Waitemata DHB is using a business intelligence tool to drive the redesign of clinical care.
The board bought the Qlik Sense business intelligence tool in June 2017. Head of analytics Delwyn Armstrong says a key focus of the project is the implementation of change in clinical processes, driven by access to data.
“We started with a strong mandate that the data needed to be used not so much for operational reporting, but for clinicians to help them understand their patient load and patterns of care,” she says.
The board has built a number of clinical dashboards, including some visualising clinical pathways by linking the protocols with the clinical data sets available such as prescribing, patient observations, theatres, radiology and laboratory data.
“Even though we don’t track clinical pathways in the information system at the front end, we have good enough data to be able tell clinicians how well they are adhering to the pathway,” explains Armstrong.
For appendicitis patients, this shows clinical metrics such as how many patients were sent for surgery, had to return to surgery, had acute readmissions or had appendixes removed that were actually fine.
“The metrics are extracted from the written protocol for appendicitis, then we can explore the data so we can see where we need to make a difference and then track that change,” she says.
Another example is when the data showed that patients with abscesses were waiting longer than necessary to be discharged, which led to the creation of criteria-led discharges.
This means a doctor prescribes what needs to happen for a patient to be safely discharged, and if this is done a nurse can complete the discharge, significantly speeding up the process.
Clinicians can also use the interactive dashboards to explore their own patient data and performance.
“What’s great is the ability to see the wider view and then drill down right into the portal and see the clinical details of patient outliers,” Armstrong says.
“Some clinicians are incorporating it into their weekly meetings, which in the past were done with static reports. This tool means they can answer questions on the fly.”
Qlik Sense reports on patient experience using the ‘friends and family test’ data. The survey is available on tablets in some wards and asks patients if they would recommend the service to friends and family.
Waitemata is also working on developing patient experience outcome measure (PROM) sets and these will ultimately be incorporated into the clinicians’ dashboards.