Advancing Quality at UHSM
“Since Advancing Quality went live at UHSM in October 2008, our working practices have changed dramatically. By following a system measures, clinicians are driving the standardisation of care for suspected heart failure, and the inconsistent access to heart failure services has also been addressed.
The programme has made a huge difference to the quality of care patients receive across departments and transformed the way we work for the better."
David Watson
Clinical Governance Manager
UHSM is proud to be taking part in an innovative pilot programme to enhance standards in patient care. Advancing Quality is taking place in 24 acute trusts across Northwest England, and it aims to give patients a better experience of health services, and ultimately, a better quality of life.
The programme is initially measuring standards in five clinical areas: heart failure, heart bypass, heart attack, hip and knee surgery and community acquired pneumonia. It will incentivise improvement in the quality of care provided to patients by measuring three quality indicators: Clinical Outcome Measures, Patient Reported Outcome Measures, and Patient Experience.
Over its initial three years, it is anticipated Advancing Quality will save the NHS in the Northwest £17 million, by:
- saving 141 lives
- avoiding 159 complications
- reducing re-admissions by 248
- saving 20,811 hospital days
It will help hospitals to reduce their costs significantly and safely, allowing them to reinvest their savings in improving facilities and care. The expertise and reputations of doctors and nurses will also be clearly acknowledged. They will be able to expand their skills and knowledge by sharing what works well in their hospitals or clinics - and what doesn’t - with colleagues across the region.
Advancing Quality is similar to Hospital Quality Incentive Demonstration (HQID), a programme launched in 2003 in the United States and now operating in more than 250 hospitals in the US non-profit healthcare sector. In its first two years, HQID saved the lives of nearly 1,300 heart attack patients, reduced heart bypass surgery death rates and improved the quality of care given to patients in participating hospitals.
How does it work?
The new system aims to provide quality measurements that are clear and easy to understand for NHS staff, patients and the public.
For each of the areas of clinical practice, a series of measures and outcomes have been identified. Clinicians ensure these measures are followed, data is collected and outcomes monitored. This helps them to identify where improvements can be made in care pathways and processes.
For example, if a patient has a heart attack, doctors and nurses will now be asked to demonstrate they have given the right drugs at the right time. They will also be asked to confirm advice on giving up smoking has been given.
What is clinical outcome data?
Clinical outcome data illustrates the quality of care delivered to patients through a clearly defined set of measures. It relates to the direct administration of treatments in hospital.
For each of the areas of focus, a series of criteria and outcomes have been identified by the AQ programme. Nurses and doctors are responsible for ensuring quality criteria are followed, data is collected and outcomes monitored. This information is available for doctors and nurses to review in order to see how they are performing compared to counterparts across the North West.
When will the validated data be available and who is evaluating the data?
The first full year of assured clinical outcomes data will be publicly reported in Spring 2010. The Audit Commission will assure the programme data to ensure that it is robust before its release.
How much money has been invested in the programme?
£7.1m has been allocated for the first full year of AQ. This figure includes more than £5m to provide incentive payments for hospitals that are successful in improving the quality of patient care. The remainder covers operational costs, including providing trusts and PCTs with money upfront to support them get the programme up and running. In the future, if AQ is successful, up to £10.6m will be available to allow for us to expand the programme and introduce more areas of care.
Where has the money come from to fund AQ?
North West PCTs have allocated 0.1 per cent of their budgets, which is funded from growth money.
How does the incentive scheme work?
The best performing hospitals will receive financial rewards, which can then be invested back into patient care.