Nicholas Black: Improving information for quality

What’s Your Hand In It? is a Dragon’s Den-style competition where healthcare organizations submit their brilliant idea for evidenced-based hand hygiene improvement. We selected five entries who will be invited to pitch their ideas via WebEx to our panel of judges. The pitch to our panel of judges will take place virtually on STOP! Clean Your Hands Day - May 5, 2014. The panel of judges will provide instant feedback on your pitch and the winner will be announced live after all three pitches have been made. Watch all the hand hygiene idea pitches to our judges: http://bit.ly/10cZ7SZ

Health & Medicine

Improving information for quality
Nick Black
London School of Hygiene & Tropical Medicine
and
Chair, NHSE National Advisory Group on Clinical Audit &
Enquiries

Insufficient attention been paid to
effectiveness in past...

Lots of useful indicators ...

Safety
Experience
(Organisational efficiency)

(Staff experience)

Need to (and can) consider effectiveness of
care
• Outcomes
– Survival
– Morbidity/disability
– Health-related quality of life

• Processes
– adherence to evidence-based clinical guidelines or
quality standards (NICE)

Adult critical care
-hospital mortality ratio (2010-11)

MKHFT

Bowel cancer (2011)
- adjusted 90 day post-operative mortality (%)

MKHFT

Patient reported outcome for hip replacement (post-op Oxford Hip Score)

45
Buckinghamshire
Burton
Colchester

40

Dudley Group

35

Basildon & Thurrock
East Lancashire

Blackpool
30
0

200

400
600
Number of operations

800

Neonatal care
(2011)

MKHFT

Proportion mothers
receiving antenatal
steroids

Diabetes care: all 9 care processes* completed (2011)

MK PCT
*NICE recommended care processes: urinary albumin, eye screening, foot exam,
smoking review, BMI, cholesterol, blood creatinine, HbA1c, BP

National clinical audits in England
Clinical area

Number

Peri & neo-natal

2

Children

7

Adult acute & emergency care

10

Long term conditions

10

Surgery/interventional procedures

7

Renal disease

3

Cancer

4

Trauma

3

Psychological conditions/treatments

3

Blood transfusion

1

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