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Edition 32 – July 2015
Keele Benchmarking
News
Contents
•Crikey–WeAreGoingDown Under!
•KUBSMulti-disciplineUserGroup Meeting
•KUBSLaboratoryBenchmarking Service
•KUBSPrimaryCareBenchmarking Service
•DoesAnybodyActuallyListento Pathology?
•AdvertisinginPathologyBenchmarking News
Regular Features
•FromtheEditor
•Coffeewiththe BenchmarkingTeam
•DatesforyourDiary
KUBS Launch Primary Care
Service
From the Editor
ThisisquitepossiblyoneofthemostexcitingtimesIhaveexperiencedduringmytimeworkingwithKUBS.Wearestillrecruitingforthelaboratorybenchmarkingservice,anditisalwaysexcitingwhennewandexistingparticipantsjoinus,butwehavealsonowfinallylaunchedtheprimarycarebenchmarkingprojectouttothewiderworld.
Thisissomethingwehavebeendevelopingandrefiningforaboutsevenyears,andhavingseenthepowerofsomeofthedataandevidencethepilotphaseshaveproduced–inparticularthefactthatwehavemanagedtofeedsomuchofitintoresearchandpublishedpapers–Iamextremelyinterestedtoseehowitprogressesnowthatmorelabswillbejoiningus.
ThisyearalsoseesthewiderlaunchofthecollaborativeenhancedbenchmarkingofferingbetweenKUBSandCivilEyesResearch.Weranahugelysuccessfulpilotofthisjoint-workinginitiativelastyear,whichessentiallycombinedtheexistingservicewithcontextualandoutcomesdataderivedprimarilyfromHES(andequivalent)systems.Itdemonstratesstrengthsandidentifiesareasforefficiencyandcostsavingsforeachlab,andalsohighlightswheretheexternalpressuresareimpactingonthepathologyservice.Finally,itpresentsevidenceandinformationaround
whereandhowpathologyimpactsonpatientoutcomesandonthehospitalstheyserve,andisdeliveredthroughreports,interactiveworkshopsandavisittoeachofthehospitalstoworkwiththedata.
Asifthatwasnotexcitingenough,wearealsonowembarkingonournewadventuretopilotabenchmarkingprogrammeacrossfourstatesinAustralia.Infact,asIwritethisIamliterallyabouttoprintoffmyboardingpassesandtraveldocumentsreadytoflyovertheretomeeteachofthestates,andtotalkthoughtheirdatawiththem!
Ahugechallengeliesaheadintermsofmappingthedata,andthisiswhereIcometomyfirstthemeoftheedition–comparinglike-for-like...or,asyouwillreadlaterinthecoffeewiththebenchmarkingarticle,comparing“applesandoranges”.ThishasbeenidentifiedasthemostimportantgoalforthepilotinAustralia,buthasalsoresonatedasacommonthemeinourUKworktoo.
Forourlaboratorybenchmarkingschemewehavedonealotofworkthisyeartofurtherdevelopoursmartpeergroupingtools.Whilstthepeergroupingworkedwelllastyear,wealwaysfeltthattherewasscopetoimprovethewayitgroupedlaboratoriestogether.Participantsthisyearwillnoticethatmoreadvancedcomplexitymeasures,aswellasrefineddemographicinformation,willbefactoredintothewaytheirlabsaregrouped.
Asmaynowbeveryapparent,wehavegotalotofexcitingthingsgoingon,andifyouwouldliketoknowanymoreaboutanyoftheworkweareinvolvedinthenpleasedropmeanemailond.holland@keele.ac.ukorcallmeon01782733277.Iwouldbedelightedtotalktoyouaboutit!Inthemeantime,Ihopeyouenjoyreadingthislatesteditionofour newsletter.
David Holland Project Lead, Keele University
Benchmarking Service
Oneofthemostimportantthingsweneedtoconsiderwithbenchmarkingisalwaysensuringcomparability.Youhaveprobablyheardtheoldclichéof“comparingappleswithapplesandorangeswithoranges”,andmorerecentlyIhaveevenheardthiseloquentlyexpandedto“comparinggreenappleswithgreenapples”.Iamnotquitesurewherethiswillend(comparingfullyripe8.5cmshamrockgreenGrannySmithappleswith…yougetmydrift!)butIdo
knowonething:that,despitemysarcasm,thisisanabsolutelycriticalbitofwhatwe do.
Ensuringcomparabilityisanessentialcomponenttoanybenchmarkingexercise.Ifwecannotcountthesamethingsinthesameway,thenanyattemptsatcomparisonaremeaningless.Withthatinmindwehavebeenworkinghardtonotonlyrefinethewaywedefineourworkloadandrefine
Coffee with the Benchmarking Team #15, Apples and Oranges
cont...
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theguidancenotesweprovidewithourquestionnaires,butalsomorerecentlytoworkdirectlywithsomeofourparticipantstotakeanactiveroleinhelpingmapthe data.
ThiscouldnotbeanymorerelevantthanintheworkweareabouttoundertakeinAustralia.AsIwritethisarticleIamliterallyabouttosetofffor“thelanddownunder”tospendtimewitheachofthefourstates,workingthroughtheiractivitydatawiththeminordertounderstandhowtomaptheminacomparableway.
