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BMJ Group presentation Quality Forum 2013

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  • 1. Expert NetworksSpecialistsAuthorsPeer reviewersTechnical ExpertsQuality AssuranceClinical EditorialPeer reviewTransparent standardsPrimaryresearchResearch qualityArticle selectionStudy designEvidence Based MedicineSystematic reviewEvidence SummaryHealth EconomicsTechnologyMultimedia deliveryClinical Audit SoftwareHealth InformaticsDomain expertiseMedical EducationDecision SupportClinical Audit
  • 2. MeasureEducateInfluence
  • 3. EducateIdentifyVariationInterpretClinical DataInfluenceAuditPerformanceMeasureDesign KPIs
  • 4. EducateSupportDecisionsInformPatientsGuideCurrentAwarenessIdentifyVariationInterpretClinical DataMeasureAlertAuditPerformanceInfluenceDesign KPIs
  • 5. SupportDecisionsInformPatientsGuideCurrentAwarenessMeasureInfluenceAlertQualifyUnderstandNeedsLearnOnlineEventsPublishEducateIdentifyVariationInterpretClinical DataAuditPerformanceDesign KPIs
  • 6. EducateSupportDecisionsInformPatientsGuideCurrentAwarenessMeasureInfluenceAlertQualifyUnderstandNeedsLearnOnlineEventsPublishIdentifyVariationInterpretClinical DataAuditPerformanceDesign KPIs
  • 7. BackHelp your clinicians make better decisionsWe can help with:• Referential knowledge to inform decisions at thepoint of care• Evidenced based orders sets that reduce cost andimprove quality• Detailed systematic reviews to help plan and designservices• Knowledge integrated into your clinical systemsSupportDecisionsSystematic ReviewEvidence SynthesisAlert DesignSystem IntegrationStudy Grading
  • 8. BackCase StudiesDemoEvidence based reference tool designed to be usedat the point of care• Over 1000 monographs covering around 2500clinical conditions• Evidence based and internationally peer reviewed• Has condition specific information, assessment ofsymptoms guidance and overviews• Include International guidelines and drug databaselinks• Links to GRADE evidence and learning resourcesUnderstand NeedsSupport DecisionsLearn OnlineGuideQualify
  • 9. MenuBack
  • 10. MenuBack
  • 11. atrial fibrillationMenuBack
  • 12. MenuBack
  • 13. MenuBack
  • 14. BackCase StudiesDemoEvidence based reference tool designed to be usedat the point of care• Over 1000 monographs covering around 2500clinical conditions• Evidence based and internationally peer reviewed• Has condition specific information, assessment ofsymptoms guidance and overviews• Include International guidelines and drug databaselinks• Links to GRADE evidence and learning resourcesDesign KPIsSupport DecisionsIdentify VariationGuideInterpret Clinical Data
  • 15. BackHelp your clinicians make better decisionsWe can help with:• Referential knowledge to inform decisions at thepoint of care• Evidenced based orders sets that reduce cost andimprove quality• Detailed systematic reviews to help plan and designservices• Knowledge integrated into your clinical systemsSupportDecisionsSystematic ReviewEvidence SynthesisAlert DesignSystem IntegrationStudy Grading
  • 16. BackWe can provide a synthesis of the available evidenceon any clinical topic• We use a robust evidence based medicine process tointerpret available evidence• Develop search strategies and set condition specificcriteria for the filtering of the studies• Create protocols for the appraisal of the evidence• Synthesise the evidence, interpreting it in thecontext of its relevance and quality• Generate evidence summaries which highlightchanges in the available knowledgeEvidence SynthesisEvidence Synthesis
  • 17. BackHelp your clinicians make better decisionsWe can help with:• Referential knowledge to inform decisions at thepoint of care• Evidenced based orders sets that reduce cost andimprove quality• Detailed systematic reviews to help plan and designservices• Knowledge integrated into your clinical systemsSupportDecisionsSystematic ReviewEvidence SynthesisAlert DesignSystem IntegrationStudy Grading
  • 18. BackIn many cases, our products can be integrated intolocal systems. This facilitates usage by making them:• Fit with local workflow• Accessible at the point-of-care• Utilise common user-interfaces where able• Record usage to local data warehouses to enabletracking• This includes the integration of decision support aswell as the consolidation of national and local datasources.System IntegrationAudit+AnalyticsSystem Integration
  • 19. EducateSupportDecisionsInformPatientsGuideCurrentAwarenessMeasureInfluenceAlertQualifyUnderstandNeedsLearnOnlineEventsPublishIdentifyVariationInterpretClinical DataAuditPerformanceDesign KPIs
