Background
County Durham & Darlington NHS Foundation Trust provides healthcare to a population of 500,000 people across Durham and Darlington. In the wake of the crisis at Mid-Staffordshire NHS Foundation Trust, patients and the public are more aware than ever about safety and this has been and continues to be a priority for the board at County Durham and Darlington NHS Foundation Trust.
Starting point
Gillian Findley, Associate Director of Nursing, explains how CHKS is helping the Trust. Gillian, a nurse by background, was Head of Clinical Governance in 2008 when the Trust’s Quality
and Innovation Committee first discussed how best to provide assurance to the board on the issue of safety. The committee decided that a more robust system of detailed analysis and
reporting of performance data was needed. The trust had been using CHKS for some time and the board decided that a risk adjusted mortality index should be included in the board reports from the Trusts four clinical divisions.
Service response
Each division produced an information dashboard which was then reported to the board through the Healthcare Governance Committee. This system provided detailed performance data
and highlighted areas which required further investigation for targeting improvements in patient safety. The benefit of this approach became apparent in July 2009, when the Trust
discovered an anomaly in the risk adjusted mortality ratio for the division of medicine which was 97 against a peer group of 76.
“We were preparing the monthly reports to go to the committee when we realised there was something going on. We found a deterioration and to find out more we decided to carry out an audit. This meant looking at patient level data, patient notes and at the clinical aspects of each
case.” Review of the case notes revealed that the anomaly had been caused by two deaths that had been coded incorrectly. Clinicians were consulted as part of the review and they worked
closely with the clinical coding team. The ratio returned to a more normal pattern the following month.
Resources used and productivity gain
This example highlights how the Trust actively uses CHKS Insight to find initial areas of concern that can be further investigated and ultimately provide assurance to the board that care is being delivered safely. Gillian believes that having a risk adjusted mortality measure in the board reports means the Trust’s four clinical divisions do not have to put extra resource into providing assurance on safety. The clinical teams can concentrate on other matters that surface on a day-to-day basis.
Outcome
CHKS intelligence is providing assurance for the Board of County Durham & Darlington NHS Foundation Trust that healthcare services are being provided safely.
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