Prepared by:
Kathy Smith, Manager Performance Analysis
Health System Information and Performance Reporting
June 2016
Surgery Redesign Training Program
NSW Surgery KPIs and You
Overview of presentation
Data for research, evaluation and
monitoring
A look at some Key Data Sources available
to you
The role of data collection
Data for research, evaluation and
monitoring
Before you start:
Need to clearly understand the role data will play in your
project from the beginning.
What is the data required for?
– Background Information and Understanding
– The need to Monitor and Answer Key Questions about your project
or program.
Align data requirement to Program, Policy or Project Goals.
– Clear justification for data to be used in the monitoring/evaluation
– Will the data you use explicitly answer the hypothesis
– Are you really embarking on research?
Key Existing Data & Information Sources:
Tap into Existing Sources of reported data
– This is the Preferred Approach
– Provides immediately useful and comparable data
– NSW Intranet:
http://internal.health.nsw.gov.au/data/access/index.html
– Health Statistics:
http://www.health.nsw.gov.au/hsnsw/Pages/default.aspx
– BHI:
– http://www.bhi.nsw.gov.au/ ,
– http://www.bhi.nsw.gov.au/healthcare_observe
– Regular reporting by MoH including Surgical Dashboard, Monthly
report and for some weekly reports
** Don’t forget your local performance team
NSW Ministry & LHD data sources
Your key sources for a local view
Key source for understanding your patient population
Provides established business process for data collection
monitoring and evaluation
Four key data collections that may be of particular interest
– Admitted Patient Data Collection (aka inpatient data collection)
– Waitlist Data Collection
– Surginet & Surgical information systems
– Emergency Department Data Collection
Unit Record data is available for research and evaluation
– HIE / Safari and Cheryl / ABM Portal
Existing External Reported Data Sources
– Australian Institute of Health and Welfare
– Elective Surgery and Waiting Times
– http://www.aihw.gov.au/national-elective-surgery-waiting-times/
– Australian Hospital Statistics
http://www.aihw.gov.au/pAustralian Bureau of Statistics
– http://www.abs.gov.au/
– World Health Organisation (WHO)
– Data and Statistics http://apps.who.int/ghodata/
– Emergency and Essential surgical care
http://www.who.int/surgery/globalinitiative/en/
– Clinical Excellence Commission
– http://www.cec.health.nsw.gov.au/
Reporting of Elective Surgery measures
( NEST) and other Indicators; NSW Ministry receives and regularly reports on Elective surgery
Data from your LHD
Much of these data are also provided to the Commonwealth
Quarterly and are reported in a variety of publications including
on by the AIHW, the National Health Performance Authority and
on the “myhospitals” website
The surgery dashboard and the monthly performance report are
a key mechanism between the LHDs nd the Ministry around
surgery performance
Reference:
Routine reporting of surgery indicators
Additional Indicators
There are many indicators routinely reported and
available via the MOH,BHI and LHD reporting systems.
These surgery indicators are reported at hospital level &
included in the Monthly performance reporting and
quarterly BHI reports.
– These indicators have agreed definitions and are used
as part of the performance management conversation
between the LHDs and the Ministry.
The Monthly Surgical Services Taskforce Dashboard
Other useful MoH Routine reports – For
internal use only
Monthly Performance Report – includes other useful
information
Whole of Hospital Weekly Snapshot – Some care required
ABM Portal - provides a useful run your own ad hoc
reports
Health Stats - are range of population health focused
information
Nationally agreed and reported Surgery
IndicatorsNationally, under agreement between States and Commonwealth
there is a range of surgery indicators reported.
(a) number of additional patients receiving elective surgery from waiting lists;
(b) number of patients removed from waiting lists for reasons other than admission as an
elective patient;
(c) number and percentage of patients seen within the clinically recommended time by
urgency category;
(d) median waiting time for the 15 indicator procedures (including knee and hip
replacements, cataract surgery, septoplasty, etc);
(e) median waiting times by urgency category;
(f) number of elective surgical episodes with one or more adverse events; and
(g) number of unplanned readmissions within 28 days of discharge from hospital
following an episode of elective surgery.
