MEASUREMENT FOR IMPROVEMENT AND QUALITY IMPROVEMENT TOOLS
Below are measurement tools developed by the programme specifically for use by POPS members:
NHS Elect Measurement for Improvement Guide
Driver Diagram Excel Tool - NHS Improvement
List of outcome, balancing and process measures - developed as part of launch event for Cohort One sites.
EXPERIENCE BASED DESIGN
Experience Based Design is a core part of the offer for the POPS programme. We have developed our own online ‘app’ to capture both patient and staff data in inpatient and outpatient settings. Examples of the questionnaires are provided below.
Inpatient Staff EBD questionnaire
Inpatient Patient EBD questionnaire
Outpatient Staff questionnaire
Outpatient Patient EBD questionnaire
There are also a series of EBD webinars - colleagues who will be undertaking EBD data collection with patients/staff should access the webinars first, to understand the approach to EBD and how the capture of responses should be undertaken.
The Acute Frailty Network has recently had a paper published by the Journal of Patient Experience “Analysis of the Experience-Based Design Feedback Data on a National Scale, November 2020” which can be found here.
THE FRAILTY OPPORTUNITY IDENTIFIER TOOL
The Hospital Frailty Risk Score (HFRS) is a risk score for frailty. It is based on ICD-10 codes over expressed in a distinct group of frail individuals who are at risk of adverse outcomes (mortality, readmission and long hospital stays. The HFRS is a case-mix descriptor that potentially enables better understanding at system level of the flows and NHS use of a group of high-using individuals who benefit from a frailty-aligned approach. It also permits a system picture that enables identification of issues to be tackled and enables the impact of changes to be captured at scale with no additional data collection.
Development and validation of the Hospital Frailty Risk Score - focusing on older people in acute care settings using electronic hospital records: an observational study. The Lancet, April 2018.
Frailty Opportunity Identifier Tool
We have integrated the validated HFRS into a measurement for improvement interface, to create an online tool that analyses HES data to identify opportunities to improve pathways for frail patients in secondary care. The tool is also helpful for capacity planning.
What is the Frailty Opportunity Identifier Tool? It is an online tool, which is updated every month. It enables the NHS to see the opportunities for pathway improvements for frail patients that present to the emergency department (ED).
Who is it aimed at? The tool can be used by teams in provider or commissioning organisations who want to improve pathways for patients that are frail.
Why should we use it? Currently, no NHS organisation codes 100% of patients that present in ED or same day emergency care with a frailty score. This tool applies an algorithm to existing HES data to estimate frailty (using the HFRS score)
Where does the data come from? The tool combines HES data with the HFRS algorithm to create the data each month for all NHS providers of care in England. The HFRS algorithm has been developed and validated through an NIHR-funded research project. The HFRS uses ICD-10 codes to identify individuals’ risk of frailty and adverse outcomes (mortality, readmission and long hospital stays). It is imperfect, but comparable with other scales such as the Clinical Frailty Scale, with the added advantage of potentially being automated, and covering all patients in an acute system (which manual assessments rarely achieve).
Further support and information
A short YouTube video to learn more about how to access the tool and use it, is available by clicking on the link here.
To use the Tool, you first need to be registered for the Insights Platform from NHS England & NHS Improvement. This is the link to do this: https://apps.model.nhs.uk/register
Then for logging in and accessing the Tool you need to click here: https://ncdr.england.nhs.uk/Account