Nau mai, haere mai to your CCDM e-news: Core data set
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What is the CCDM Core Data Set?
The ‘Core Data Set’ is the name given to a balanced set of measures in the Care Capacity Demand Management (CCDM) programme. You may be more familiar with terms such as ‘balanced score cards’, 'key performance indicators' or ‘dashboards’. These all have a similar philosophy which is: if you don’t measure, you can’t improve.
The Core Data Set (CDS) is made up of 23 measures. All 23 measures are required for the CDS to be considered fully implemented. The 23 measures are from the three sides of the CCDM triangle:
1. Quality patient care
2. Quality work environment
3. Best use of health resources
They are called balanced measures because the programme places equal priority on all three goals. All measures have been developed based on research findings.
The Allied Health Advisory Group is currently reviewing the CDS measures. It is envisaged that a few additional metrics will be required to ensure relevance to the allied health workforce. Anticipated release for the additional allied health metrics is September.
The measures will help monitor the effectiveness of care capacity demand management, and because the measures are collected monthly or quarterly, they will track progress overtime.
Why do you need a Core Data Set?
Apart from being the key to improvement, there are many reasons to implement the Core Data Set. They provide/enable:
Sounds good, but how does it work in practice?
- Common language
- Targeted communication with staff
- Staff activities aligned to DHB priorities
- Staff engagement
- Solidarity for shared goals
- Monitoring of care capacity demand management
- Discipline and structure for improvement activities & resourcing
- Early warning to prompt decision-making
- Evidence for Health and Disability Sector Standards
- Single voice to lead
The measures are collected, collated and formatted for the different audiences. They should be reviewed at a minimum of monthly (or quarterly for some measures).
The Core Data Set should be discussed at different forums including:
- Ward staff meetings
- Allied health staff meetings
- One on one meetings with line manager
- Directorate / service meetings
- Quality improvement meetings
- CCDM council meeting
The Core Data Set data should guide decision-making and improvement planning.
The below charts are an example of the core data set being viewed at a ward level
How are DHBs approaching core data set implementation?
Hutt Valley DHB
The Core Data Set (CDS) has 23 measure that focuses on quality patient care, quality work environment and best use of health resource. These measures help you to understand how well care capacity demand management is working.
Much like monitoring patient observations, what you don’t measure, you don’t know. The measures are designed to be simple and tell a story that allows Ward Quality Groups (WQG) to identify areas for improvement.
Gathering the CDS and presenting it in a clear, understandable format within a timely manner has proven to be a challenge for many DHB’s to date. Traditionally collecting the CDS has required extensive manual data gathering. Following the additional funding received through the nursing MECA accord many DHBs have invested in data analytical support and tools (such as Qlik) to support their CCDM programmes.
Hutt Valley DHB have opted to use ‘in house’ capacity instead of purchasing new systems to automate CDS data collection. Yasmina Azmutally was appointed to the role of CCDM Data Analyst in late October 2018. Yasmina immediately identified the importance of the CDS, the need to automate and present these measurements in a user-friendly format.
To date, Yasmina has collected, and automated 18 CDS measures and is working towards building a further 4 measures into her system. Yasmina has also developed an interactive dashboard and heat map, allowing users to see trends at a glance.
Yasmina is also actively providing training to help users better understand the CDS measures, how they impact on each other, identify opportunities for improvement and also to report on their findings to their line manager on a monthly basis. Initial feedback from the wards and service managers has been very positive and supportive of CCDM Coordinator Karen Holden and support person, Sally Huntsman.
The next step is to promote the use of CDS in driving quality improvement. The CCDM team is working in partnership with the DHB’s quality team to develop a training programme on model for improvement.
Capital and Coast DHB
CCDHB decided upon a sequential approach to CCDM implementation. Core Data Set (CDS) was an organisational imperative to report and monitor on CCDM. After overcoming the initial barrier of the CDS not being seen as a priority, work commenced. This involved a 3-hour workshop to clarify the CDS definitions and what resource was required. Another 2 hour working group meeting was held to discuss the best method for trending data over time.
The organisation had just acquired Qlik Sense (a data visualisation tool). This was the perfect view to visualise the CDS metrics.
To start, it was agreed that 6 metrics would be tested within Qlik. A group including clinicians and health unions, agreed on 6 metrics would most likely tell a story about their clinical environments. Testing 6 metrics to begin with, gave a good steer as to the time and future resource required for on-going development of the dashboard.
Through regular meetings, it soon became apparent that the CDS would be a one-stop-shop source of truth in Qlik, and that data could be used from existing applications in Qlik to build the CCDM dashboard. The team involved in the CDS work included CCDM programme manager, SSHW unit programme consultant, business intelligence management and analysts, Qlik developer, Associate directors of Nursing, Director of the Integrated operations centre, Charge Nurse Manager, health unions and union delegates.
