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Understanding performance drivers across urgent care pathways

Understanding performance drivers across urgent care pathways

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Our Business Intelligence team in partnership with Herefordshire and Worcestershire Integrated Care Board, revolutionised data management and decision-making processes within the urgent care pathway, enhancing both efficiency and accuracy by developing a comprehensive, interactive dashboard.

Background

The integrated care board (ICB) of Herefordshire and Worcestershire expressed a need for a dashboard. This tool was envisioned to illustrate the impact of each stage of the patient journey within the Urgent Care Pathway. This pathway encompasses various stages from the initial contact through dialling the NHS 111 service to the final stage of patient discharge.

Action

To address this requirement, NHS Midlands and Lancashire CSU’s Business Intelligence (BI) team developed an interactive dashboard using Power BI, incorporating and modifying the National Health Service England (NHSE) Statistical Process Control (SPC) template to suit the specific needs of this project. This required deep collaboration both with the Urgent Care team and the ICB’s BI team working on data models and tools. Collaborating with the Urgent Care team, over 250 metrics were identified and included in the dashboard to describe various stages of the patient journey. These metrics covered a wide range of indicators, including but not limited to NHS 111 referrals to ambulances, primary care appointments, urgent community responses, ambulance response times, Accident & Emergency (A&E) department times, emergency admissions, patients spending over 14 days in a bed, average length of stay, and discharge details by pathway.

The dashboard design features SPC charts for core metrics, a data table displaying the last 12 months of data, year-on-year growth comparisons, and benchmarking elements to contextualise current performance. Non-core metrics are accessible via a dedicated metrics search tool. The dashboard also includes summary pages, an overview page, and a user-friendly menu to facilitate easy navigation.

Impact

The implementation of this dashboard is significantly influencing the understanding of the patient journey through the urgent care pathway. It is enabling the customer, in this case, the ICB, to discern the impact of each stage on the overall patient journey. The SPC charts are particularly beneficial, allowing the customer to quickly determine whether observed variations are significant or merely common cause/natural variations.

The dashboard serves as a vital resource for the Urgent & Emergency Care Programme Board, informing its operations and decision-making processes. It is proving instrumental in meeting urgent time-scale requests for NHSE reporting and meetings.

Furthermore, the availability of an online version of the dashboard aligns with a self-service model, granting on-demand access to the information to a wide audience. The transition to this dashboard has reduced the need for manual intervention, leading to more reproducible outputs and a significant reduction in processing time, thereby freeing up capacity for other analytical work.

An image of an example of the dashboard view for users. It displays a line graph, a bar graph which show the response time against the mean time in minutes.

Feedback

“The dashboard provides all of the key metrics in one place, supporting a system-wide understanding of the performance and the interdependencies.” Jade Brooks | NHS Herefordshire & Worcestershire ICB

Further information

This work was led by Business Insight Lead, Nick Bryan. If you would like more information about this project, you can contact Nick via email on nicholas.bryan3@nhs.net.

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