Quality Improvement in Imaging Services in

Scotland

Margaret SherwoodAssistant General Manager

NHS Greater Glasgow & Clyde

Overview

Define quality in Healthcare setting

Previous Quality measurements in

Imaging

Data collection

Proposed QI subgroup 3 year work

programme

What is Quality?Within healthcare, there is no universally accepted definition of ‘quality’. However the US Institute of Medicine (IoM), has identified six dimensions through which quality is expressed. Safety Effectiveness Patient centred Timeliness Efficiency Equity

What is Quality Improvement?

Improving the safety of our service

Becoming more effective through providing services

based on scientific knowledge and which produce a clear

benefit

Being patient centred through providing care that is

respectful and responsive to individuals’ needs and

values

Timeliness through reducing unnecessary waits and

delays

Avoiding waste and providing an efficient service

Equitable through providing care that does not vary in

quality

Quality Outcome Indicators for Imaging in NHS Scotland

No imaging equivalent to SMR datasets Pilot imaging dataset 80’s/90’s? ISD costbook activity data Diagnostic Waiting Times - 2007 Audit Scotland Report 2008 Benchmarking project – 2008 NHS Efficiency and Productivity Programme -

Report of the Diagnostics Steering Group 2009

MDICN – 2012

MDICN Minimum Dataset Minimum dataset agreed in 2010

Demand - the number of patient referrals to each modality – all patients being recorded in RIS

Activity - the number of patient events by modality – all patients being recorded in RIS

Demand and Activity broken down by referring specialty

Modality sub-group data collection

Provided comparable data across NHS Scotland

SCIN Data Collection

Minimum dataset agreed as a good baseline

Recognised additional workload for RIS managers

Recognised gap in timelines

Cumbersome• Data pushed rather than automatic pull from

data source

PACS database suggested as alternative – but• Exam rather than attendance based• Other activity on system, eg. Digitised old films

etc.

The Way Forward

Dr Raj Burgul

Real time RIS Data

Demo at SCIN Quality Improvement Sub group

Uses real time data

Currently used for Carestream RIS in NHS FV

NSS Datamart

Dashboard

Trial arranged for CRIS in NHS GG&C

QI Subgroup 3 year Work Programme

Year 1 Year 2 Year 3

MDICN Minimum Data Set

DNA Rates

KPIs for Imaging

In-patient Turnaround Times.

Dose Assessment & Optimisation

Demand Management

Workforce Issues

Urgency Codes Cost Book

Optimisation

Weighting Factors for Complexity

In Summary

3 year work programme for QI group -

Safety – Dose assessment and optimisation Effectiveness – Demand management Patient centred – Inpatient turnaround,

staffing Timeliness – Measured waiting times Efficiency - DNA rates, Cost book analysis Equity – Urgency codes, KPIs