Access to Qlik Sense was also a barrier that needed to be overcome. The DHB initially purchased a limited number of access tokens. The risk was elevated to the CCDM council and mitigated. As a result it was envisaged that all CNM’s would have access so that Local data councils could be effective, and decisions made based on contemporaneous and accurate data. Subsequently operations managers and associate directors of nursing now have access.
The result is now a comprehensive one-stop dashboard that can be viewed at organisation, directorate, service and ward level. There is drill down capability into all metrics. Key DHB stakeholders are now receiving training on data analytics with the view of managing on metrics, supported by clinical context and professional judgement. The CDS will be used to inform Local Data Councils and monthly reporting. The advantage is that all metrics will be available in one location.
The CDS visualisation tool has been well received by all key stakeholders and has drawn national attention. Recently two webinars supported by the Qlik developers were run to demonstrate the CDS in action.
Update from the SSHW Unit
SSHW Unit director, Bridget Smith
The Safe Staffing Healthy Workplaces Unit is delighted to announce the recruitment of two Allied Health
Programme Consultants, and one Maternity Programme Consultant. They have all joined the SSHW Unit on 0.6FTE, 12-month fixed term contracts.
Stuart White is originally from England and now lives in Hawke’s Bay. With a background in Sport Science
and Physiotherapy, Stuart has worked in the health industry for over 20 years, both in the UK and NZ. Most
recently he has worked with Habit Group as a Vocational Management and Rehabilitation Consultant, in
addition to ongoing clinical physiotherapy work.
Lynda Wheeler is also originally from England. She completed her physiotherapy undergraduate and post
graduate studies in London, specialising in Neuro-physiotherapy. Lynda emigrated to New Zealand in 2002
and have called Tauranga home ever since. Lynda has worked for the local DHB as a community
physiotherapist and within the hospital. More recently she has worked at BOP NASC and TAS as an educator
and competency manager.
These roles will support the existing Allied Health Programme Consultant roll out CCDM to the allied health, scientific and technical workforce.
Julie 'Jules' Arthur from Hawkes Bay DHB will be joining the SSHW Unit (on secondment) from 1st July, as Programme Consultant for Maternity services. Jules will be working 3 days a week with the Unit whilst maintaining 2 days a week as Midwifery Director at HBDHB. This role will see Jules working with all 20 DHBs to support the implementation of CCDM in Maternity services, whilst working alongside the rest of the team.
Variance response management: Work is nearly completed to ensure the Variance Response Management tools and processes are suitable for the allied health workforce. A Variance Indicator System tool and supporting documents will be available to the sector in July. These will enable allied health to align their processes and tools to existing DHB capability, including Capacity at a Glance screens. This will enable the DHB to have visibility of allied health services and be able to proactively manage any impact of care capacity variance.
Data collection: A revised Activity Data Set (version 2) was released in January. This data set can be used in any data collection tool. This activity level data set, along-side the Allied Health Data Standard, will enable the development of a staffing methodology, which TAS is progressing. There will be a further update on the staffing methodology later this year.
Core data set: The majority of CDS metrics are applicable to allied health. There are a few additional metrics that will be added to ensure the CDS provides a comprehensive picture of care capacity demand management effectiveness. These additional metrics are currently under consultation.
With the recruitment of the Maternity Programme Consultant, the key priorities identified by the Advisory Group are:
- Tangible TrendCare improvement plans for all inpatient DHB Maternity services
- Getting the Core Data Set operational - increasing visibility of important safe staffing data for this workforce
- Variance response management - The Advisory Group will become the key advisory body for midwifery safe staffing work.
Governance Group visits
The SSHW Unit Governance Group is progressing well with their DHB visit schedule. Governance Group members will visit all 20 DHBs over the next 15 months. They meet with the CCDM council to review the implementation plan. DHBs have the opportunity to showcase good practice /partnership working. In some cases, the Governance Group will visit if there are persistent concerns raised with regards to programme implementation, or if the CCDM council cannot reach agreement and have come to an impasse preventing progress.
The SSHW Unit Governance Group has endorsed the development of milestones for national reporting of CCDM implementation. The SSHW Unit want to make this as easy as possible and have begun work on building the milestones into the CCDM software. When released, this will replace quarterly reporting against the DHB’s annual workplan.
National reporting will enable the health sector to see progress with CCDM implementation at multiple levels (national, DHB, hospital site, service and ward).
The SSHW Unit plan to release specific communication and guidance for the new reporting by the end of July. In the interim, DHBs should complete their normal quarterly report against the annual work plan which is due by 20th July.
CCDM website - your one-stop-shop for CCDM resources
The CCDM website contains an entire section on the Core Data Set. To see the road map on how to get there and associated resources, follow this link: www.ccdm.health.nz
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