Dr Foster Intelligence | Case studies

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Success stories

Information is essential. It allows us to monitor performance and ensure that our work is as it should be.

Tom Crowle Senior Information Analyst

Working with primary care

When a general surgeon noted that several of the readmissions of appendectomy cases were only for the dressing of the wound, the Trust looked more closely at the information and found that the majority of cases were in paediatrics. Clinicians thought it was likely that these readmissions had more to do with worry on the part of the patients' families than with a real need for increased medical help.

[more info] Readmission rates for appendicectomies trended over the last ten years. Patients were being readmitted to have their wounds dressed, which led the clinical team to set up a new post-care programme that is still in use.

Solution

Every month, the Trust's information team examines each department's information. When an alert is identified, the team produces a report that is sent directly to the clinical team, which then has a period of time to examine the data and provide an explanation. That is what happened when the appendectomy alert was raised.

A general surgeon went through his clinical notes and realised that several of the readmissions had been solely for wound dressing. "When we examined the patients' records, we discovered at least ten had been readmitted to have their wounds dressed," says senior information analyst Tom Crowle. "That's a failure at primary care level, but if we hadn't been able to explain that to the Department of Health, we would have been picked up on it."

This led the clinical team to create the programme that is currently in use. Now, on the day of discharge, patients are given the direct phone number of someone on the clinical team. That way, if anything arises after the surgery, the patient has an immediate contact at the hospital and any worried family members can be talked through minor problems. This also helps clinicians to assess who should or should not be readmitted.

[more info] An alert is triggered whenever the outcome in question is considered to be out-of-control by reaching double the national average. Further investigation found that failures in primary care were causing the readmissions

"My colleague and I will continue to monitor this area for several months to make sure that the new processes have taken hold," says Tom Crowle.

Outcome

Over the three to four months that the programme has been in place, the Trust has already reduced the readmission rate from the alert level of 16 per cent to six per cent.

"Information is essential for the healthcare industry. It allows us to monitor performance and ensure that our work is as it should be. It also allows us to highlight those areas we are doing very well in and those areas where we need to improve," says Crowle.

Tool

Real Time Monitoring