Ihavehonestlygotabsolutelynoideawhattoexpectatthismomentintime–yesIhaveseensomedatafromSouthAustraliaduringtheAdelaidereviewlastyearandspentalotoftimeworkingonit,butbyallaccountseachstateiscompletelydifferent,notonlyinthewaytheirLIMSsystemswork,butalsointhewaytheydeliverpathologyasawhole.Furthermore,earlyindicationssuggestthateachhospitalwithineachstatehavesignificantlydifferentwaysof
working,soitcertainlylookslikeitwillbeafascinatingchallenge.
AndthisisbeforeIhaveevenattemptedtomapitagainstUKdata!
Thatsaid,andthisissomethingwhichhasbecomeabitofacommonthemeformetowrite(andspeak)about,butIstillinsistthat,essentially,everyservice(whetherinAustralia,theUK,oranywhereelseforthatmatter)isstillunderpinnedbythesamecommonprinciple–specifically,thattheyemployagroupofstaffwhichconsistofqualifiedlaboratoryscientists,laboratoryassistants,andmedics/consultants,andaresupportedbyateamofadministrative,managementandqualityassuranceprofessionals,theyallreceiverequestsforworkanddo‘stuff’asaresult,andtheyallhavetomanagefinancesinordertodelivertheservice.
Inmymindthatmeansthereisenoughcommonalitytobeginaprocessofcomparisonandbenchmarking,anditisatthatpointwetacklethe“appleswith
apples”bitofhowwecountdata,andstarttolookatthewidercontextofhowwecomparelaboratoriesonalike-for-likebasis...whichbringsmenicelyontomyfinalpoint:comparabilityoflaboratories.
Ihavespokenmanytimesaboutpeergrouping,andwrittenarticlesaboutitinpreviouseditionsofthisnewsletter,soIamcertainlynotgoingtocoveroldgroundagain.However,whatIdowanttomentionbrieflyisthat,astimeprogresses,thewayweareabletogroupandcomparelaboratoriesinameaningfulway(withouttheneedtomentionanykindoffruit)isgettingnoticeablybetter.
Inthisyear’slaboratorybenchmarkingprojectwearenowfactoringinmoreintermsofworkloadcomplexity,specialisationanddemographicdata,inadditiontototalvolumeandpopulationserved,andintheprimarycarebenchmarkingprojectweareabletotakeittoanevengreaterlevel...foreachGPpracticewehaveawholewealthofdata,rangingfromthenumberofpatientswithlong-standinghealthconditionsanddeprivationindextosomeofthemoresimplecomparisonslikeageprofiling.WithsomanyGPpracticestochoosefromwearefindingsomeinterestingwaystocreaterelevantpeergroups,anddespitethefactthateveryoneseemstoclaimtheyare‘unique’,wewillalwaysfindthemagroupthat,ifnotanabsoluteexactmatch(because,youknow,theyreallyare‘unique’),isascloseasdammitthatmostpeoplewouldnotbeabletotellthe difference.
Or,asitisnowknown,wearecomparing“appleswithapples”,ratherthan“shamrock-green-8.5cm-Granny-you-get-my-drifts….”which,fortheoverwhelmingmajorityofpeople,isaperfectlyacceptableandvalidmethodology.And,ifweacceptthatthecomparisongroupisafairone,wecanfinallythenmoveontowhatmakesbenchmarkinginterestinginthefirstplace
–lookingatvariation,andexploringthereasonswhyitexists.
Tofinish,IwillhintatanarticleIamabouttostartwritingupasadiabetesresearchpaper...thisisonewherewegroupedGPpracticesfromourprimarycarebenchmarkingpilotintermsofdeprivationscore,ethnicityandageprofile,andbegantolookatvariationincostperpatientfortesting,prescribingandoutcomes.
Apartfromthefactthatpathologyismadetolooklikethebargainofthecentury,therearesomeextremelyinterestingquestionstobeaskedaroundtheextremevariationinoutcomes.HowcanoneGPpractice,whoperformapproximatelythesamenumberoftestsperdiabetespatient,prescribethesameamountofdrugsperdiabetespatient,andhaveaverysimilar(ifnot,onpaperatleast,nigh-onidentical)populationasanotherpractice,havethreetimesthenumberofdiabetes-relatedadmissions,averagealmosttwicethelengthofstayperadmission,andaccumulatealmostfivetimesthecostofdiabetesrelatedadmissionsthanitspeer?
Inthepast,theanswerwouldprobablyhavebeen“ah,butwearedifferent”.Butthistime,havingusedasystemwhichis...wait for it...“comparingappleswithapples”,theanswernowneedstoberevised.Weactuallyneedtolookatthereasonswhyvariationexists,notjusttakingthecop-outrouteof“thedataaremeaningless/notatruereflection/etc…”.
Andthatisoneofthereasonswhytheneedtocompareappl...err,“tocompareinarelevantway”...issoutterlycritical.
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Crikey – We Are Going Down Under!
