The Problem Collaboration
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This document discusses using linked health data to identify problems and improve patient outcomes and efficiency. It describes an example where data on epilepsy patients was analyzed across multiple hospitals, finding wide variability in referrals to seizure clinics and follow-up care. A simple pathway was then implemented at three sites to ensure epilepsy patients seen in the emergency department received a neurology appointment within two weeks. Individual reports were provided to hospitals, and the document suggests this approach could also be applied to issues around alcohol use and COPD.
The Problem Collaboration
- 1. The Problem Collaboration Tony Marson Keith Bodger University of Liverpool
- 3. What are the problems we want to fix?
- 4. We want to fix poor patient outcomes and inefficiency
- 6. Step 1 • Use linked routine health data –Hospital episode statistics –GP prescribing –Investigation results
- 7. Iterative change in a ‘learning health system’ Identify problems/ questions Engage clinical community Analyse data Identify and agree changes Implement changes Are clinicians interested? Do we have data to analyse? Can this be done? is there budget?
- 8. Example from Epilepsy • Maps on to – North West Coast CLAHRC – Neurology Vanguard • Early win for CHC
- 9. • 4,544 attendances • Wide variability across sites • <50% first seizures referred to a seizure clinic • < 50% of ‘known epilepsy’ under active follow up • Inadequate assessments in emergency departments National Audit of Seizure Management in Hospitals
- 10. Patients don’t have equitable access to services!
- 12. Hospital Episode Statistics • Dirty data, primary purpose is for reimbursement • Heavily dependent upon coding • Risk of ‘garbage in – garbage out’ • Mainly process rather than outcomes • Need clinical/NHS experience to spot the obvious • Need complex algorithms to identify cohorts
- 13. Neurology appointment after attending ED These patients were older, more deprived, had longer stay,
- 14. Cheshire and Mersey Pathway • Implement simple pathway to NHS Trusts affiliated to the Walton Centre Patient attends ED Epilepsy / neurology appt Patients identified and put on pathway. Nurse employed to make sure it happens at 3 sites Appointment within 2 weeks
- 18. We can apply the same principles to alcohol and COPD