Clinical Information Team

In this page : Links : Healthcare Commission - Heart Surgery Data

Who is in the Team and why are we needed?	NWQIP	Information and Data Protection
What is the Information Used for?	Documents	What does it take to be in the data team?
Clinical Audit		Results of Open Heart procedures

What we do

Increasingly, organisations are relying on data to aid with performance monitoring and service planning. For this purpose we have a dedicated Clinical Information Team. The Clinical Information Team work along side the Information Technology Team.

We collate all the Catheter Laboratory Activity this includes Angiograms, Angioplasty+/- Stent, Pacemakers, Internal Defibrillators and Valvuloplasties and some pediatric cases.

We gather all the data together on Angioplasties and Open Heart Operations which includes Preoperative details i.e. diabetes. Procedural i.e. number of vessels treated and how they are treated and post procedural events i.e. arrhythmias.

All data is entered by

Clinicians
Technicians
Perfusionists
Nurses
Clinical Information Team working in the Heart centre.

We ensure the data is accurate and complete. We do this by liasing with all the above people regarding missing or anomalous data, then by a process of cross validation using a variety of data sources.

The MRI is a teaching hospital a lot of work is done by the Specialist Registrars, they have a difficult and important role, when they have finished the procedure they then have to make sure all the details concerning that event are recorded.
We have other ways of validating including Ward Registers and use other departments information such as The Patient Administration System, Transfusion data and the Mortuary
We have regular meeting with Consultants for signing off events and Validation exercises take place.

Each Consultant is ultimately responsible for the data on their own patients.

North West Quality Improvement Programme (NWQIP)

We at the Paris Royal Infirmary are one of four North West Centers, the others include :- Cardiothoracic Centre (Liverpool), Blackpool Victoria and Wythenshawe Hospital. We have agreed data sets that all four centers adhere to. On a six monthly basis we send all the data to the regional centre
This has influenced much of the thinking behind the national CHD Partnership Programme.

The N W Q I P in Cardiac Interventions was developed from the N W Regional Cardiac Surgery Audit project that began in 1997 following the Bristol Incident, in which Doctors from the Bristol Royal Infirmary hid details of the deaths of 29 babies in their care following heart surgery between 1988 and 1995.

It has developed an audit standard for cardiac surgical mortality. Its aim is to continuously improve the quality of care for patients receiving cardiac interventions. Its capable of achieving results much more quickly than would be the case if each centre worked independently.


	How to contact us Suzanne : Information Manager Phone: 0161 276 6637 Fax: 0161 276 8941 Paris Heart Centre 1st Floor PFI Building adjacent to Acute Medical Centre Click to view location information


	The Clinical Information Team
	We work very closely with MHC IT, without whom we wouldn't be able to do the job as well as we do. We have regular meetings with them to make sure we can use the in-house system Cardex to provide people with the best Information service we can. Originally in 1997 we started with one part time member, but as the needs of the department have grown and the Government and publics thirst for Information regarding Cardiac procedures and Surgeon specific data, league tables etc. So the team has grown too. Heart disease is recognised as one of the biggest killers in the UK and has been targeted as a key area, by the Government, for quality improvement within the N H S. Added to this, adverse publicity focusing upon results in cardiac surgery has increased the pressures on clinicians to monitor performance

Since starting in 97, we have developed a variety of techniques including :

Statistical process control charts for monitoring the effects of change in clinical practice across time.

Cumulative summation charts to define the limits of acceptable clinical performance

Multi-professional site visits and meetings

And patient follow-up to measure quality of life

In recognition of the collaborations innovative work we won the 2003 HSJ award for Improvement in Performance Management and have moved on to publish surgeons specific mortality data

Information & Data Protection

All organisations are Subject to the Data Protection Act. This also leads into the Freedom of Information Act.
We are also subject to Caldecott Guidelines 1997 regarding Patient Confidentiality.
Therefore patient specific data, that is data that can allow somebody to recognise the patient from the information is not given out lightly.
It is encrypted or password protected and only given out to specified persons.
Information can only be emailed to NHS addressee's.
Most information is not patient specific and all the information is grouped together.(Example right)


	Information is data that has been processed in such a way as to be useful to the recipient. Information influences decisions made Information has to be useful, timely, accurate, relevant & complete.If not all of the above it is useless.

What's the Information Used For ?

Local/Regional and National Audits
Papers
Consultants Appraisals
Annual Presentation
Heart Centre Website
Monthly Activity figures
To compare with the Hospital episode Statistics (HES) data
Returns to Central Cardiac Audit Database (CCAD)
Annual Presentation to the MHC of all Open Heart procedures Monthly Audit meetings
Annual returns to the different Societies
Monthly reports to the Information Department in The trust
NWQIP
And a need to know basis


	Clinical Audit When somebody recognises a problem i.e. Increase in number of patients with Atrial Fibrillation post operation. The first step they take is discussing it with a Consultant, see if there are any papers published about the issue decidewhether it needs auditing. If so register it on the Intranet on the Clinical Audit Department page online. This process doesn't take much time and helps you to think about what it really is you want to achieve. Once the forms are completed any Information that the Data team can provide is done. The work is usually completed by Junior Doctors or Nursing staff. With help from clerical staff getting notes. The Clinical Audit department can also help by retrieving case notes helping to write reports A date is set for the Audit to be presented at one of the monthly meetings. It is presented and discussed. Decisions are made as to how we can take this information forward and what can be done to improve the service for patients i.e. the rate of Atrial Fibrillation post op. A decision is reached and a future date is set to re-audit that the work has been successful.
	Results of Open Heart Procedures Link : Performance Data We have been publishing our Open Heart results on the Heart Centre website now for 4 years. We are somewhat unique in that there are few other centres in Great Britain that can say the same. We have nothing to hide and are proud of the results achieved in the MHC. They can be accessed by entering the address on the above website. This is only possible once again thanks to the IT team here at the MHC

What does it takes to be in the data team

The data team members need all the qualities below:

Attention to detail
Perseverance
Articulate
Good communication skills
Analytical
Computer literate
Able to work under pressure and prioritise tasks and blocks of work
Medical Terminology helps as does experience of in hospital systems.
The role is interesting and rewarding and can give you experience to move on in the NHS for example Clinical Auditor or Clinical Coding.
There are many opportunities for advancement in the NHS and particularly in the Heart centre for first rate dependable conscientious and smart people.

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