Lastyearwecontributedtowardsahugere-configurationprogrammeinAdelaide,SouthAustralia.LedbyErnstandYoung,andwithsignificantcontributionfromBeestonConsulting,theprojectwassuccessfullycompletedattheendoflastyear.
KUBSwereinvolvedinarolewhichanalysedperformancedataandprovidedinternationalbenchmarkingcomparisonstohelpassessperformancelevels.WefirsthadtogainsomeunderstandingoftheSouthAustraliahealthsystem,andthenhadtoworktowardsmappingtestnamesandstaffgrades(andpayscales)toUKequivalents.
Whilstthemappingprocesswascertainlyachallenge,andacceptingthattherearesomesignificantdifferencesinthewaythepathologyservicesofSouthAustraliaandtheUKfunction(particularlygeographically)weactuallyfoundthat,essentially,thefoundationofthewaythedifferentservicesaredeliveredhadenoughcommongroundforvalid comparison.
AndsowiththesuccessfulcompletionoftheAdelaideproject,welookedintothepossibilityofpilotinganationalbenchmarkingprogrammeacrosstherestofAustraliaalongwithBeestonConsulting(workingincollaborationas‘TheBenchmarking Partnership’).
Asluckwouldhaveit,TheNationalCoalitionforPublicPathology(NCOPP),anorganisationwhich(accordingtotheirownmissionstatement)“wasformedin2001togiveasinglevoiceforarticulatingandrepresentingthevaluesandissuesofrelevancetopublicpathologyservicesthroughoutAustralia”,invitedustospeakatoneoftheirannualmeetingsaboutourideasforanational programme.
Asaresultofthatmeeting,wewereinvitedtobeginworkingonapilotbenchmarkingprogrammewithfourstates–SouthAustralia,WesternAustralia,NewSouthWalesandQueensland.Wearenowatthebeginningof
averyexcitingjourney,havingcollectedaninitialsetofdataandabouttoworkwitheachofthestatestogainanunderstandingofthewaytheirsystemsreportactivityandstaffing.
Wewillprovideaprogressreportlaterintheyear,butneedlesstosayweareexcitedaboutworkingonthisproject,andparticularlyinterestedtoseewhetherwecanaddanyvalueonbothsidesoftheworldintermsofmappinginternationalcomparabledata.PerhapslabsintheUKwillbeabletolearnsomelessonsfromtheircolleaguesinAustraliaandviceversa.
Aseriesofroadshows,heldacrosstheUK,provedhighlysuccessfulinpromotingthe
adoptionoftheNationalLaboratoryMedicineCatalogue(NLMC),andtheNationalPathologyExchange(NPEx),resultinginthefirstScottishlaboratoriespurchasingtheNPEx system
Atleast60organisationsfromacrossEnglandandScotlandwererepresentedattheroadshows,whichwerepreparedonthebackoftheDigitalFirstpathologyreportfromNHSEngland.Thereporthighlightedtheimportanceofintegrateddigitalsystemsinthefutureofpathologyservices.Theroadshows,heldfromJuly2014toFebruary2015,andorganisedincollaborationwithNHSEnglandandtheRoyalCollegeofPathologists,providedanopportunityforhealthprofessionalstogainadeeperunderstandingoftheimpactofadoptingtheNLMCandNPEx systems. cont...
Christopher Johnson, NHS England, speaking at the West Midlands roadshow
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KUBS Multi-discipline User Group Meeting
Afterlisteningtofeedbackfromlastyear’sMulti-disciplineUserGroupMeeting,andsourcingasuitablevenue,thedateforthisyear’smeetinghasnowbeenfixed.Wewill
betravellingnorthinNovember…toManchester…andTheManchesterConferenceCentre&Pendulum Hotel.
Findingsfromthe2014-2015benchmarkingexercisewillbediscussedandthemeetingwillgiveparticipantsthechancetoairtheirviewsontheprocess.Theywillalsomeetpeoplefromdifferentinstitutionswithvaryingareasofexpertise.
ThemainpresentationthisyearwillbedeliveredbyourProjectLead,DavidHolland,anditwill“DemonstratetheValueofPathologyinImprovingPatientOutcomes”.Itshouldprovetobeaveryinterestingtopicandtherewillalsobeplentyofchancesforquestions!
Ourparticipantsaregiventhechancetoprovidefeedbackonthebenchmarkingprocessandtorequestanyimprovementsormodificationsforthefuture.Weprideourselvesonthefactthatwearea‘userled’service,andwerelyonfeedbackfromparticipantstoensurethatwhatweofferremainsrelevantanduseful.Thepointsraisedwithintheindividualdisciplinebreakoutsessionsareagreatwayforthistohappen.Manyofthechangesmadetotheprocessovertheyearshavebeenmadeasadirectresultofcommentsgiventousatsuchmeetings.Ofcourse,wedoalsoliketohearoccasionallythatwehavegotthingsright!!
Themeetingisalsoagreatopportunityforparticipantstonetworkandgettoknowothermembersoftheprofession.Withamulti-disciplinemainsessionandparallelbreakoutsessionsfordifferentdisciplines,therearecertainlyplentyofchancesforcontactstobebuiltwithinpathologycircles.RepresentativesfromallofourSpecialtyPanelswillalsobeinattendanceontheday.
