1. Emergency flow improvement tool
Changing the way we look at data
29 November 2017
Title slide with embedded images

3. If we look at data the same way we will get the same results
The challenge
If we look at data the same way we will get the same results

4. Pleasant Surprise Trust : A&E performance
This is also Pleasant Surprise Trust.
Here we are looking at monthly data – we can see the improvement that was identified in the previous slide.
But what happened before then?
This is an SPC chart (not going to talk about these in detail in this session). If people want to know more about SPC I have some tips at the end.
Simply by plotting the dots, it is easy to see where performance is changing over time –and to investigate what might have happened and to take action
A pleasant surprise?
A pleasant surprise?

5. Take two different numbers, one will be bigger
beware point measures, before and after

6. Sea of green or algae bloom
The tool is provided as an improvement aid and diagnostic tool to help Trusts to understand the issues impacting most on flow through their hospital.
By using the flow tool, Trusts will be able to focus interventions on these issues and understand whether changes that are being put in place are resulting in improvements.
The flow tool uses an analytical technique (Statistical Process Control or SPC) which is helpful in identifying when changes have occurred which are statistically valid and not just random chance.

7. Early warning obscured by fog of green
The tool is provided as an improvement aid and diagnostic tool to help Trusts to understand the issues impacting most on flow through their hospital.
By using the flow tool, Trusts will be able to focus interventions on these issues and understand whether changes that are being put in place are resulting in improvements.
The flow tool uses an analytical technique (Statistical Process Control or SPC) which is helpful in identifying when changes have occurred which are statistically valid and not just random chance.

8. Red Green blindness

9. Basically if there is not a threshold or target why are we RAGing it?
Recognition of need to balance measurement for improvement and judgement
Basically if there is not a threshold or target why are we RAGing it?
And to build capacity to help support the change

10. Emergency flow improvement tool

11. Timeline Alpha testing 28th June 2017 – 10th September 2017
Launch of tool 11th September 2017 At
Health and Care Innovation Expo 2017
Version Two
November 2017

12. Co-designing the tool with acute trusts
150 users
30 acute providers
Weekly WebEx’s
Walkthroughs, polls, question and answer sessions
One to one site visits and virtual demonstrations with
North Middlesex
West Suffolk
South Tees
Royal United Hospitals Bath
Northumbria
South Warwickshire

13. Inspired by
Based on

14. Describing patient flow with 28 indicators
Hospital
Accident and Emergency   
2018


15. What does each chart show?
Indicator title
Benchmarking icon
Upper control line
Mean line
Latest activity value
Lower control line
Data point roundels – one for each of the last 25 calendar months
Grey – common cause variation
Orange – special cause variation – cause for concern
Blue - special cause variation – to note/investigate

16. What are the rules behind each chart?
Six rules shown on the indicator detail page….

17. Why is six points significant?
Probability
Considering a random system with 50% chance of improvement and 50% of decline (e.g. based on a coin toss)
A trend of 2 has the probability of 25% occurrence (one in four)
= (0.5)*(0.5).
A trend of 4 has the probability of 6.25% occurrence (one in sixteen)
= (0.5)*(0.5)*(0.5)*(0.5) = 6.25%
A trend of 6 has the probability of 1.56% occurrence (one in sixty-four)
= (0.5)*(0.5)*(0.5)*(0.5)*(0.5)*(0.5) = 1.56%

18. Finding out more
Watch the webinar:

19. Outreach
116 separate organisations and 448 unique users have accessed the Efit tool since launch in September 2017

20. How to access NHS Provider Staff
Register for an account
Other NHS Staff / Non NHS Staff
for terms and conditions which will govern your use of the tool

21. So why is this different?
Social change across
#plotthedots
Backed up by the leadership framework
Finally starting to use technology
Tableau visualisations available on multiple devices
Paper, pdf, laptop, phone, tablet
Automation
daily downloads
updates
Daily sitrep flow tools with minimal human involvement
Near real time tracking
Replicable to other sectors and pathways