  • 20. BackHighlight opportunities for clinical improvementWe can give you better information on:• Variation between providers in your health system• Clinical areas where variation is greatest• Specific interventions to help reduce variance• Comparison of individual clinicians performanceagainst quality measures• Sharing of comparative performance data betweenprovidersIdentifyVariationAlert DesignAudit SoftwareData AnalysisPerformanceMeasuresAudit+Contract+AnalyticsClinical Dashboards
  • 21. BackOur data analysis capability, including statisticians,technologists and health economists, provides theability to:• Baseline current performance and standards• Identify areas of concern to target• Develop meaningful KPI’s• Monitor change and performance to drivesustainable benefits• Show you where savings and quality improvementscan be madeData AnalysisAudit+Data AnalysisAnalytics
  • 22. BackHighlight opportunities for clinical improvementWe can give you better information on:• Variation between providers in your health system• Clinical areas where variation is greatest• Specific interventions to help reduce variance• Comparison of individual clinicians QOFperformance• Sharing of comparative performance data betweenprovidersIdentifyVariationAlert DesignClinical DashboardsAudit SoftwareData AnalysisPerformanceMeasuresAudit+Contract+Analytics
  • 23. BackPowerful clinical dashboards are available to providelocal clinicians and commissioners with visibility ofdifference process and outcome measures tofacilitate:• Identification of variation• Targeting of services to where they are needed• Identification of problem areas to focusimprovement strategies• Monitoring of quality, safety and efficiencyClinical DashboardsAudit+Contract+Prescribing+Clinical DashboardsAnalytics
  • 24. EducateSupportDecisionsInformPatientsGuideCurrentAwarenessMeasureInfluenceAlertQualifyUnderstandNeedsLearnOnlineEventsPublishIdentifyVariationInterpretClinical DataAuditPerformanceDesign KPIs
  • 25. BackEnhance your clinicians knowledgeWe can help you with:• Online learning modules to allow your clinicians tolearn in their own time• A record of all of their learning activity• Reducing the number of face to face educationalevents• Delivering your organisation’s mandatory trainingLearnOnlineLearn OnlineMedical WritingExpert AuthorsMultimediaproductionMedical EducationCurriculumDevelopment
  • 26. BackCase StudiesInstitutionsThe trusted independent online learning service formedical professionals• Interactive, learner centric website designed tosupport personal development• Over 1,000 peer reviewed, evidence basedmodules• Link practice professional development planningwith learning resources• Curriculum driven, editorially independent and up-to-dateQualifyLearn OnlinePublishUnderstand NeedsCurrent AwarenessModulesPlatform
  • 27. BackEnhance your clinicians knowledgeWe can help you with:• Online learning modules to allow your clinicians tolearn in their own time• A record of all of their learning activity• Reducing the number of face to face educationalevents• Delivering your organisation’s mandatory trainingLearn OnlineMedical WritingCurriculumDevelopmentExpert AuthorsMultimediaproductionMedical Education
  • 28. BackOur experience in medical education can be applied in yourorganisation. We can help you with:• The principles of adult learning in healthcare professionals• Planning and delivering a curriculum• Small and large group teaching• Teaching practical skills• Problem based learning• The principles of assessment• How to evaluate your teaching and quality assurance inmedical educationCurriculumDevelopmentCurriculumDevelopment
  • 29. BackEnhance your clinicians knowledgeWe can help you with:• Online learning modules to allow your clinicians tolearn in their own time• A record of all of their learning activity• Reducing the number of face to face educationalevents• Delivering your organisation’s mandatory trainingLearn OnlineMedical WritingCurriculumDevelopmentExpert AuthorsMultimediaproductionMedical Education
  • 30. EducateSupportDecisionsInformPatientsGuideCurrentAwarenessMeasureInfluenceAlertQualifyUnderstandNeedsLearnOnlineEventsPublishIdentifyVariationInterpretClinical DataAuditPerformanceDesign KPIs
  • 31. Identify variationKPI DesignAudit ‘Screening’prompt‘Assessment’promptPatient listsPortfolioReferenceDecision SupporteLearningmodules‘Management’promptBespokedecision treeReferenceDecision SupporteLearningmodulesLink to localpathwaysPerformancemonitoringPatientinformationRelevantarticlesPerformance