Fornewusersandthosewhowanttogettogripswithmoreadvancedusesofthedatacollected,wewillagainberunninganAnalysisToolstrainingsessionatthisyear’smeeting.ThiswillaimtogiveabasicunderstandingastothepossibleusesoftheExcelfilethatisprovidedalongwiththefinalbenchmarkingdata.Itwillalsoansweranyquestionsregardingtheseversatiletools.
CurrentparticipantswillreceivetheirinvitationsinAugust2015totheUserGroupMeeting.Weencourageyoutojoinusandlookforwardtoseeingyouthere!Fornon-participants,wearestilltakingsubscriptionsforthecurrentscheme,whichwillincludeaninvitationtotheUserGroupMeetinginNovember2015.Forfurtherinformation,pleasecontactGillTriggong.s.trigg@keele.ac.ukandyoucouldalsobehelpingtosteerthefutureofthebenchmarking!
Written by Gill Trigg, Keele University Benchmarking Service
Sevenvenues,whichincludedTowerBridgeinLondonandTheNationalMotorcycleMuseum,werechosenforaseriesofpresentationsthatincludedaworkshoponthechallengesofadoptingthesolutionsandatalkfromacurrentNPExuser.NPExwaslaunchedin2009asanationalNHSservice.ItisthefirstofitskindintheUK–aninnovativefacilityforNHSpathologylaboratoriesconnectingthemtoanationalnetworkandenablingthemtosendandreceivetestrequestsandresultselectronically.Therearecurrently45NHSlaboratories subscribed.
Thefeedbackfollowingtheroadshowshasbeenoverwhelminglypositive,withmostorganisationscitingforward-thinkinglab-to-labcommunications,cost-effectivenessandtime-savingastheforeseenstrategicadvantagesofimplementingthesystems.FollowingtheScottishroadshow,AberdeenhavebecomethefirstScottishNHSlaboratoriestohavepurchasedNPExandbelieveotherswillfollow.IanRothnie,LaboratoryManagerforClinicalBiochemistryatNHSGrampian,attendedtheScotlandroadshow.Rothniesaidthechoicewasmadeasawaytoease,“theever-increasingburdenofhandlingsamplesthatrequiresendingtoreferrallabsandthemanual
transcribingofresults,commentsandreferenceranges.“NPExwillhelpspeedupthewholeend-to-endprocess,improveourturnaroundtimes,helptracktheprogressofsendawaysamplesandreducepaperwork.Webelieveitwillimproveaccuracyandmakethewholesystemmorerobust.“Goingforward,oneofourrequirementsforreferrallabswillbeauseoflab-to-labsystems.ThereisalargeappetitefortheminScotland,especiallyamongmycolleaguesinGrampianandthosein Lanarkshire.”SteveBox,BusinessDevelopmentmanagerforX-Lab,thecompanythatdevelopedNPEx,said:“TheroadshowswereverywellattendedandsuccessfulinraisingawarenessofbothNPExandNLMCacrossthenation.BecauseNPExrequiresatleasttwolaboratoriestoconnect,likeatelephoneexchange,itwasproductivetohaverepresentativestogetherinthesameroomandweexpectanetworkeffect–onceonelabhassubscribed,otherswilljoin.Sincewestartedtheroadshowswehavehadover30laboratoriesshowinterest.“Wecontinuetoworkonourvalueandservices,suchasanewscalablearchitecturethatwasdeployedandisnowbeingusedbyallsubscribers.Iamconfidentthatwecanget75percentoflaboratoriesonlineinthenexttwotothreeyears.”ForfurtherinformationonNPExcontactTheHealthInformaticsServicewww.this.nhs.uk.ForPressandMediaEnquiries,contactSteveBox,BusinessDevelopmentManager,[email protected] orNikkiMason,PressOfficer,[email protected]
Written by Steve Box, X-Lab
Southern General Hospital, Glasgow, Scottish Venue
KEELE UNIVERSITY BENCHMARKING NEWSKEELE UNIVERSITY BENCHMARKING NEWS KEELE UNIVERSITY BENCHMARKING NEWSKEELE UNIVERSITY BENCHMARKING NEWS
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How can you nd out more?
Telephone: +44 (0)1782 733755
Email: [email protected]
www.keele.ac.uk/benchmarking
Frequently Asked Questions
What does it cost? A single discipline submission for the ‘standard’ KUBS service costs just £1,250, and then each subsequent discipline specific submission is only £600 per discipline. For laboratories interested in participating in the ‘enhanced’ service there is just one flat rate of £4,950, which covers all disciplines, and includes the PowerPoint slide packs, workshops and hospital visit, in addition to the standard Keele reports and analysis tools.
Is it good value for money? Absolutely. As a not-for-profit organisation who are also aware of the significant cost pressures in the NHS, we set the cost of participation very low. With the cost savings and wider service improvements that can be made as a result of good use of the data, it represents excellent value for money.
Who gets to see my data? Only yourselves and other members of your peer group (unless you decide to remain anonymous). We do not share individual laboratory data with anybody outside the scheme, and we do not send reports to anybody else in your department or organisation unless you have named them specifically in the distribution list.
