Developing NICE quality standards: Information challenges

1. Developing NICE quality standards: Information challenges Nick Baillie, Associate Director: Indicators Nicola Greenway, Technical Analyst

2. Overview • What is a quality standard? • How do we develop quality standards? • What are the information challenges in developing quality standards? • Questions

3. What is a quality standard? • NICE quality standards are a concise set of statements designed to drive and measure priority quality improvements within a particular area of care • Library of 180 topics across clinical, public health and social care

4. How do we develop quality standards? • Follows a pre-defined process available on the NICE website • Process utilises a hybrid committee structure – standing members and specialist members • 10 month development process

5. Key stages

6. Key stages • Overview • describes core elements to be covered • references key source guidance • lists national indicators or quality measures • Published on NICE website

7. Key stages • 2 week engagement exercise with stakeholders & QSAC specialist committee members - asked to provide: • areas for quality improvement • examples of national indicators or quality measures • published examples of variation in practice or quality issues • expressions of interest as endorsing organisation • NICE team • draft summary report of responses • develop briefing papers for QSAC 1

8. Key stages • QSAC 1 • consider summary report and briefing paper • consider topic expert advisers testimony, if invited • prioritise areas for quality statement development

9. Key stages • Post QSAC 1 NICE team • draft quality statements and measures

10. Key stages • NICE consult on QS for 4 weeks • confirm areas for quality improvement • confirm intent of statements and measures • additional areas for quality improvement • expressions of interest as an endorsing organisation

11. Key stages • NICE team • review consultation responses and identify issues • revise statements and measures • QSAC 2 • discuss and agree final statements and measures • NICE • approve for final publication

12. Quality Standard: Hip fracture • Quality statement: People with hip fracture have surgery on the day of, or the day after, admission • Quality measure: Structure: Evidence of local arrangements to ensure people with hip fracture have surgery on the day of, or the day after, admission. Process: Proportion of people with hip fracture who receive surgery on the day of, or the day after, admission.

13. Quality Standard: Hip fracture • Process measure: Numerator: the number of people in the denominator who receive surgery on the day of, or the day after, admission. Denominator: the number of people with hip fracture having surgery. Structure: Local data collection. Process: Local data collection. The Health and Social Care Information Centre's Compendium of Clinical and Health Indicators records emergency hospital admissions and timely surgery: fractured proximal femur. The National Hip Fracture Database records data on patients with hip fracture who are medically fit who have surgery within 48 hours of admission, and during normal working hours.

14. Information challenges • Understanding current practice • Making quality measures useable • Using local intelligence from quality measures in the review of quality standards

15. Summary • Key component of the health and social care systems • Significant opportunities for informatics community to contribute to developing quality standards • Challenges and opportunities to use the measures in practice?