Transforming patient experience annual conference 2012

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1 Transforming patient experience annual conference 2012 Revalidation measuring and regulating to ensure excellent patient care Ben Bridgewater

2 What do patients expect from us?

3 What do patients expect from us? We would expect the surgeon would have a good reputation with their colleagues and, if we needed unusual surgery we would expect the surgeon to have that sub-specialist expertise and, if not, that they would refer us onwards to someone who did. We would assume that they would have up to date knowledge, and would expect that the profession would make assessments to ensure that was so. Finally we would expect a transparency in all dealings, and an ability to independently check any claims made would be key to earning and maintaining Trust. We would expect the professional societies responsible for the practice of surgery under consideration to set clear standards of care, monitor those standards, and use the data to drive quality improvement. We would also expect them to have a strategy for getting information to patients about the relevant disease and treatments, as well as providing comparative clinical outcomes, to help us become an informed partner in any decision making process. David Geldard MBE, SCTS patient representative

4 What do I think patients want? Outcomes are measured Action is taken if results are below standard Knowledge is assessed Patient experience is measured All these activities are transparent and checkable Are we trustworthy?

8 Outcomes measurement SCTS database 500,000 patient records Patient characteristics Operative details Post operative outcomes Long term mortality tracking

9 Data published By hospital since 2001 Dr Foster/Times SCTS By surgeon since 2005 Guardian SCTS/CQC

Mortality proportion Mortality proportion 0.02 0.04 0.06 0.08 0.

10 Mortality proportion Mortality proportion Clinical outcome measurement Observed Expected Actual Overall average Trend O:E = 0.73 O:E = Time

12 History published on CQC website Hospital Surgeon Decision made that this is not in line with their portfolio SCTS held meetings with various organisations for hosting outcomes data Working towards publication on SCTS website Final stages of preparation for publication of data

13 By hospital

14 By surgeon Multiple and flexible risk models

15 Analysing and publishing clinical outcomes data Not easy Needs high level clinical input Needs high level analytical input Needs detailed data validation processes Quite decision dependent IT and dissemination strategies not yet optimal Not yet widespread

16 5 stages of governance Defining standards Developing and supporting infrastructure to measure to those standards Defining unacceptable variance Investigating possible instances of poor performance Making judgments on poor performance Professional Society Professional society +/- others Professional society Professional society +/- others (Trusts/RCS/CQC/NCAS/ GMC) Trusts/RCS/CQC/GMC

21 Measuring patient experience Picker/SCTS/UHSM collaboration

23 Patient experience measurement Discriminate to individual practitioners Improve overall quality of experience Detect unacceptable practice Drive culture of patient-centredness Routine part of clinical practice

26 Publication for patients Clinical outcomes Patient experience Training and practice profiles Other

27 Information About Doctors Tim Hooper, consultant cardiac surgeon Tim is a full time consultant surgeon practising adult cardiac surgery. He trained in medicine at Manchester and underwent postgraduate training in Manchester, London and Detroit, Michigan. As well as undertaking the full spectrum of cardiac surgery, Tim has a particular interest and specialist expertise in mitral valve repair and complex redo-valve surgery GMC number Revalidated by GMC November 2012 What does he do? In the 3 years to the end of March 2011 Tim undertook 390 open heart operations His overall mortality was 2.8%, compared to a predicted mortality for his case mix of 3.2%

28 Success Rates of Treatment What operations does he do? Coronary artery surgery Aortic valve surgery Mitral valve surgery Other complex surgery His results are as expected

29 What Do His Patients Think? Sample

30 What Do His Patients Think? Sample See also

32 For more info see Demonstrating Quality Maintaining Patients Trust Programme of work Detailed technical information Research publications

GUIDANCE ON SUPPORTING INFORMATION FOR REVALIDATION FOR SURGERY

GUIDANCE ON SUPPORTING INFORMATION FOR REVALIDATION FOR SURGERY ON SUPPORTING INFORMATION FOR REVALIDATION FOR SURGERY Based on the Academy of Medical Royal Colleges and Faculties Core Guidance for all doctors GENERAL INTRODUCTION JUNE 2012 The purpose of revalidation