This section aims to update you on new work and events within the programme.

Scottish Intensive Care Audit Group
Audit of Critical Care in Scotland 2008, reporting on 2007
Published 29th July 2008

In this year?s report, we are reporting on the management of over 10,000 patients admitted to Scottish Intensive Care Units (ICU) and over 18,000 patients admitted to High Dependency Units (HDU) during 2007.

The format of the report continues to follow the patient?s journey through three sections: activity, interventions and outcomes. This is the first year that hospitals are identified throughout the report (including the outcomes section).  This decision was taken in conjunction with the Scottish Intensive Care Society and the Critical Care community. At this time, however, we are unable to report on HDU outcomes as most units do not collect case-mix adjustment data.

 SCOTTISH CLINICAL INDICATORS on the WEB 29/01/08 

An update for four established acute care indicators which were published in the 2002 Clinical Indicators Report went live on 29th July 2008.

Figures are available at NHS Board and hospital level for years ending 30th June 1998 to 30th June 2007

July 2008 update of clinical outcome indicators
ISD have decided not to update two of the hospital acute care patient outcome indicators: medical and surgical readmissions within 7 & 28 days of discharge. NHS Lothian have discovered a coding error that has inflated the number of emergency admissions substantially. This issue also affects the Scotland totals and the standardised rates for all other Boards. Therefore it would be misleading to publish these figures.

The next release of these indicators is planned for January 2009. However, ISD and NHS Lothian are currently working together to rectify this issue and as soon as we have correct data we will publish these two indicators. The crude rates are available on request for these two indicators for each NHS Board.

Survival at 30 and 120 days following admission with hip fracture;

Mortality within 30 days of selected planned operations;  

Survival at 30 days following admission with stroke;

Survival at 30 days following admission with acute myocardial infarction.

Scottish Audit of Intracranial Vascular Malformations (SAIVMS)

The purpose of the Scottish Audit of Intracranial Vascular Malformationsis is to monitor the quality of care, treatment, and outcomes for adults with intracranial vascular malformations (arteriovenous and cavernous malformations). SAIVMs does this by using multiple overlapping sources of case ascertainment to find every adult resident in Scotland, who is newly diagnosed with one of the malformations above, and enrolling them in a confidential audit. SAIVMs aims to include every adult in order to get a truly representative picture of what happens to people with your condition in Scotland. The audit involves adults who were first diagnosed in the years 1999-2003, and 2006 onwards. The audit is run by a team in the Department of Clinical Neurosciences in Edinburgh, and is overseen by a Steering Committee of consultants, who are representative of the relevant specialties at the four Scottish Neuroscience centres in Aberdeen, Dundee, Edinburgh, and Glasgow.

Stoma Care Audit
March 2008
Clinical Nurse Specialists (CNSs) approached NHS Quality Improvement Scotland to ask for help in carrying out a short audit following the introduction of a new community pharmacy contract on 1st April 2006. This new contract involved a change in the reimbursement arrangements to stoma suppliers as documented in NHS HDL (2004) 54. CNSs lost their sponsorship from stoma suppliers and are now fully funded by the NHS. NHS QIS commissioned the Information Services Division to carry out an audit with an aim to ascertain the impact of the new stoma contract on the quality of the service provided to patients. This report summarises the findings from the audit.

INFORMATION for QUALITY IMPROVEMENT (IQI) BULLETIN

Bulletin 15: July 2008:   International Forum on Quality and Safety in Helathcare
The Quality Improvement programme at ISD Scotland has produced an e-mail bulletin with all the work that ISD is doing to support quality improvement in healthcare in NHS Scotland. Click here to see the current and previous bulletins

 

 

 Clinical Indicators Report 2007

The report - the 12th in series presenting clinical indicators in NHSScotland - presenting data on three topics: depression, arthritis and upper gastrointestinal conditions.

Surgical Profiles

The Surgical Profile reports were launched in November 2006. These reports were the first of their kind and consist of a wide range of indicators, which give an insight into the quality of surgical care across Scotland. Data has been taken from a wide range of sources including national audits and Scottish morbidity records. The reports have been tailored for each individual NHS Board and give a detailed breakdown of surgical volume and mortality at NHS Board and hospital level.

The Profiles were designed to improve the quality of surgical care through the effective use of data by identifying potential areas for attention as well as highlighting areas of good practice (e.g. surgical services with particularly low mortality rates). NHS Boards were given 16 weeks following the launch of these Profiles to formally respond with an action plan detailing how services could be improved as well as sharing best practice. Out of the 15 NHS Boards that received the profiles, 14 provided a formal response.

This information has been updated to include the most recent information available and has been published on the indicators website (www.indicators.scot.nhs.uk ).

The Clinical Indicators Support Team received funding for the 2006/07 financial year from NHS QualIty Improvement Scotland to support a programme of work analysng data collected by The Scottish Programme for Improving Clinical Effectiveness in Primary Care (SPICE).

The SPICE data offer a unique and innovative data source that has been collected consistently from a large number of practices. It permits direct examination of variations in the recording and treatment of chronic conditions across practices.

The objectives of this project involve four distinct but related strands of analyses using the SPICE data. These are:

a) Before and after analysis of the new GMS contract

b) Measures of change

c) Treatment of deprived individuals in affluent and deprived practices

d) Improved presentation of feedback.

 

Statistical Process Control Tutorial Guide      
NHSScotland routinely collects a vast array of data from healthcare processes. The analysis of these data can provide invaluable insight into the behaviour of these healthcare processes.

Statistical Process Control (SPC) techniques, when applied to measurement data, can be used to highlight areas that would benefit from further investigation. These techniques enable the user to identify variation within their process. Understanding this variation is the first step towards quality improvement.

The purpose of the tutorial guide is to provide an introduction to the application of run charts and control charts for identifying unusual behaviour in healthcare processes. SPC techniques are a tool for highlighting this unusual behaviour. However, these techniques do not necessarily indicate that the process is either right or wrong - they merely indicate areas of the process that could merit further investigation.