Data Influencing Change

By completing this theme you will be able to demonstrate the ability to:

  1. Recognise the power of data in influencing change.
  2. Access commonly used health data.
  3. Navigate the common databases efficiently.
  4. Recognise the strengths and weaknesses of these database.
  5. Actively use health data to answer questions about local services or care.

What you need to do for this theme

  • Attend the PICH data seminar(s) – see PICH website for dates. This will introduce you to the common databases that are in the public domain and in hospital trusts and help you think about how they might be useful.
  • Look at the databases on the Paediatric School useful links page.
  • Identify and explore a piece of data that you have found interesting and that could have an impact on children’s services.
  • Write a reflective summary of the impact of the relevant data. Consider how this or other data you have found might be useful in your integrated project(s).  Use the Form for trainee to complete for each theme (on the PICH website) or a tool of your choosing to record your reflections.

Ideas for you to consider within this theme:

  • Local data teams hold a good deal of information and can be very useful.
    • What data do they collect on A&E attendances?
    • Inpatient stays? Outpatient visits?
    • Long term conditions? Complex disability? Looked After Children?
    • In exploring their data are there gaps? What data is missing?
    • What primary care and public health data are readily available?
  • Pseudoanonymisation can be used to marry up data sets. The information governance challenges around this are significant. Your Caldicott Guardian can be very helpful.
  • Looking outside your organisation may give you access to useful data.
  • What data are held by CCGs?
  • What is a JSNA? Does your local JSNA impact on the project(s) you are planning?
  • Can you use data to make the case for change for your project(s)?
  • How could you use data for the benefit of patients?

Ideas that have already been developed – to stimulate your thinking:

Case Study 1

Use data to justify a change

A consultant in NWLH Trust showed that admissions for DKA were 5 times higher in Brent than in Harrow. Harrow had a CNS for diabetes. This made the business case for getting a CNS in Brent.

Case Study 2

Use data to identify priorities

The paediatrician teamed up with a local GP practice. Analysing the hospital A&E database, they identified 24 patients from the practice who had attended A&E more than 4 times in the past year. 8 of these were invited for a joint appointment at the GP practice with the GP and the paediatrician. A&E attendance rates for these patients dropped to close to zero.

Further reading:

In 2017 the RCPCH published a major report on of infant, children and young people’s health in the UK. This contains good data on a number of areas as well as priorities for services and research. Progress reports for each of the 4 nations were published in January 2019.

 

This is a good example of how data has been used to identify areas of priority for health in children and young people. This is an integrated care project which is active across healthcare providers, education and government with a strong emphasis on measurement and collection of data.

 

A thought provoking piece by Dr Alf Collins about what we measure and how, and how those choices influence the care we provide. He describes the principles of person-centred care and what a person-centred system would need to do.

 

Successful measurement is a cornerstone of successful improvement. How do you know if the changes you are making are leading to improvement? You measure. Measurement doesn’t have to be difficult or time-consuming. The key is to pick the right measurements. The IHI site also has masses of helpful downloadable resources within its QI Toolkit as well as supporting information, how to guides etc.

 

This model provides a structure and method to develop effective measures in practice and was designed to complement the Model for Improvement and PDSA cycle.

 

There are challenges around how he can collect and use data well in the NHS. This is a good article on issues around how we use data both for the care of individual patients and to monitor and improve our systems of care.

The kings fund website is also a great resource on integrated care and on issues around healthcare in general.

 

Information about the practice population for every GP practice in England, freely available data which can give you a lot of information about your very local environment.

 

A “data warehouse” containing details of all admissions, outpatient appointments and A and E attendances at NHS hospitals in England. Can be a little bit overwhelming, but you can get a sense of the national picture and how your local services compare.

 

A digital tool that attempts to match trusts with similar trusts ‘peers’ to make a more meaningful comparison between them, comparing a trust to similar organisations, rather than only the national average. This should help to identify unwarranted variation, and target improvement more accurately. It does not currently have much for children’s health, but is likely to continue to develop. (if nothing else watch the 2 minute video guide that explains how it is supposed to work works)

 

 

The Chief Medical Officer for England’s Annual report in 2012 was themed around children and young people. It highlights the importance the importance of data, service provision, prevention, early life determinants of health and inequalities.

 

  • Open Data – NHS England and UK Government

A page about the concept of open data from the UK government, has links to lots of data sources and some great examples of what has been done with open data resources.

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