  • 32. EBM ContentArticlesEducationBackIdentify variationKPI DesignAudit ‘Screening’prompt‘Assessment’promptPatient listsPortfolioReferenceDecision SupporteLearningmodules‘Management’promptBespokedecision treeReferenceDecision SupporteLearningmodulesLink to localpathwaysPerformancemonitoringClinical RulesServicesRelevantarticlesPatientinformation
  • 33. BackAudit ‘Screening’prompt‘Assessment’promptPatient listsPortfolioReferenceDecision SupporteLearningmodules‘Management’promptBespokedecision treeReferenceDecision SupporteLearningmodulesLink to localpathwaysPerformancemonitoringRelevantarticlesPatientinformationKPI DesignIdentify variation
  • 34. EndBackConsultation with the CCG, clinical leads and GPsenabled identification of key priorities and design ofKPIs.Bespoke audits were designed in Audit+ using acombination of National Guidelines, QOF and localpriorities.Data from these audits allowed us to identify variation.KPI DesignAuditIdentify VariationAudit+AnalysisAuditKPI DesignIdentify variationPerformanceMeasuresSystem IntegrationAudit SoftwareData AnalysisRule Design
  • 35. Audit+
  • 36. Use of diagnostic tests.Prescribing in BPSD.Anti-dementia prescribing.Prevalence of Dementia and use of softer codes.Audit+
  • 37. BackAudit ‘Screening’prompt‘Assessment’promptPatient listsPortfolioReferenceDecision SupporteLearningmodules‘Management’promptBespokedecision treeReferenceDecision SupporteLearningmodulesLink to localpathwaysPerformancemonitoringRelevantarticlesPatientinformationKPI DesignIdentify variation
  • 38. BackAudit ‘Screening’prompt‘Assessment’promptPatient listsPortfolioReferenceDecision SupporteLearningmodules‘Management’promptBespokedecision treeReferenceDecision SupporteLearningmodulesLink to localpathwaysPerformancemonitoringRelevantarticlesPatientinformationKPI DesignIdentify variation
  • 39. BackA wide range of reference materials are provided atthe point-of-care from prompts and bespoke webpages:• These aim to help the GPs with case-finding,diagnosis, management and prescribing• Web pages have been designed which contain linksto relevant resources• These include BMJ resources and local carepathways and services.Systematic ReviewEvidence SynthesisAlert DesignSystem IntegrationStudy GradingReferenceDecision SupportDecisionSupport
  • 40. BackAudit ‘Screening’prompt‘Assessment’promptPatient listsPortfolioReferenceDecision SupporteLearningmodules‘Management’promptBespokedecision treeReferenceDecision SupporteLearningmodulesLink to localpathwaysPerformancemonitoringRelevantarticlesPatientinformationKPI DesignIdentify variation
  • 41. EducateSupportDecisionsInformPatientsGuideCurrentAwarenessMeasureInfluenceAlertQualifyUnderstandNeedsLearnOnlineEventsPublishIdentifyVariationInterpretClinical DataAuditPerformanceDesign KPIs
  • 42. Quality
  • 43. Making healthcare improvement simpleDr Ashley McKimmHead of BMJ Quality
  • 44. 150,000 articles/month120,000 RCT/year
  • 45. Amount of medicalinformation doublesevery 5 years11. Mattox DE. Welcome to ARCHIVES CME. Arch Otolaryngol Head Neck Surg. 2000;126:914
  • 46. 1. Balas EA, Boren SA. Managing clinical knowledge for health care improvementIn: Bemmel J, McCray AT, editors. Yearbook of Medical Informatics 2000On average it takes 17 yearsfor clinical research to becomeroutine practice
  • 47. The challengeMake healthcareimprovement simple
  • 48. 1. Help identify area for improvement2. Find out how others have solved it– and what didn’t work3. Support step-by-step through theimprovement process4. Get advice from mentors, expertsand the global community5. Publish and share your work
  • 49. BMJ Quality Improvement Reports• Aims to become the world’s largestrepository of quality improvementevidence• A standardised SQUIRE guidelinetemplate• Made it searchable to help cliniciansfind what works - and what doesn’t -work before they start
  • 50. • Step-by-step guide foreveryone – whether abeginners or expert• Over 20+ tools andresources to help youalong the way• Worked examples andadvice from experts• One-click submissionwith rapid peer reviewand publication
  • 51. Learning modules
  • 52. • Australia and New Zealand customisedversions (June 2013)• Programme for organisations• PDF mini-journal showcasing all the work by your staff annually
  • 53. BMJ Publishing Group Limited 2013. All rights reserved.Visit the BMJ Stand fora live demonstrationWeb: quality.bmj.comEmail: quality@bmj.comTwitter: @bmjqualityFind out moreJoin us for breakfast!Friday 8amBreakfast session