Nicholas Black: Improving information for quality

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Nicholas Black: Improving information for quality

  1. 1. Improving information for quality Nick Black London School of Hygiene & Tropical Medicine and Chair, NHSE National Advisory Group on Clinical Audit & Enquiries
  2. 2. Insufficient attention been paid to effectiveness in past...
  3. 3. Lots of useful indicators ... Safety Experience (Organisational efficiency) (Staff experience)
  4. 4. 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)
  5. 5. Adult critical care -hospital mortality ratio (2010-11) MKHFT
  6. 6. Bowel cancer (2011) - adjusted 90 day post-operative mortality (%) MKHFT
  7. 7. 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
  8. 8. Neonatal care (2011) MKHFT Proportion mothers receiving antenatal steroids
  9. 9. 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
  10. 10. 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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