the development of good management practices and ict use in nhs hospital trusts
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The development of good management practices and ICT use in NHS Hospital Trusts. Patrick Dunleavy, Leandro Carrera and Jane Tinkler. How to measure Management and ICT use within the NHS?. - PowerPoint PPT PresentationTRANSCRIPT
The development of good management practices and ICT use in NHS Hospital Trusts
Patrick Dunleavy, Leandro Carrera and Jane Tinkler
How to measure Management and ICT use within the NHS?
It’s vitally important that the NHS does patient care in an organization for service delivery that is as efficient as possible, using management good practice and modern ICTs
Previous researchers have relied on surveys of trusts to tap progress on these fronts, but Generating full responses is often a problem Responses show a bias towards “correct”
answers
Organization represents itself online as doing
Organization is actually doing
A lot A little
A lot 1. Web census analysis correctly identifies situation
2. Façade activity
Not much 4. Organizations with ‘stealth’
activities
3. Web census analysis correctly identifies situation
Organizations’ underlying pattern of activities can be mapped from their online presence
Web-census IndicatorNumber of
Trusts% Coverage
Link to press releases 140 84Trust board minutes provided 139 83Financial Report updated 136 81
List of Trust board future / past meetings provided 133 80
Links to individual hospitals 129 77NHS Direct link available 125 75Biography of directors provided 122 74Trust phone lists available 120 72Mention to Care Quality Commission 119 72Link to Trust charity available 116 70Link to the communications team 116 70Link to Annual Health check 115 69
Information on the benefits of working in the trust 115 69
Annual audit letter available 114 68Information on Trust history 111 67
15 Indicators of good management practices found in most hospital trusts
Web-census Indicator Number of Trusts % Coverage
Information on volunteering positions 106 64Trust board agenda informed 104 63Link to performance documentation 102 61Hospital infrastructure link 100 60Information on how to cancel appointments 93 56Information on learning possibilities for non-medical staff 93 56
Infection rates provided 89 54MRSA statistics provided 89 54Recent developments on trust performance 88 53News on each hospital available 86 52Is the website still mentioning the Healthcare commission? 83 50
Trust organigram provided 82 49Information on programmes or placement for student placements 82 49
Link to Care Quality Commission report on the trust 80 48Information on Trust mission 79 48
15 indicators of management practices present in around half of hospital trusts
15 Indicators of management practices not found in most hospital trusts
Web-census Indicator Number of Trusts % Coverage
Information on Trust values 78 47Information on Trust goals 72 43FOI link available from the home page 69 42Information about flexible approach to work provided 69 42Dedicated Research & Development section 68 41Information on moving to the area provided 64 39Care Quality Commission’s summary statistics on the trust provided 56 34
Link to events organised by the trust 55 33Hygiene code report available 54 33Caldicott Guardian name provided 49 30Centre for Postgraduate Professional education 45 27PALS representative name provided 39 24Complaints manager name provided 35 21Links to PCT in the area 34 21Information on Trust pay scales 13 8
Management Practices Index
We included 45 indicators covering 11 dimensions
Dimensions were weighted to reflect relative significance for good management practice
DIMENSION INDICATORS % WEIGHT
Key partners 2 18%Performance 9 18
About the Trust and its Board
5 12
CorporateDocuments
3 12
HR: Work for Us 6 8HR:Training 3 8
Care for Patients / Visitors
4 8
Care: Contacting 4 4Care: Values 3 4
Marketing: About Us
3 4
Marketing: News 3 4
Management Practices: Frequency distribution
Management Practices: How Trusts perform
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Median
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Top performers in Management Practices
TRUSTS SCORE
OXFORD RADCLIFFE HOSPITAL NHS TRUST 4.0UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST 3.9