New Data Collection: A course of last resort
Do not under estimate the complexity of even the simplest data
collection
New Data Collection - Only after other sources exhausted
– Impacts of starting a data collection must be considered
– impact on other staff and other data being collected
– Minimum resource and time requirements
– “who is paying” what is the “opportunity cost”
– Privacy, know your obligations
– Avoid “nice to have” data and data collection - Clear
statement of justification of each and every piece of data
– Avoid the data taking over your project
Data Collection: Some do’s and don’ts
Do
– your homework, be clear of your objectives and document them
– exhaust all avenues for exiting data sources first
– Use standard definitions, clear collection guidelines and pilot
before rolling out full collection
– You have adequate resources
– Seek help from the professionals – See attached
Don’t
– assume knowledge of data collectors – you must provide
definitions, guidelines and ready access to help - pilot your
proposed collection tools
– Don’t dictate, bring your data collectors along with you or suffer the
inevitable fate of poor data quality
Know Your Data Definitions
Use exiting data definitions where they exist
http://internal.health.nsw.gov.au/data/standards/index.html
– Data collection data dictionaries
– NSW Health Minimum Data Set
National Minimum Data Sets – Check out Meteor http://meteor.aihw.gov.au/content/index.phtml/itemId/181162
Many indicator definitions already specified ready for use
– Surgical KPI dictionary
– Service Agreement Indicator and Service Measure
Dictionary
– National KPI catalogue
Need Help ?
Resources in Your LHD / Region
Redesign leader / managers
Clinical Governance Units
Medical Records Department:
Performance and Reporting Units
Casemix and Funding Units
Public Health Units
Library Services
Thank youPlease feel free to contact me:
Kathy Smith: Manager, Performance Analysis
Health System Information and Performance Reporting
Phone: 9391 9778
Email: [email protected]
Extra Bits MoH Data Collection Reference Resources
General http://internal.health.nsw.gov.au/data/collections/index.html
Surginet http://emr.health.nsw.gov.au/home/my_emr/sbb/surginet_reports
Admitted Patient Data Dictionary
http://internal.health.nsw.gov.au/im/ims/ap/ap-data-dictionary-current-
public.html
Waitlist Collection Terminology
http://internal.health.nsw.gov.au/im/ims/wtc/terminology.html
EDW & HIE: Health Data repositories
– http://internal.health.nsw.gov.au/data/data-warehouses.html
– http://internal.health.nsw.gov.au/data/edward/index.html
– WaLT (Waiting List Tool) Contact your Area Health Service Waiting List Coordinator for
further information
Extra Bits Useful Health Information Management References
ICD10 AM, DRGs, Casemix and Activity Based Funding
http://www.health.wa.gov.au/activity/docs/cch.pdf
General Knowledge on Health Information
http://www.healthknowledge.org.uk/e-learning/health-
information
National Centre for Classification in Health
http://sydney.edu.au/health-sciences/ncch/
Extra Bits General References & Data Sources - cont
General state-wide Statistics for NSW Ministry of Health
– NSW Health Published Reports, http://www.health.nsw.gov.au/reports/index.asp
– Yellow book; http://www.health.nsw.gov.au/reports/index.asp
– Health Statistics NSW, http://www.healthstats.nsw.gov.au/ealth Statistics
– Annual Report: NSW,
http://www.health.nsw.gov.au/pubs/2010/annualreport10.html
– Local LHD: available on the local website
Bureau of Health Information http://www.bhi.nsw.gov.au/home
– Performance Profiles – review by hospital
http://www.bhi.nsw.gov.au/publications/the_insights_series
Australian Council on Healthcare Standards
– http://www.achs.org.au/
Research Methods
http://www.healthknowledge.org.uk/public-health-
textbook/research-methods
http://www.hqip.org.uk/assets/Downloads/Audit-Research-
Service-Evaluation.pdf
http://www.hqip.org.uk/assets/Downloads/Audit-Research-
Service-Evaluation.pdf
http://www.who.int/surgery/globalinitiative/en/
Extra BitsOther Helpful Sites – Research Methods
Indicators and Measures
Understanding leading and Lagging indicators: -
http://www.leanhealthcareexchange.com/?p=4639
Defining Measures
http://www.institute.nhs.uk/safer_care/primary_care_2/mea
surement_for_improvement.html
http://www.institute.nhs.uk/quality_and_service_improveme
nt_tools/quality_and_service_improvement_tools/performa
nce_measures_sheet.html
Link your project to the organisations aims: -
http://www.institute.nhs.uk/quality_and_service_improvement_
tools/quality_and_service_improvement_tools/four_columns_-
_link_your_project_to_the_organisation.html