Thursday, 10 June 2010

HC 2010 notes

Hmmmm....some time since the HC2010 conference but finally here are my notes:

- Gwyn Thomas – Informing Healthcare talked about the programme in Wales. He covered how they established “rules of the road” at the start to manage communication and expectations. The approach has been to take mostly small rapid steps with occasional large ones. There has also been an emphasis on learning together and developing a sense of common purpose. The architecture model considers different types of architecture: information; systems; and social (trust, relationships, collaboration).

- Aidan Halligan – gave a talk on values. He quoted Don Berwick “culture eats strategy for breakfast” giving the example of what hasn't worked with the NPfIT. He outlined how the explosion of knowledge has outstripped the ability of the NHS to keep up and some of the tools they are using in Imperial such as After Action Reviews (lessons learned debriefings) but set up to ensure that lessons learned are immediately implemented.

- Richard Hamblin from CQC – talked about the new Quality and Risk Profile and how it will show the synthesis of information on an organisation and will be used to identify problems. V1.1. available May, v2 in Autumn. A network of RIEOs has been set up (Regional Intel Officers). The plan is not to publish risk estimates but they do plan to publish judgements of inspectors. Data is fed and aggregated into a risk model – this is used to produce a dashboard which has dials (RAG) prepared by analysts – the dashboard is shared with the organisation; the inspector will then confirm any red lights (or not) at the inspection. Dashboard measures are around involvement, innovation; quality and management; suitability of staffing; safeguarding and safety; personalised care, treatment and support; suitability of managementt. Drilling down enables exploration of inherent risk, situational risk, population risk, uncertainty risk. Indicators are derived from HES, patient/staff surveys, national clinical audits, regulators and bodies such as PEAT and NPSA. Publicly accessible data will be based on the inspection not data alone – public will be able to view high level dials and be able to drill down into inspection report. Planning to provide access to principal commissioner.

- Samantha Riley – SEPHO – presented on how they have changed the culture of presentation and visualisation of data and information, through education/training and design of dashboards. They now provide regional benchmarking for 6 standard indicators (example of incorporating knowledge from library service on MRSA/C Diff). They're looking at how to evidence variation e.g. one example around hip replacement was due to innovative practice – needs to be shared to improve length of stay, mortality, readmissions across the health economy.

- Robert Lake – talked about Strategic Programme for Adult Social Care Information – includes development of the Adult Care Support Record ( aCSR), review and update of social care information guidance, zero-based review of data/information needs. 5 key themes – standards, aCSR, intelligence (NASCIS launched by IC in Oct 09) and JSNA, infrastructure, workforce (culture, leadership, training). NHS number to be applied to all adult social care records. aCSR will lead to a NMDS and data dictionary. Need to engage with self funders – currently no information on this, not even sure of extent of population. aCSR will assist personalisation agenda, by helping individuals to identify and manage their needs.

- James Walker – talked about localising MoM. Suggests that a typical pathway involves 800 hours of development. Highlighted importance of clinical ownership. Demonstrated ability to drill down to BNF and NHS Evidence. Outlined differencess between administrative and clinical localisation and implications of each.

- Rick Jones – talked about national pathology info strategy. Data in pathology has unpredictable downstream uses, can be merged from multiple sources and persists over time. Tests throughout 18 week pathways – data collected from different places (e.g patient in Cumbria could get referred to number of DGHs) and there are some variations which may not be taken account of if the data is used later for R&D. For example, different formulae can be used to test for chronic kidney disease – can lead to misclassification, unreliable results, underdetection, inappropriate referrals. Equivalent of BNF for lab tests is run by Royal College.

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