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Quality Improvement in Imaging Services in
Scotland
Margaret SherwoodAssistant General Manager
NHS Greater Glasgow & Clyde
Overview
Define quality in Healthcare setting
Previous Quality measurements in
Imaging
Data collection
Proposed QI subgroup 3 year work
programme
What is Quality?Within healthcare, there is no universally accepted definition of ‘quality’. However the US Institute of Medicine (IoM), has identified six dimensions through which quality is expressed. Safety Effectiveness Patient centred Timeliness Efficiency Equity
What is Quality Improvement?
Improving the safety of our service
Becoming more effective through providing services
based on scientific knowledge and which produce a clear
benefit
Being patient centred through providing care that is
respectful and responsive to individuals’ needs and
values
Timeliness through reducing unnecessary waits and
delays
Avoiding waste and providing an efficient service
Equitable through providing care that does not vary in
quality
Quality Outcome Indicators for Imaging in NHS Scotland
No imaging equivalent to SMR datasets Pilot imaging dataset 80’s/90’s? ISD costbook activity data Diagnostic Waiting Times - 2007 Audit Scotland Report 2008 Benchmarking project – 2008 NHS Efficiency and Productivity Programme -
Report of the Diagnostics Steering Group 2009
MDICN – 2012
MDICN Minimum Dataset Minimum dataset agreed in 2010
Demand - the number of patient referrals to each modality – all patients being recorded in RIS
Activity - the number of patient events by modality – all patients being recorded in RIS
Demand and Activity broken down by referring specialty
Modality sub-group data collection
Provided comparable data across NHS Scotland
SCIN Data Collection
Minimum dataset agreed as a good baseline
Recognised additional workload for RIS managers
Recognised gap in timelines
Cumbersome• Data pushed rather than automatic pull from
data source
PACS database suggested as alternative – but• Exam rather than attendance based• Other activity on system, eg. Digitised old films
etc.
The Way Forward
Dr Raj Burgul
Real time RIS Data
Demo at SCIN Quality Improvement Sub group
Uses real time data
Currently used for Carestream RIS in NHS FV
NSS Datamart
Dashboard
Trial arranged for CRIS in NHS GG&C
QI Subgroup 3 year Work Programme
Year 1 Year 2 Year 3
MDICN Minimum Data Set
DNA Rates
KPIs for Imaging
In-patient Turnaround Times.
Dose Assessment & Optimisation
Demand Management
Workforce Issues
Urgency Codes Cost Book
Optimisation
Weighting Factors for Complexity
In Summary
3 year work programme for QI group -
Safety – Dose assessment and optimisation Effectiveness – Demand management Patient centred – Inpatient turnaround,
staffing Timeliness – Measured waiting times Efficiency - DNA rates, Cost book analysis Equity – Urgency codes, KPIs