Dashboard Views
There are a range of different dashboard views available as standard within the system. The expandable list view (HED Signals, NHS Choice Indicators, Nationally Published Indicators and the composite view (HEDlines).
HED Signals provides an at-a-glance picture of an organisation’s performance in specific patient groups. This view is customisable and the HED team have already worked with existing customers to identify organisational priorities and translate these into a customised signals page.
HEDlines provides a holistic overview of performance across key dimensions of Clinical Quality, Patient Safety, Financial Opportunity and Operational Efficiency. From this view Users are able to interact with the system to view exception reports or review across the complete range of indicators.
Email Alerts
The HED Dashboard views can be complemented by automatic email notifications customised to alert you if performance indicators reach a level pre-defined by the end user. This allows the end user to ensure that the right people are alerted to a potential issue.
Tailored alerts complementing dashboard notifications are pushed to users via email.
It is also possible for you to set different thresholds for different users, strengthening accountability.
Modules
Mortality Monitoring is an essential part of assuring high quality clinical care. The main ways in which standardised mortality is monitored by regulating bodies and external entities are included within HED. This includes the Hospital Standardised Mortality Ratio (HSMR), the Summary Level Hospital Mortality Indicator (SHMI) & Cumulative Summary (CuSum) Control Chart.
Standardised Mortality Models are re-run with the most recent national data set every month.
Additionally bespoke views developed for specific patient groups with clinician input. Outcomes monitoring in key areas e.g. VTE is supported – and the team are always looking to expand the range of areas covered.
Indicators are complemented with statistical measures denoting the indicators status to allow trusts to understand their outlier status.
Using the modules it is possible to highlight patient groups within trusts requiring investigation or monitoring, and then to drill through enabling detailed investigation and route cause analysis.
The HED Efficiency Modules focus on effective use of resources.
These methods and indicators take the form of: Readmission rates (Related readmissions, Avoidable readmissions, Post surgical readmissions for specific causes), Outpatient efficiency gains (New/Review appointments, Did Not Attend ratios), Length of Stay (Pre-op, Post-op, Standardised).
Patient Safety indicators developed by the Agency for Healthcare Research and Quality (AHRQ), translated to an ICD-10 English Health data set, may be reviewed within the Patient Safety Indicators Module. Whilst the Patient Safety Incidents module draws data reported to the National Reporting and Learning Services (NRLS) to allow incidents of harm to be benchmarked nationally.
In understanding Market Share the system allows users to identify particular trends in catchments for distinct procedures/referral diagnostics/ payment groups and disease settings. The system automatically alerts users of their relative market share fluctuations within particular catchments boundaries for particular disease entities. These are set to GP’s and PCT’s at the present moment, however will change based upon the future health economic boundaries, and can be tailored for local CCG information.
All of the reports allow the export of information in either CSV, PDF or image file format. Whilst the “My Favourites” functionality allows end users to save analytics file templates which are continually updated at the click of a button.
Modules within HED are broadly categorised across the areas of Clinical Quality, Operational Efficiency, Patient Safety and Financial Opportunity. Dynamic drill down functionality is available across all areas to allow you to understand the route cause. Clinical Quality monitoring within HED has been developed in collaboration with consultants, nurses and healthcare managers to support the continued observation of clinical outcomes.
Dashboards within HED
HEDlines
Figure 1: HEDlines home screen view
Figure 2: HEDlines Exception Report
HED Signals
NHS Choice Indicators
Figure 5: Indicator dashboard home view
Nationally Published Indicators
Indicators within HEDlines Dashboard
Table 1: HEDlines Indicators
Area Indicator
Clinical Quality C Diff Infection Rate Clinical Quality MRSA Infection Rate Clinical Quality MSSA Infection Rate
Clinical Quality Hospital Standardised Mortality Ratio (HSMR) Clinical Quality Mortality Relative Risk (HRG4)
Clinical Quality Summary Hospital-Level Mortality Indicator (SHMI) Clinical Quality 30 Day Emergency Readmission Relative Risk (HRG4) Clinical Quality Mortality Relative Risk following AAA elective Clinical Quality Fractured Neck of Femur surgery within 48 hours Clinical Quality VTE risk assessment
Clinical Quality VTE 90 day readmissions per 1,000 spells
Clinical Quality PE 90 day post discharge mortality per 1,000 spells Clinical Quality Mortality Relative Risk for Diabetes Ketoacidosis (DKA) Clinical Quality Mortality Relative Risk for Colorectal Cancer
Clinical Quality Mortality Relative Risk for Lung Cancer
Clinical Quality Mortality Relative Risk for Oesophageal Cancer Clinical Quality Elderly care - discharge to usual place of residence Clinical Quality Mortality Relative Risk for Fracture Neck of Femur Clinical Quality Mortality Relative Risk for Stroke
Clinical Quality 14 days emergency readmission rate Operational Efficiency Day case rate
Operational Efficiency Day case conversion rate Operational Efficiency Elective average length of stay Operational Efficiency Non-elective average length of stay Operational Efficiency Zero day length of stay
Operational Efficiency Elective pre-operative length of stay over 3 days Operational Efficiency Average excess bed days
Operational Efficiency Percentage of inpatients with a length of stay over 30 days Operational Efficiency Trust outpatient appointment cancellation rate
Operational Efficiency Outpatient appointment patient non-attendance rate Operational Efficiency Ratio of first and follow-up outpatient appointments Operational Efficiency Day Case Rate - Arthroscopy of the knee
Operational Efficiency Day Case Rate - Coronary angiography Operational Efficiency Day Case Rate - Coronary angioplasty Operational Efficiency Day Case Rate - Pacemaker implantation Operational Efficiency Day Case Rate - Repair of hand tendon Operational Efficiency Day Case Rate - Repair of inguinal hernia Operational Efficiency Day Case Rate - Repair of umbilical hernia
Operational Efficiency Day Case Rate - Surgery for Dupuytrens contracture Operational Efficiency Day Case Rate - Surgery for haemorrhoids
Operational Efficiency Day Case Rate - Breast Cancer Screened
Operational Efficiency Length of Stay (Unadjusted) - Radical prostatectomy for prostate cancer
Operational Efficiency Length of Stay (Unadjusted) - Heart Failure
Operational Efficiency Length of Stay (Unadjusted) - Coronary Angiography Operational Efficiency Length of Stay (Unadjusted) - Alcoholic Liver Disease
Operational Efficiency Length of Stay (Unadjusted) - Surgery on the Lower Back (Lumbar Spine)
Operational Efficiency Length of Stay (Unadjusted) - Surgery for Oesophageal Cancer Operational Efficiency Length of Stay (Unadjusted) - Fractured Neck of Femur
Operational Efficiency Length of Stay (Unadjusted) - Mastectomy to treat breast cancer, without immediate reconstruction
Patient Safety Mortality Relative Risk for surgical inpatients
Patient Safety Percentage of mortalities occurring in low risk CCS groups Patient Safety Patient Safety Incidents
Patient Safety Deaths in high-risk conditions Patient Safety E-Coli Infection Rate
Patient Safety Complication Rate in elective admissions Patient Safety Complication Rate in non-elective admissions Financial Opportunity Coding quality
Financial Opportunity Inpatient Activity: Patient groups increasing by at least 5% Financial Opportunity Inpatient Activity: Patient groups decreasing by at least 5% Financial Opportunity Outpatient: Patient groups increasing by at least 10% Financial Opportunity Outpatient: Patient groups decreasing by at least 10%
