1. Transforming costing information
HFMA 2018 SW Conference
Steven Wainwright
Jenny Richards

2. Complex Patient journeys
Adult SALT
Bone Health
District Nursing
Occupational Therapy
Integrated Community Teams ‘Other’ services
Community Physiotherapy
Integrated Assessment & Discharge Team (IADT)
Community Inpatients
IV Therapy
Minor Injury & Illness Unit
Other Specialist Nursing
Parkinson's & Motor Neurone Disease
Podiatry
Respiratory Services
Tissue Services
Urgent Care services
Patient 1
77 year old with COPD
Patient 2
83 year old with MND
Patient 3
78 year old with Diabetes
Patient 4
65 year old End of Life Patient
This data has given us the power as a Trust to see how our patients are using our services, and how our services interact with one another.
For very convoluted patient journeys, pathway data has prompted patient audits
Particularly interested in patients using our Rapid Response service – indicates a crisis
Presented at monthly Trust-wide management meeting
Number of Contacts / Bed Days by service over a 12 Month period

3. Timeline Patient Journey – Patient 3
Patient journeys over a timeline are providing insightful information as to exactly how services are interacting with one another, and through our links with the Acute Trust through our Integrated Assessment team and data from our Single Point of Clinical Access service, we are able to identify in many cases where patients are admitted to the Acute Trust and then are handed back to the Community Trust.
All these services being deployed – is this patient being managed across all services?

4. Patient Pathway Audit for Transformational Change
We’re able to highlight patients that should be included within patient pathway audits, highlighting what went well in the patient’s care, what could have been better and what is required for a transformed approach

5. Variation in Diabetes District Nurse Contacts by Band
Diabetes District Nursing Contacts by Band by locality
Cheltenham
Cotswolds
Forest of Dean
Gloucester
Stroud
Not only do we have patient-level information, but we have significant clinician information as well.
We have the information to start questioning clinical variation, to identify and start to eliminate unwarranted variation.
Not only this, we now have the ability to start to look at the structure of episodes of care, in the case of DN this will be used to understand how the new B4 Nursing Associate role can fit into the episode of care, and indeed to inform workforce planning.

6. How we got here and where we’re heading
Creative, flexible, iterative approach
Excellent joint project approach with Informatics team
The Next Phase
Outcome Measures
BAU use of data by Operations Management to highlight and eliminate unwarranted variation, inform CIP, transform patient pathways