These Excel sheets and graphs, available for download below, contain individual DHBs’ data on progress made against the quality and safety markers (QSMs) process measures and in reducing patient harm from falls, healthcare associated infections and surgery (the outcome data).
The release of this information complements the pre-Christmas release of QSMs by providing greater detail, including time series data for outcomes at a local level. This DHB-specific data details where outcomes have improved, and identifies areas that may need more work. These data are designed to show change over time for individual DHBs, not comparison between DHBs.
The following context is important in understanding and interpreting the DHB-specific outcome data.
- There is good evidence that patient harm in the areas of falls, healthcare associated infections and surgery can be reduced by putting in place the right interventions. For example, the World Health Organization (WHO) estimated in its 2007-2008 pilot study of the surgical safety checklist that worldwide implementation would prevent at least half a million deaths per year; new studies have now confirmed these results.
- The first report against quality and safety markers was published on the Commission’s website in December 2013 – see the media release and other materials here. The December report had data on process measures, which show whether the desired changes in practice have occurred at a local level (eg, giving older patients a falls risk assessment and developing a care plan for them); and outcome measures, which focus on harm and cost that can be avoided, at a national level.
- The DHB-specific data released today measure outcomes which indicate progress made in DHBs over time to reduce patient harm from falls, healthcare associated infections and surgery. The data is presented on a timescale so each DHB can see where it is improving, and where improvements could be made.
- The data does not compare or rank DHBs’ outcomes as this would be misleading. Such comparisons would not be comparing ‘apples with apples’. For example, one DHB may have less favourable outcomes than another because it provides specialist services, meaning it treats more seriously ill patients from other DHBs, with greater likelihood of complications. We have not attempted to standardise for this which is why we present data by DHB only.
- As identified in the national outcomes data released in December 2013, in many DHBs the individual data show an increase in sepsis following surgery. This finding is a prompt for DHBs to investigate the trend in their hospitals, and to take action where needed. Infection prevention and control and reducing perioperative harm are major work programmes for the Health Quality & Safety Commission, and both are a focus of the Commission’s patient safety campaign Open for better care. As well as continuing to work with DHBs to reduce sepsis, we will continue to monitor sepsis data closely.