Data analytics and visualisation are at the heart of our Insights function. The team employs cutting edge data science techniques and tools to interrogate and format data to conduct in-depth analysis that can support better decision-making.
QUALITY IMPROVEMENT AND PATHWAY REDESIGN
Quality improvement in healthcare is about identifying best practice and spreading this across multiple organisations to:
- Promote best practice
- Improve patient care and outcomes
- Reduce unwarranted variation
- Spread QI knowledge and skills across the health system
Accurate, interpretable data is an essential element of any successful Quality Improvement Programme. By providing timely access to process and outcome data, measured against agreed baselines, we enable teams to better understand their performance and progress.
We provide data that can be measured against a team’s own performance over time as well as against their peers in a variety of formats including funnel plots, run charts and SPC charts.
Timely access to this data means that any observations can be acted on quickly, helping teams to maximise the impact of their improvement work. Each of our programmes also contains a QI curriculum element to upskill clinicians and other staff in use of these tools.
The NHS long-term plan and CVD ambition aims to prevent 150,000 strokes, heart attacks and dementia cases over the next 10 years. As an example of this, NHS England has invested £500,000 in procuring Lead-1 ECG devices for distribution by all 15 AHSNs.
Our aim is to reduce the number of people who do not know that they have AF and to increase the number of people with AF who are adequately anti-coagulated.
Since March 2018 KSS AHSN has distributed 556 Lead-1 ECG devices and provided bespoke training sessions and support to the organisations who have the devices. In addition, a Tableau visualisation has been created to show the impact by CCG, STP and KSS AHSN as a whole. We have provided ongoing support to each of 120+ organisations and 800+ people involved or registered in the project.
The impact has yet to be fully realised in national datasets. We do know that through the Lead-1 ECG devices KSS AHSN has distributed from March 2018 to March 2019 there have been 793 ‘possible AF’ traces which if confirmed could potentially save 32 strokes and provide a health and social care cost saving of £638k over 1 year.
Data visualisation is a key tool to enable engagement, interpretation and detailed analysis. The KSS AHSN Insights team often work with highly complex data and need to translate the message they present to busy clinicians or stakeholders, who do not have time to delve into the detail. This can be conducted through many means including; engaging dashboards, mapping, summary documents and infographics – depending on the purpose and outcome required.
Beyond just visualising the data, the KSS AHSN Insights team try to connect the user to the data explaining how it is compiled, algorithmized and the definitions beyond it. This truly open approach does not leave the user confused with “black box” type questions and enables transparency for assurance. With the user understanding their data they can make informed decisions leading to action.
SPREAD METHODOLOGY AND VISUALISATION
As part of its second five-year licence, the AHSN Network chose seven high-impact programmes for national spread. The AHSN Network is also charged with supporting the adoption of products which show the potential to create a transformative effect on the care of patients across the country through the NHS England ITT and ITP programmes. All of these programmes require significant time and effort at the start to build awareness and gain buy-in from clinicians and managers alike.
The KSS Insights team worked with NHS England and the AHSN network to develop a measurement strategy which shows the spread and adoption journey. The data from these measurements is collated each quarter by the KSS Insights team, and visualised through a combination of geographic maps, charts, infographics and commentary which adds a rich layer of intelligence for the network and our commissioners to understand progress, barriers to adoption and learning for future work.
The impact of this work has enabled the AHSN network to truly understand the rate of spread, and therefore, the areas that need more support. With this intelligence we have been able to focus delivery efforts on the right sites to fulfil the AHSN adoption ambitions.
Our analysis is rigorously backed up with statistical testing, carried out in line with universal scientific standards to define differences and relationships between groups and measures.
We use the appropriate statistical method for data interpretation such as t-test, chi-square test, one-way ANOVA, contingency table test and linear regression as well as the statistical power and effect size. However, the arsenal of statistical methods available for use is unlimited, due to our use of the internationally recognised R platform for statistical and graphical programming.
Our work combines a mixture of ‘soft’ approaches to tackle complex and unstructured problems with multiple stakeholders, to ‘hard’ systems modelling that provides quantitative analysis and insights to problems that have a clearer structure, metrics and quantitative outputs.
Statistical analysis was utilised within the pulmonary rehabilitation (PR) workstream as a key driving force for the KSS regional working group to drive engagement and quality improvement with clinicians. The findings were also submitted to the winter BTS conference for presentation to showcase the exciting and inclusive work conducted within KSS versus a national perspective.
As part of the AHSN’s Patient Safety Collaborative the deteriorating patient workstream aims to protect patients by improving recognition and awareness of Acute Kidney Injury (AKI) and Sepsis.
To achieve this, the programme supports the spread of the National Early Warning Score system (NEWS2) which provides a measure of a patient’s condition, and a trigger for care escalation.
Data provided by trusts across the region has been analysed by the KSS AHSN Insights team to measure the effectiveness of the workstream in helping at-risk patients access the correct treatment at an earlier stage. The results have also enabled the team to assess the savings to the health care system by providing treatment prior to deterioration.
Since the start of the Deteriorating Patient workstream in 2016, between 4,086 and 4,796 lives have been saved due to AKI and as of September 2018 50% of trusts across KSS have adopted NEWS2.
Following the initial analysis, metrics have been tracked and compiled into a live dashboard to give commissioners and managers an ongoing insight into the spread and adoption of NEWS2 and its subsequent impact on the population.