What about political and commercial sensitivity? We try to avoid collecting data of a particularly sensitive nature (e.g. individual test prices), and participants have the option to remain anonymous if they wish.
What about the private sector getting access to my data? This service is for NHS laboratories only.
Will we be compared with ‘like-for-like’? Yes. We now use a ‘smart’ grouping facility which places you in a peer group of comparable laboratories based on a combination of factors, which include workload volume and service complexity.
Are the questionnaires easy to complete? Yes. The questionnaires have been streamlined and offer the ideal balance between effort and value of data. Guidance notes are provided to assist with completion.
What if I do not understand some the questions? The Keele team are available throughout the process, with support from the specialty panels, to help with any difficulties you may be having.
What if I made mistakes in my submission? Do not worry, not only do you receive two separate data checking drafts of the reports before final submission, but Keele’s thorough data checking processes will help ensure any mistakes are identified and corrected.
When do I get my data back? The first draft of the report is issued within a fortnight of the final submission date for questionnaires, and usually within the first week after submission.
Are the reports easy to understand? Yes, they have changed and improved dramatically over the past two years. We report information back in concise charts and tables, using heat-mapping to identify where your laboratory sits in relation to your peer group and the whole group.
What if I missed the submission deadline? No problem, we can include new submissions at any stage of the process prior to final publication.
KEELE UNIVERSITY LABORATORY BENCHMARKING SERVICE
It reports essential quality, workload, staffing, productivity and finance data back to participating NHS pathology departments.
Est. in 1994, it is the only provider of such data in the UK
It is guided by specialty panels representing the RCPath, IBMS, ACB and ACS
Demonstrate your quality and value for money Identify strengths, weaknesses, opportunities, and
potential for growth Identify areas for making cost savings and efficiency
improvements Inform business and strategy planning processes Help you meet your Quality Agenda and CIP Get sight of long-term trend data in Pathology Join a network of likeminded individuals to help
share best practice and collaborate on initiatives which help deliver Pathology service improvement
You will be required to complete a questionnaire for each discipline you wish to take part in. We gather data for Clinical Biochemistry, Haematology (incl. Blood Transfusion), Immunology, Microbiology (incl. Virology), Cellular Pathology (incl. Histopathology, Cytology and Mortuary), and Combined Blood Sciences
You will then receive a first draft of each report within a fortnight of the final submission date for the questionnaires, giving you quick access to early data
Thorough data checking and revision processes allow you to make adjustments to your submission before publication
You also receive electronic analysis tools for each discipline, allowing you to drill down into and filter the data to create customised reports
The process ends with a user group feedback meeting, in which we review the data, provide networking opportunities, and discuss ways to develop the service for the upcoming year
The Keele team and specialty panels are available to assist you at all stages of the process.
After a highly successful pilot last year, we are delighted to offer an optional ‘enhanced’ benchmarking service to all participants this year. Working in collaboration with Civil Eyes Research, the enhanced service integrates contextual and outcomes data with your existing data to demonstrate the pressures and causes of variation in KPIs, in addition to the impact your service has on patient outcomes.
Delivery of the enhanced part of the service comes through a series of interactive workshops, a comprehensive set of customised PowerPoint slides, and a laboratory visit at the end of the process where we will deliver a bespoke presentation of your data to members of your team to help you understand the data, host a Q&A session, and to help you build your data into your business case.
Enhanced Benchmarking Service Case Study: “Laboratory X” participated in the enhanced benchmarking service pilot last year. The data highlighted a strong connection between their high hospital infection rate and low number of related microbiology requests per patient compared with other hospitals. Through the workshops and the hospital visit we were able to help them build a business case to bring in additional volume of the relevant microbiology requests by demonstrating the positive impact these would have on outcomes.
What is it?
Use the benchmarking service to:
What does it involve, and what do I receive?
Enhanced Benchmarking Service – Contextual and Outcomes Data
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Our research has shown that GP engagement with pathology professionals and data of this type can change requesting behaviour and produce better patient outcomes*
KEELE UNIVERSITY
PRIMARY CARE PATHOLOGY BENCHMARKING SERVICE
How does it work?ThesystempullstogethermonthlytestdatafromyourLIMSsystemforaround30keymarkertests(wehavearecommendedlist,butthefinaldecisionisyours).Itthenmapsthedatatonumberofadmissionsandlengthofstayforarangeofconditions(suchasdiabetes,cardiovascularetc...)andanalysesitatGPpracticeandCCGlevel.Finally,thesystemdrawsinawealthofdemographicdatasuchasnumberofpatientsineachconditiongroup,deprivationscore,percentageofpatientswithlongstandinghealthconditionsandage
demographics(amongstothers)toallowcomparative analysis.
ThefinaloutputsareExcelbasedwithfulltrainingprovided.AseniormemberoftheKUBSteamwillspendtimewithyouatyourlaboratorytoconfigurethesystemandtocreatethereportsthatwillhelpyoumosteffectivelyusethedata.Yoursubscriptionisfor12months,meaningthatyoucanprovideregulardataupdatesandmonitortheimpactofthesystemovertime,butitcanbepre-loadedwithhistoricaldatatoprovideinstanttrendanalysisfromtheget-go.
