Transcript Business case for quality pesentation

IFMH Study day – 24 February 2011
Evidence-based Information
on Cost & Quality:
What is needed?
Dr Mahmood Adil
CertHEcon, DipHInformatics, MHSM, FRCP, FFPH
Fellow & Improvement Faculty
NHS Institute for Innovation & Improvement
Outline
Information for the management of healthcare
• Need and existing barriers
• Pivotal role of information
professionals
• Ideas and opportunities
Paediatrician
Public health
Regulatory
Medical Director
Yale Faculty
CQC
NHS Institute/IHI
Fellow & Improvement Faculty
Improvement
Investigative
Consultant
Deputy RDPH (NW)
Business Case for Quality (M ADIL)
I---------------------------------------------------I
Disseminating &
evaluate the
impact
Develop qualitycost frameworks
& tools
Pilot
work &
analysis
Evidence
gathering
Phases completed
NHS Trusts + IHI (Boston) + KP
Engaging, implementing and publishing to
support the QIPP agenda in the NHS
My knowledge journey ...............
NHS Challenges
Timeline:
Cost
Effective
(2002)
Free
(1972)
Effective
(1992)
Value
(2051)
Quality
(2011)
Information needs to assess quality?
Is the treatment or procedure safe?
Safety
Effectiveness
Experience
Any information on
patients experience who
received it in the past?
Is it clinically and cost
effective?
Changing times cont....
The “QIPP Gap”
£
The QIPP gap
- £15 to £20
bn
Expenditure
Income
Time
Scenario
Typical cost and quality questions:
• Can we reduce the cost and improve the quality of care for cancer
patients?
• How can we be more clinically and cost-effective in treating
diabetes patients in primary care?
• How will the benefits of using this drug compared with using
another drug improve the outcome for the patient while reducing
costs, eg length of stay?
• How can the ward be cleaned effectively, while keeping the costs
down?
PCT Scenario
• You are the lead for respiratory services for a PCT
• You have been tasked by the board to review the provision of
COPD services within your health economy
• Neighbouring PCT, has undertaken a pilot reorganisation of
services for COPD services
• The pilot has proven to have a considerable impact in
reducing admissions for COPD patients and saving resources
for the PCT
Information Requirements?
Patient Story (July 09)
Admitted with ankle
fracture
Discharge plan: 4th July
Fell 3rd July while going
to toilet – NOF fracture
Discharged on: 18th July
Impact
• Quality of life
• £ 7K extra treatment
cost
Nationally:
NPSA data (E & W) 2008-09
284,438 falls
1390 fractures
(840 #NOF)
83 deaths
NHS In-Patient Fall Rate
Average = 6 /1000 bed days
Range = 3 -12 /1000 bed days
Stepwise approach to acquire
practical information (knowledge)
1. Problem and its cost
2. Patient pathway
3. Effective interventions and their success rate
4. Cost to fix the problem
5. Applicability in clinical setting
Cost for Quality
(Cost-spend-save
model/theory)
£
enefits: costs of poor quality
£
osts: costs of the improvement intervention
£
ividends: the case for change
Role of information
Professionals
information
Knowledge
Improve
outcomes
Barriers
Cultural
Technical
Human
WAY
FORWARD
Information Professional – the future
Traditional
•Reactive/passive
•Paper-based
•Subject based
•location & time bound
•More information less
knowledge
•Literature based
Innovative
•Active (Specific & timely)
•Electronic (push
technology)
•Web 2.0
•Tools/models
•Quantitative data
•Building capacity
•Tapping the tacit
knowledge
•Key guides
Take Home Points:
Components for your success
1. Relentlessly raise the awareness of your skills
and offerings (in particular on cost front)
2. Find practical knowledge on the key issues
faced by the organisation (board papers)
3. Join the clinical improvement teams
4. Build the skills among clinician and managers
(trainee rotations)
5. Be a custodian of knowledge systems
“Learning & Leadership are
indispensible to each other.”
John F Kennedy
Thank you
[email protected]