2. Did you know that every year in England there are… 50,552 patients with pressure ulcers (category III&IV) like these 13,945 patient falls (with harm) 74,689 patients with catheters & infection

4. Judgement!! Improvement!! Research!!

5. View data over time View different data sources side by side Look for similarities and understand the reasons for differences; don’t be afraid of uncertainty

6. – Plot as you go; set up a spreadsheet to help you – The more the better; try to measure as often as possible – Print and scribble; annotate your charts to add context and additional qualitative information – Display your charts for all to see – Assess trends, not absolute numbers – Use run chart or SPC methods to help detect a change – Embrace your analytical resource……

7. Julie Jones, Patient Safety Lead, Birmingham Community Health Care NHS Trust www.ihi.orgwww.ihi.org for advanced measurement for improvement

8. 1.When it comes to data collection: Reduce, Reuse, Recycle 2.Discuss as a team, and agree, your approach to recording and using data 3.Make data collection and analysis part of your daily routine 4.Triangulate different data sources to give a broader picture (consider a dashboard) 5.Plot your dots as you go- don’t leave it all to the ‘end’

9. Carefully consider data collection mechanisms Acknowledgement of different way of working Data awareness sessions can help ‘demystify’ data for staff Feed data back to front line staff as soon as possible, with commentary Utilise different incentive mechanisms

15. Measures harm at the bedside in a systematic way Ask the right questions about key outcomes Integrates measurement of harm in to your daily work Supports patient care and patient experience Allows you to understand how things can be improved Measures across the health economy in any care setting HarmFreeCare A call to action for frontline healthcare professionals – staff at Salford Royal NHS Foundation Trust are using the NHS Safety Thermometer once per month to rapidly review the proportion of patients free from harm: matron Dylan Edwards with patient Kathryn Shuttleworth, and staff nurse Helen Gresty

16. Question 1: Did the patient experience the harm?

17. Pressure Ulcer Fall (with harm) Urine Infection (catheters) VTE Patient 1noyes Patient 2no yes Patient 3yes Patient 4yes Patient 5yes noyes 3/54/5 5/5 Question 2: Was the patient protected from harm?

18. Question 3: PROTECTED FROM ALL 4 HARMS ?

19. HarmFreeCare from pressure ulcers, falls, catheters & urine infection & new VTE What’s different about the way we measure ‘Harm Free Care’? NHS Safety Thermometer Harm Free Measure What does this mean? Two points outside the control limits Some organisations reaching 95% on pilot wards

20. The East Lancashire Story John Goodenough - Deputy Director of Nursing Peter Weller - Associate Director Patient Safety & Governance

22. Where did we want to be …..? 1. Reduction in harm & the levels of harm 2. Full Health Economy Clinical Engagement 3. Measurement – Measurement to understand Measurement to engage Measurement to improve Measurement because “it was the right thing to do” !

23. How did we get there …..?

24. 1.Executive lead 2.Model - Clinically led / Managerially supported 3.Safety & Quality driving principles 4.Understanding Safety Express 5.Compliance with standards & targets were a “given” 6.Full Health Economy engagement 7.“Driving the Drivers”

25. Measurement for Improvement

26. 1.Reusing existing measuring systems VTE NHS Safety Thermometer 2.Engaging staff – creating a rising tide of change 3. Using Measurement 4.Commissioning

27. “A picture is worth a thousand words”

28. Have you developed an innovative approach to measuring harm? Do you still have any burning measurement questions?