This presentation by Alison Moores, Director of Nursing and Practice, Devon Partnership NHS Trust, shows how accurate, high quality and timely data is driving improvements in local mental health services. Alison suggests ingredients for effective quality governance include: Team to Board lines of accountability Clarity of standards and metrics to measure them. Active and ‘real time’ use of information at the right level (ie governance is not about writing reports) Use the information to measure emerging risk and be clear about the actions that will follow. Useful questions to consider include: How do commissioners move from ‘assurance from data’ to ‘assurance that data is being used to improve services’? How far should quality measures be standardised? How will providers, commissioners and people who use services work together to decide the measures of quality? How do we balance data value with data cost?

1. Alison Moores
Director of nursing and Practice
Devon Partnership NHS Trust
11.07.13

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Quality governance is the combination of structures and processes for
ensuring quality performance.
Quality performance incorporates safety, effectiveness and experience of
using services and is measured across inputs, processes and outcomes.
Quality Governance is about dynamic functions:
o Ensuring required standards are achieved
o Investigating and taking action on substandard performance
o Sharing best practice
o Identifying and managing risks to quality of care.
o Measuring (and encouraging) improvement
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Quality governance requirements:
o Clear lines of accountability: teams to Board
o Clarity of expectation
o Reliable and credible information

3. Defining key standards and metrics:
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Seeing the wood for the trees
Board leadership and sign off
Clinical engagement
People who use services and their supporters
Regulatory and contractual
Reliable and credible information infrastructure

4. Orbit:
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real time data – overnight refresh
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Data to team / practitioner level
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principle sources are the electronic clinical record (RiO,
IAPTUS, HALO), survey data and electronic audits – direct
feeds via a data warehouse.
Available to clinicians and managers on a self service basis
Automatically generates bespoke performance reports / alerts
– can be daily to support clinical practice (eg medicines
reconciliation within 72 hrs, follow up within 48hrs of
discharge)

6. Physical health assessment within 24 hrs of admission:
Medicines reconciliation within 72 hrs of admission:

9. Team level self assessment (PCA)
Modern matron / service manager verification
Peer ‘observations of care’ visits
Board quality and safety walkrounds

16. Information overload (woods and trees)
Tension between required information and clinically valuable
information
Overloaded clinicians and reduced capacity
Engagement with the use of information to make quality
improvements.
The system will only be as effective as the structures it is
designed to inform.

17. Ingredients for effective quality governance.
• Team to Board lines of accountability
• Clarity of standards and metrics to measure them.
• Active and ‘real time’ use of information at the right level (ie
governance is not about writing reports)
• Use the information to measure emerging risk and be clear
about the actions that will follow.

18. How do commissioners move from ‘assurance from data’ to
‘assurance that data is being used to improve services’?
How far should quality measures be standardised?
How will providers, commissioners and people who use
services work together to decide the measures of quality?
How do we balance data value with data cost?