Contextual Anonymised GP Practice CCG Average Target
Practice List Size 16,791 7,468
Diabetes Mellitus (Diabetes) Register (ages 17+) 500 320
Diabetes Prevalence 3.0% 4.3%
GP Deprivation Score (IMD) 27.3 23.4
Activity
Total Tests (HbA1c) 3,728 1,345
Tests (HbA1c) Per: Diabetes Mellitus (Diabetes Register (ages 17+) 7.5 6.8 1.5
NICE Guideline HbA1c Tests per Patient Per Year 1-2 Tests Per Patient Per Year
Outcomes
Diabetes Admissions 156 80
Diabetes Bed Days 998 613
Diabetes Days Per Admission 6.4 7.7 7.0
Diabetes Admissions Per Patient 0.31 0.25 0.25
Example of a condition specific GP dashboard - diabetes
Diabetes Performance Dashboard Summary for Anonymised GP Practice
Example of a condition specific GP dashboard - diabetes
Demandmanagement(optimisation!)isasignificantdriverinmanagementofpathologyservices,andfeaturedinthePathologyQualityAssuranceReviewin2014.TheRoyalCollegeofPathologistsalsorecentlypublishedademandmanagementtoolkit.It is widely acknowledged that doing the “Right Test” on the “Right Patient” at the “Right Time” can lead to better patient outcomes and financial savings to the wider health economy,butprovidingevidencetodemonstratethishasproveddifficult….untilnow!
KeeleUniversityBenchmarkingServicearedelightedtoannouncethelaunchoftheirnewPrimaryCareBenchmarkingproject,aservicewhichaimstoempowerpathologydepartmentswithinformationthatwillplacethematthecentreofpatientcarebydoingthe following:
• Demonstrating the value of your pathology service to your GPs and commissioners, and to the wider health economy
• Highlightingtheimpactyourservicehasonpatientoutcomes,andusingthisasevidencetomanageserviceusage.Increasedtestingoftenequalsbetter outcomes!
• Providingcriticalinformationaboutserviceusageandoutcomestoyourcustomersviaaseriesofdashboardsand reports
• Informingstrategyplanningdecisions,andmonitoringtheimpactofinterventionsovertime
• Providingthe“addedvalue”servicethatgivesyouanadvantageoveryour competitors
CostThecostofa12monthsubscriptiontothisservicedependsonthesizeoflaboratory:
• SmalltomediumlaboratorieswhoprimarilyserveoneCCG:£4,000(+vat)
• MediumtolargelaboratorieswhoprimarilyservemorethanoneCCG:£5,000(+vat)
• MultiplelaboratorieswithinthesameTrust/organisation:£4,000(+vat)perlaboratory(regardlessofsize)
Itisdifficulttodothesystemjusticeinashortleaflet!
Ifyouwouldlikeamemberofourteamtocomeandtalktoyouabouttheprojectandtoshowyousomeexamplesfromthesystem(withnoobligation!)thenpleasegetintouch–[email protected]
How do I [email protected]
Telephone:+44(0)1782733755
www.keele.ac.uk/benchmarking
* Results of GP masterclass research available on request
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Does Anybody Actually Listen to Pathology?
SinceIstartedworkingforKUBSover10yearsagoandthroughoutthispastdecade,Ihaveheardmany
people–bothinsideandoutsideofpathology–sayingthatpathologysitsinasilo,busilyworkingawayproducingverygoodwork,butrarelyconnectingwiththeworldinwhichitexists.WhilstIthinkthatisstilltruetoacertainextent,Ibelievethesituationisconsiderablyimprovedcomparedwith2004.Pathologydoesnowseemtobegettingoutintotheworldalittlemoreoften,andtouseyetanothercliché(Iamonarolethisedition)ismanagingtoraiseitsprofile.Otherareasofhealthcarehavestartednoticingthatweexist,andifImaybesoboldastosay,itisabouttime!DrBarnesquotedthatpathologyrepresents“involvementinaround80%ofpatientinteractionswiththeNHS”,andwithresearch(includingworkwehavebeendoinghereatKeele)demonstratingthesignificantandpositiveimpactthatpathologyhasonpatientoutcomesandthecarepathway,itwouldappearthattheworldmaybestartingtonoticethatthepeopleinthelabaremakinga difference.Butthequestionstillstands:doesanybodyactuallylistentopathology?Youmightrespondwithaquick“yes”,becausehowcananybodynotlistentopathology?Ifsomebodyasksforatest,andyouprovidetheresultstothattest,thensurelytheywillatleasttakeonboardthatresultandactuponit?WhilstIamsurethatpathologytestresultsareacknowledgedandacteduponinmostcases,justaskyourselfthis:howmanytimeshaveyouprovidedatestresultthatnobodybotheredtothenpickuporlook at?Furthermore,Ihavesomeinterestingfindingstosharewithyoufrommyon-
