1. Implementing Clinical Governance COMPASS Consultant Outcome Indicators Programme

2. Contents l About CHKS l Implementing the Programme l Future developments of indicators

3. About CHKS l Specialist healthcare information provider with 15 years experience l Leading UK provider of comparative healthcare information l 50+ staff l Working with healthcare organisations on a wide range of agendas – hospital performance, clinical governance, clinician appraisal, specialist clinical benchmarking and financial planning l Extensive experience in the analysis and presentation of healthcare data across the UK and elsewhere

4. CHKS programmes l COMPASS Consultant Outcome Indicators l Signpost l Patient outcomes l Health Check programme l Payment by Results Risk Assessment Programme l Clinical benchmarking l Ad hoc projects

5. Signpost – a corporate reporting programme l A corporate reporting system to assist trusts manage their business performance l Tailored views of organisational performance for CEOs, Board directors, clinical directors, general managers and others l Key measures covering activity volumes, performance, costs, demand and data quality l Tracking of trust performance versus internal targets and external benchmarks l Focus on identifying areas for performance improvement and providing pointers for audit and potential action

6. Signpost – example reporting

7. Patient reported outcomes l Capture and analysis of patient-reported health outcomes to better understand the quality of delivered healthcare l Using SF12 / EQ5D outcome measurement tools 4 Physical and mental health status, including recovery from treatment, experience of pain / discomfort, mobility, resumption of usual activities l Working with selected group of trusts to create a linked activity: outcomes database l Reporting by hospital, specialty and consultant

8. Clinical benchmarking networks l Working with multi-disciplinary groups of doctors, nurses, managers and other professionals l Network topics include: 4 Emergency medicine 4 General surgery 4 Trauma & orthopaedics 4 Radiology 4 Accident & emergency 4 Intensive care 4 Neurosciences

9. Implementing the programme l We suggest each trust establishes a project team - potentially including Medical Director, clinical directors / general managers, information manager and CHKS consultant – a similar group may already exist l A CHKS consultant has been allocated to work with each trust – they will explain and execute the process and key tasks l The CHKS consultant will work with the trust to validate the details of the consultants for whom reported should be produced: 4 Inclusion in the process, correct clinical specialism, individual or departmental reporting l CHKS produces and presents reports to the trust l Entry of additional data via secure web-based tool

10. Summary of key tasks for each trust l Supply of in-patient data for relevant period l Supply of out-patient data for relevant period l Establish trust project group l Nominate trust key contact and any “super users” l Validation of consultant list l Local dissemination of reports l Completion of surveys to capture additional data

11. Demonstration of tool

12. Indicator development – the current situation l The reports use about 300 outcome indicators: 4 Indicators from routinely captured data 4 Indicators derived from reported data via the survey tool – currently focussed on readily available information l Indicators have been derived by: 4 Talking to doctors about what measures are appropriate 4 The analysis of routinely available data 4 Reviewing research and literature materials

13. Indicator development – ongoing developments l There are also two ongoing areas of development: 4 Defining additional specialism-specific indicators in tertiary specialties not present at the pilot trusts 4 Extending the coverage of the reports to all indicators not derived from routinely captured data l The intention is to develop the programme at a practical pace with which trusts can cope l We expect and welcome feedback from consultants and others and will seek to make amendments and additions in a managed and appropriate way

14. Indicator development – the process l CHKS will work with three bodies to co-ordinate the development of the Programme and indicators 4 An external Steering Group containing trust representatives such as CEO / Medical Director / Finance Director / Senior Information Manager 4 An external Technical Group containing trust representatives such as information and business manager membership to consider technical matters 4 Additional ad hoc groups as necessary l The groups will meet as often as required

15. Example of indicator development: Accident & Emergency l Number of new patients seen sorted by Triage Code to profile case mix l Number of discharges and admissions l Possible recording of activity versus staff member if EPR allows l Number of patients referred by A&E junior to Consultant for advice l Number of Unbooked Returns for that individual. i.e. patient not satisfied or condition not resolved l % patients seen within four hours of discharge l Thrombolysis figures for any individual would be very small..... and only worth looking at if there was a significant delay in thrombolysis for any individual patient l Complaints l The number of juniors for whom the Consultant is acting as educational supervisor l Appropriate training and the amount of training done, for example on Life Support Courses

16. Summary of indicator development l The aim will be to continue indicator development that optimally reflects clinical activities l Taking on board feedback and working with appropriate groups to consider changes and additions l Moving the indicators forward in a practical yet meaningful way through: 4 Feedback 4 Additional research 4 Incorporation of new datasets 4 Using patient reported outcome measures