1. Clinical quality indicators: progress update Jim Chalmers & Lindsay Mathie Information Services Division, NHS National Services Scotland

2. Overview –What is the project about –Approach to deriving indicators –Suggested indicators –Examples

3. What is it about? Investment in Children’s Specialist Services –Is it working? –How can we tell? What does “good” look like Need to measure relevant outcomes National Delivery Plan for Children and Young People’s Specialist Services in Scotland: –“71. There is, therefore, a need to be able to identify, gather and analyse a number of key clinical or service outcome measures that would allow an accurate and timely understanding of progress across the spectrum of specialist children’s services.”

4. Relevant Indicators Multiple dimensions of health care quality –safe, effective, efficient, patient-centred, timely, equitable Exploit currently collected data where possible Develop data collection/analysis without excessive costs

5. Approach Following Institute of Healthcare Improvement model and proposed Healthcare Quality Strategy for Scotland –Catalogue existing indicators –Engage with exemplar MCNs and Steering Group for further suggested indicators –Feed back to clinical leads –Compare indicators to dimensions specified by Association of Public Health Observatories Importance, relevance, validity, possibility, meaningfulness, implications

6. Examples of Indicators in Practice

7. EF06 Compliance with Standards & Protocols –Cincinnati Children's Hospital –Use of evidence Based Guidelines July - September 2009 – 92% compliance. (Percentage of condition specific evidence- based guidelines followed in the emergency department and on inpatient units) –1996- 2007 Resulted in Fewer hospital admissions (12-71% decrease) Shorter average length of stay (12-37% decrease)

8. EQ02 How far the patient has to travel As an example the project group looked at Access to General Surgery of Childhood Looked at –Estimated travel times –Length of stay by travel time

10. Estimate Travel Time 1 Mean length of stay (days)Number of admissions 0 – 30 minutes2.31,315 30 – 60 minutes2.8577 60 – 90 minutes4.6141 90 – 180 minutes4.9183 Table 1: Mean Length of Stay by Estimated Travel Time1 Elective Admissions to General Surgery of Childhood, 2008/09