goingdiabetesresearchproject.IdonotwanttogivetoomuchawayatthisstagebecauseIamclosetogettingthisworkpublishedasaresearchpaper,butwhatIwilldoissharethechartwith youonpage14.Thischartisshowing,viathebluebars,theaverageannualHbA1ctestsperdiabetespatientbyGPpractice(usingananonymisedcode).Thisiscomparedtotheyellowdots(connectedbyablacklinetomakethemeasiertoread)onthesecondaxis,whichisthenumberofdiabetesinsulinandnon-insulinbaseddrugsprescribedperdiabetespatient.IamtryingtofindoutwhetherGPswhorequestalotofteststhenfollowthisupbyprescribingalotofdrugs,butasyoucanseefromthischartthereisverylittlecorrelationbetweenthetwo.Thetrendforprescribingistotravelinadownwardspatternwhilstthetestsperpatientrises.Thethreehighestintermsofprescribing(markedwiththreeredringstowardsthetopportionofthechart)areatthebottom,middleandtopofthetestvolumechart.Thelowestintermsofprescribing(alsomarkedbyaredring)arethefifthhighestintermsoftests,whichperhapsbegsthequestion:whyaretheyrequestingsomanytests,andifadditionalinvestigationsarenotleadingtoanychangeintreatmentthenaretheyactuallylookingatthetestresults?Moreworryingstill,aredrugsbeingprescribedwithoutanyreferencetotheirroutinemonitoringtests?Ifso,howcanwebesurethatpatientsarebeingtreatedwiththecorrectdrugs?Thisisthekindofquestionwehopethat,byworkingwithpathologyprovidersandGPstogether,newdevelopmentsinourprimarycarebenchmarkingprojectwillhelpusto understand.
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Expanding POCT inAmbulatory Care
implementing innovative point of care testing solutions to secure your service
Tuesday�8th�September�2015������Doubletree�by�Hilton,�Manchester
The role of point of care testing inreducing hospital length of stay
PLANNING YOUR SERVICE
Securing your POCT Service: Applying POCT in an Ambulatory Setting• How pOcT can be re-directed to benefit the Trust and patients• What is stopping you? Securing backing and persuading colleagues to
support your vision• What are the challenges? practical insight into hurdles that you will need
to jump
Achieving Funding and Buy-in: Planning for the Expansion of POCTin an Ambulatory Unit• engaging with the drivers for change within your trust: stepping pOcT up• identifying where new models can impact on current service delivery• How to raise funding: working with commissioning and finance to change
mindsets
Practical Exercise: Project and Risk Planning for your InnovativePOCT Service
PUTTING THE PLAN INTO ACTION
Getting the Workforce Right: Extending POCT in an Ambulatory Unit• What support mechanisms are required for the day to day running?• How to build the right skill mix, training and clinical leadership for
sustained delivery• Tackle the challenge of increased workload within the pOcT team
Measuring the Outcomes: Proving your Impact on Length of Stayand Patient Experience• How effective is your service? How to go about measuring your
outcomes• Monitoring patient experience and length of stay: building a picture
through quantifiable data• Using your outcomes to implement change: review, improve and progress
Practical Exercise: What to Measure and When to Measure?
Benefit from this accelerated learning event and develop anaction plan:
calling all pOcT leads: attend this interactiveworkshop to share practical advice on how to set upand deliver innovative point of care testing within yourtrust. examine the role pOcT has played in reducinglength of stay in one Trust’s ambulatory unit.
In just one day you will learn how to:• Secure the future of your pOcT service• Share best practice to raise funding and get the
trust on board• Develop an action plan to implement in your trust• Understand the importance of measuring your
successes• Boost patient experience and reduce length of stay• Investigate the application of pOcT in other
ambulatory settings
Your workshop leader: Phil Weihser, POCT Co-ordinator, James PagetUniversity Hospitals NHS Foundation Trust
Event Timing: Registration 9.30am – Start 10.00am – close 4.30pm
For further event details please visit www.sbk-healthcare.com
Plus: POCT Update 2015Wednesday 9th September 2015, Manchester
N H S S p e c i a l p R i c e S£299 each with 2 places
£284 each with 4 places
Tel: 01732 89 77 88 Follow on Twitter: @SBKevents
www.sbk-healthcare.com
Calling all POCT Leads: attend this interactive workshop to share practical advice on how to set up and deliver innovative point of care testing within your Trust. Examine the role POCT has played in reducing length of stay in one Trust’s ambulatory unit.
Benefit from this accelerated learning event and develop an action plan:
PLANNING YOUR SERVICESecuring your POCT Service: Applying POCT in an Ambulatory Setting• HowPOCTcanbere-directedtobenefitthe
Trustandpatients• Whatisstoppingyou?Securingbackingand
persuadingcolleaguestosupportyourvision• Whatarethechallenges?Practicalinsightinto
hurdlesthatyouwillneedtojumpAchieving Funding and Buy-in: Planning for the Expansion of POCT in an Ambulatory Unit• Engagingwiththedriversforchangewithin
yourTrust:steppingPOCTup• Identifyingwherenewmodelscanimpacton
currentservicedelivery• Howtoraisefunding:workingwith
commissioningandfinancetochangemindsetsPractical Exercise: Project and Risk Planning for your Innovative POCT Service
PUTTING THE PLAN INTO ACTION
Getting the Workforce Right: Extending POCT in an Ambulatory Unit•Whatsupportmechanismsarerequiredforthedaytodayrunning?
