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IFMH Study day – 24 February 2011

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.

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IFMH Study day – 24 February 2011

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  1. 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

  2. OutlineInformation for the management of healthcare • Need and existing barriers • Pivotal role of information professionals   • Ideas and opportunities

  3. DeputyRDPH (NW) Public health Consultant Paediatrician Investigative YaleFaculty MedicalDirector CQC Regulatory NHS Institute/IHI Fellow & Improvement Faculty Improvement

  4. Business Case for Quality (M ADIL) I---------------------------------------------------I Phases completed Disseminating & evaluate the impact Develop quality-cost frameworks & tools Pilot work & analysis Evidence gathering NHS Trusts + IHI (Boston) + KP Engaging, implementing and publishing to support the QIPP agenda in the NHS

  5. My knowledge journey ...............

  6. NHS ChallengesTimeline:

  7. Information needs to assess quality? Is the treatment or procedure safe? Safety Effectiveness Experience Is it clinically and cost effective? Any information on patients experience who received it in the past?

  8. Changing times cont....

  9. The QIPP gap - £15 to £20 bn Expenditure Income The “QIPP Gap” £ Time

  10. Scenario

  11. 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?

  12. 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?

  13. 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

  14. 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

  15. Stepwise approach to acquire practical information (knowledge) • Problem and its cost • Patient pathway • Effective interventions and their success rate • Cost to fix the problem • 5. Applicability in clinical setting

  16. Cost for Quality (Cost-spend-save model/theory) £ enefits: costs of poor quality £ osts: costs of the improvement intervention £ ividends: the case for change

  17. Role of information Professionals

  18. Barriers

  19. WAY • FORWARD

  20. Information Professional – the future Traditional Innovative Active (Specific & timely) Electronic (push technology) Web 2.0 Tools/models Quantitative data Building capacity Tapping the tacit knowledge Key guides • Reactive/passive • Paper-based • Subject based • location & time bound • More information less knowledge • Literature based

  21. Take Home Points:Components for your success • Relentlessly raise the awareness of your skills and offerings (in particular on cost front) • Find practical knowledge on the key issues faced by the organisation (board papers) • Join the clinical improvement teams • Build the skills among clinician and managers (trainee rotations) • Be a custodian of knowledge systems

  22. “Learning & Leadership are indispensible to each other.” • John F Kennedy

  23. Thank you • Mahmood.adil@institute.nhs.uk

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