CALDERDALE AND HUDDERSFIELD NHS TRUST 3.8
PLYMOUTH HOSPITALS NHS TRUST 3.7
EAST KENT HOSPITALS NHS TRUST 3.7
MILTON KEYNES GENERAL HOSPITAL NHS TRUST 3.6
PETERBOROUGH HOSPITALS NHS TRUST 3.6
EPSOM AND ST HELIER NHS TRUST 3.6
BEDFORD HOSPITALS NHS TRUST 3.6ADDENBROOKE'S NHS TRUST / CAMBRIDGE UNIVERSITY HOSPITALS 3.6
Low performers in Management Practices
TRUSTS SCORE
MAYDAY HEALTHCARE NHS TRUST 1.7
LEWISHAM HOSPITAL NHS TRUST 1.7
ROTHERHAM GENERAL HOSPITALS NHS TRUST 1.7
LIVERPOOL WOMENS HOSPITAL NHS TRUST 1.6
NORTHERN LINCOLNSHIRE AND GOOLE HOSPITALS NHS TRUST 1.6
HEREFORD HOSPITALS NHS TRUST 1.5
NEWHAM HEALTHCARE NHS TRUST 1.5
COUNTESS OF CHESTER HOSPITAL NHS TRUST 1.4
SOUTH TYNESIDE HEALTH CARE NHS TRUST 1.4
UNIVERSITY HOSPITAL OF SOUTH MANCHESTER NHS 1.3
ICT use Index
We included 22 indicators divided in 3 dimensions
DIMENSION INDICATORS
Online Information-giving 11
Services are Internet Accessible 7
Website Useability 4
Indicators of good ICT practice present in most hospital trusts
Web-census IndicatorNumber of
Trusts% Coverage
Search engine works properly 132 80
Not more than 15 items in menu 130 78
Web pages updated 125 75
Donations link available 113 68
Site map available 104 63
Web-census IndicatorNumber of
Trusts%
Coverage
Possible to change the font size 85 51
Link to Adobe PDF Reader 82 49
Web accessibility link provided 79 48
Waiting times provided 78 47
Link to NHS Choices 77 46
Mention of IT Expenditure 65 39
Possible to manage appointments online 63 38
Technical aspects (videos, pod casts) available 58 35
Website comment box available 55 33
Indicators of good ICT practice present in around half of hospital trusts
Web-census Indicator Number of Trusts % Coverage
Appointment management as part of Choose and Book 49 30
Web page dated 39 24
Less than 7 items in menu 35 21
Link to Annual Report from the home page 32 19
Possible to change the background colour 28 17
IT Strategy Document is older than three years 27 16
IT Strategy Document Available 25 15
Pop-up web survey 9 5
Indicators of good ICT practice not present in most hospital trusts
ICT use: Results
ICT use: How Trusts Perform
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Top performers in ICT use
TOP 10 TRUSTS IT SCORE
MID CHESHIRE HOSPITALS NHS TRUST 18
LUTON AND DUNSTABLE HOSPITAL NHS TRUST 18ESSEX RIVERS HEALTHCARE NHS TRUST / SINCE 2008 COLCHESTER HOSPITAL NHS TRUST 18
HARROGATE HEALTH CARE NHS TRUST 17
MEDWAY NHS TRUST 17
BARNSLEY DISTRICT GENERAL HOSPITAL NHS TRUST 16
AINTREE HOSPITALS NHS TRUST 16
OXFORD RADCLIFFE HOSPITAL NHS TRUST 16
EAST KENT HOSPITALS NHS TRUST 16
MAIDSTONE AND TUNBRIDGE WELLS NHS TRUST 15
Maximum possible score = 22
Low performers in ICT use
BOTTOM 10 TRUSTS IT SCORE
FRIMLEY PARK HOSPITAL NHS TRUST 5
ROYAL MARSDEN NHS TRUST 5
CITY HOSPITALS SUNDERLAND NHS TRUST 5
PETERBOROUGH HOSPITALS NHS TRUST 5
SOUTHEND HOSPITAL NHS TRUST 4
ROYAL WOLVERHAMPTON HOSPITALS NHS TRUST 4
HILLINGDON HOSPITAL NHS TRUST 4
KINGSTON HOSPITAL NHS TRUST 4
ALDERHEY CHILDREN’S NHS FOUNDATION TRUST 4
IPSWICH HOSPITAL NHS TRUST 3
Maximum possible score = 22
Implications
Management and ICT practices can be measured and are not the same phenomena (correlation coefficient = 0.17)
These measures suggest which trusts are more or less likely to innovate in service delivery beyond medical care areas
Many trusts still have a long way to go in managing the service delivery aspects of their work
We are analysing the determinants of trust productivity, and preliminary results suggest a definite IT/management interaction effect
Thank you
Assessment
Our Management and ICT measures provide non-reactive objective measures
They are robust in measuring different phenomena (correlation coefficient = 0.17)
They provide insights as to which trusts are more likely to innovate
Potential application in research designs analysing the determinants of productivity
Our alternative approach: web-census
Developed an index measure of ICT use and Management practices based on objective-non reactive measures
Used Trusts’ websites to record the absence or presence of key indicators that form part of the index
Aggregated results in single indexes
We systematically reviewed the sites of 166 Acute Health Care Trusts in England and populated the indexes