•Howtobuildtherightskillmix,trainingandclinicalleadershipforsustaineddelivery
•TacklethechallengeofincreasedworkloadwithinthePOCTteam
Measuring the Outcomes: Proving your Impact on Length of Stay and Patient Experience•Howeffectiveisyourservice?Howtogoaboutmeasuringyouroutcomes
•Monitoringpatientexperienceandlengthofstay:buildingapicturethroughquantifiabledata
•Usingyouroutcomestoimplementchange:review,improveandprogress
Practical Exercise: What to Measure and When to Measure?
Your workshop leader:
• Phil Weihser,POCT Co-ordinator, James Paget University Hospitals NHS Foundation Trust
POCT Update 2015How to tackle your accreditation,
training, quality and community challenges
Wednesday 9th September 2015 DoubleTree by Hilton, Manchester
N H S S P E C I A L P R I C E S£299 each with 2 places
£284 each with 4 places
2015’s ‘must attend’ eventfor all POCT Co-ordinators
With point of care testing under pressure to deliver quality testsand adhere to accreditation criteria with limited resources, thisseminar will bring together POCT Co-ordinators, Managers andLeads from across the country to hear from teams leading theway and exchange ideas with other attendees.
With opportunities to share advice, best practice and hearinformation on the practical things you can put into place to worktowards accreditation and tackle training and quality issuesboth in the hospital and in the community. The day will look at thefollowing key themes:
• Achieving POCT accreditation: What you need to know tobecome an accredited service
• Building robust quality systems: Putting the rightdocumentation and training processes in place
• Enabling quality control: Using technology and datamanagement tools to your benefit
• Community POCT: Engaging with and aligning your hospitaland community POCT services
Hear practical insights, participate ininteractive sessions and take away newideas with:
• Felicity Dempsey, Point of Care Co-ordinator, St James's Hospital
• Annette Thomas, Chair, Wales ExternalQuality Assessment Scheme (WEQAS)
• Lisa-Marie Button, POCT Manager,North Tees and Hartlepool NHSFoundation Trust
• Kath Ashton, Trust POCT Manager, TheRoyal Liverpool and BroadgreenUniversity Hospitals NHS Trust
• Samantha Ekin, POCT Co-ordinatorStockport NHS Foundation Trust Plus: Expanding POCT in Ambulatory Care
Tuesday 8th September 2015, Manchester
Tel: 01732 89 77 88 Follow on Twitter: @SBKevents
www.sbk-healthcare.com
With point of care testing under pressure to deliver quality tests and adhere to accreditation criteria with limited resources, this seminar will bring together POCT Co-ordinators, Managers and Leads from across the country to hear from teams leading the way and exchange ideas with other attendees.
With opportunities to share advice, best practice and hear information on the practical things you can put into place to work towards accreditation and tackle training and quality issues both in the hospital and in the community. The day will look at the following key themes:
• Achieving POCT accreditation: what you need to know to become an accredited service
• Building robust quality systems: putting the right documentation and training processes in place
• Enabling quality control: using technology and data management tools to your benefit
• Community POCT: engaging with and aligning your hospital and community POCT services
• Felicity Dempsey,Point of Care Co-ordinator, St James’s Hospital
• Annette Thomas,Chair, Wales External Quality Assessment Scheme (WEQAS)
• Samantha Ekin,POCT Co-ordinator, Stockport NHS Foundation Trust
• Lisa-Marie Button,POCT Manager, North Tees and Hartlepool NHS Foundation Trust
• Kath Ashton,Trust POCT Manager, The Royal Liverpool and Broadgreen University Hospitals NHS Trust
Hear practical insights, participate in interactive sessions and take away new ideas with:
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Diary Dates/Events for 2015SBK Healthcare Pathology Events• Expanding POCT in Ambulatory Care, Tuesday8thSeptember2015,DoubleTreebyHilton,Manchester
• POCT Update 2015, Wednesday9thSeptember2015,DoubleTreebyHilton,Manchesterwww.sbk-healthcare.co.uk
Keele Participant User Group Meetings• Multi-discipline–Thursday26thNovember2015,TheManchesterConferenceCentre&PendulumHotel,Manchester
* Participants will recieve a formal invitation to attend this meeting in August 2015 *
IBMS Events• IBMS Biomedical Sciences Congress –Monday28thtoWednesday30thSeptember2015,TheICC,Birmingham www.ibms.org/go/congress
• ForinformationonIBMSeventsseewww.ibms.org/go/biomedical-science/events
RCPath Events• National Pathology Week–Monday2ndtoSunday8thNovember2015
www.ilovepathology.org/events/national-pathology-week• International Pathology Day–Wednesday18thNovember2015
www.ilovepathology.org/events/international-pathology-day• For information on RCPath eventssee
www.rcpath.org/meetings/college-conferences/college-conferences
ACB Events• FiLM:TBC• FOCUS:Monday18thtoThursday21stApril2016,UniversityofWarwick
www.acb.org.uk
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