Andrea Race is assistant director of information and performance at the hospital. She says that wherever data-gathering processes were examined, it was found that some staff did not understand the importance of the information they were recording. The information did not accurately reflect the health of the patient and the care they received throughout their care pathway.
Key to the success of the project was ensuring their clinicians were on board.
Once they understand the impact of data they are invaluable and really help to drive changes needed in their specialities.
Assistant director of information and performance, Nottingham University Hospitals NHS Trust
Strong leadership was a vital component of the project. Stephen Fowlie, the trust’s medical director, was involved in communicating with staff, sending trust briefings and emails to consultant colleagues. Many well-attended workshops were held, along with specialty meetings. There were also PowerPoint presentations, leaflets and examples of improved documentation to support raising the profile of the project.
The trust found that a one-size-fits-all approach was not appropriate and instead supported individual teams to find solutions.
We found documentation issues arose when clinicians didn’t realise they were writing something that coders were not allowed to interpret. On the other hand, there could also be coding errors which were then fed back to the coding teams. This no-blame approach was a great opportunity to go through the records and get them right by improving together.
This wasn’t a small project. It took about a year and one of the biggest challenges in such a large organisation with many specialties was to engage everyone. Far from being a tick-box exercise, the intention was to create continuous and sustainable improvement.
Clinical champions and lead coders were appointed for each directorate, and regular teaching sessions continue to be held for junior and trainee doctors. Sessions can also be requested for other staff. Many staff were surprised to hear that the data are used for so many areas, from commissioning to mortality benchmarking.
Race says of the initial workshops and the wider awareness sharing:
It‘s always encouraging that once people understand the importance of how they influence our clinical data, they are happy to get involved and support the process. Feedback is invariably positive and we really appreciate the collaborative working we do to keep improving our data.