other information in the dashboard for this chapters activity 4. Shows OPCS4 Procedures for the selections made (in this case ‘Mouth’ Chapter. Note can chose specific activity type, Day case, elective activity, non elective episodes.

Other Potentially Useful Dashboards BQBV (Better Quality Better Value):- Discovery Level 1:- Click for Link The summary view enables the user to view potential cost saving opportunities in tabular form, across a range of factors:- Ambulatory care BADS Procedures of low clinical value New outpatients – did not attends Pre operative stay Average length of stay Elective average length of stay – spells Users can compare their selections to the Scottish Mean or Upper Quartile.

Summary Identification of Number of Procedures undertaken by Specific Health Board. Compared activity to Scotland, Monthly trend information available. Analysis of Cross Boundary Flow Dashboard to identify if other HB patients are being treated here Identified that other HB’s were able to treat a higher proportion of these patients as a Day case (In this example) Highlighted BQBV Dashboards that enables the user to view potential cost saving opportunities in tabular form, across a range of factors

Discovery Hints and Tips The A to Z page : highlights all the information available in Discovery and provides specific links to this information. Tool Tips: Throughout Discovery if the user hovers their cursor over any of the charts or data points a tool tip will appear with additional information Custom Views: Within each dashboard area it is possible to save specific visualisations (Custom Views) incorporating any filter selections the user has made. Pause button:- Clicking on the ‘Pause’ button allows users to make all of their filter selections at once rather than one at a time. Dynamic visualisations: Many of the dashboards in NSS Discovery are dynamic. This means that if you click on one area of a chart/table it will update the other areas/panels to reflect this choice. Exporting data from Discovery: To export data, select the chart or table containing the information you wish to export (by clicking on it), then click on the button (normally located near the top right of the dashboard) and choose the format you wish the data to be exported in. Metadata: - detailed metadata is available via the head icon at the top right of all dashboards.

For Discovery support and more information on accessing and using NSS Discovery, email us at:  nss.discovery@nhs.net or visit our website: www.nssdiscovery.scot.nhs.uk