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Measure data to spot trends


Let staff know how they are performing by displaying outcome stats on wards

If you want to improve your performance - and that of your team’s - you really have to be able to measure it.

One problem that we found when thinking about how to reduce our incidence of hospital-acquired pressure ulcers or staff absence was that although we collected this information through Productive Ward, not everyone on the ward had access to it or knew how to use it. There was no standard way of getting information across the whole organisation. People would know how many falls there had been that day, but not how many there had been two days before. So if you wanted to know about things such as management of complaints or number of falls, there was no standard way of displaying the information. We couldn’t see the key things that were happening or learn from the trends.

We decided to introduce Knowing How We are Doing, which is an approach to measure, track and help improve against Productive Ward objectives. It highlights how the care that an individual team give contributes to the trust’s strategic goals.

Tips to implement a new information programme

● Get staff to buy in from day one, it’s vital to get them to understand how using it will improve patient care
● Make sure you get support from your IT team and get them to show staff how to use Microsoft Excel or other report-generating software
● Involve all the staff
● Make sure the presentation of the data means staff can see what it means straight away
● Give staff the power to challenge each other over the results

White boards were bought for nine pilot areas. The trust’s vision and values were used as the heading for each section (quality, safety and environment) using the same colours for each topic to make the board a more effective visual tool.

Each month the data is inputted into an IT system by ward staff and once the spreadsheet is updated, graphs are produced for each section. This data displays trends for each key area for the previous month and the safety cross at the side of the graph is updated in real time each day. It is an extremely powerful visual tool for patients, visitors and all staff.

The biggest challenge we had was encouraging nurses to use Excel and accessing different IT programmes. Having an information team is key. It’s vital to have an intranet and help people to input the data to populate

the graphs.

You need to spell out to teams how to use it at ward level - tell everyone from healthcare assistants and housekeepers to ward sisters. This is key in keeping up with improvement ideas.

We surveyed the staff before they implemented the pilot, and again afterwards. We found ward staff were actively engaged and interested in how they are doing as a team and they now have access to data that they historically never saw, unless they were directly involved in an incident.

● This project at Blackpool won the Patient Safety Awards 2012 for Data/Information Management. Enter your project at for our 2013 awards


Paul Jebb has worked in numerous posts including modern matron and senior nurse manager. He is now acting assistant director of nursing and head of patient experience at Blackpool Teaching Hospitals Foundation Trust


















Readers' comments (8)

  • Interesting to note that Blackpool is one of the Trust organisations with a persistantly high mortality rate!

    Maybe if nurses were able to care for patients rather than play with Excell better outcomes would be achieved !

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  • tinkerbell

    Already done all this with Productive Ward, with safety crosses, pie charts, WOWing areas, time round the ward board, taking photos, downloading photos, printing photos, It was on display for all to view with the noughts and crosses compared to previous month.

    The aim of productive ward was to 'release time to care' instead we spent more time on the above activities, unlocking/locking the board, filling out the safety crosses, putting red dots on pieces of paper where incidents occurred called the 'measles chart' and having meetings on how it was going. The bods/shiny arses would then come round once a month to sign off our pyramid but rarely showed up. What a game.

    I have no interest or energy to get back on that particular merrygoround under a different name. PLEASE STOP!

    Let nurses nurse. Strangely enough, it's what most of us do best.

    'Data/Management', feel a scream coming on.

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  • been there, read that, what is the next idea, and the one after that, and then the next, and the one following that, and the one which will appear after that one, and so on. they will soon be running out of people to dream up or 'vision' all of these ideas, then what? what will happen after that? .......(and we still haven't got the T-shirt for the last one!)

    instead of all these dreams, couldn't these poor deluded visionaries give a hand in the meantime with looking after the patients? after all these grandiose ideas and schemes surely do not come to them every day!

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  • Angel nomore

    Lies dam lies and statistics ! We called it the counter productive ward. Its supposed to release nurses to care, if we had clerks filling it in maybe it would ,but instead, as well as trying to do nursing dutys and the huge amount pf paper work thats goes with nursing,they added more paper /pc/white board work for the nursing staff to deal with,with threats of disciplinerys if not done .This has ended up with stressed staff going with out breaks,staying behind up to two hrs a day to get everything done .Of course all un paid . So management well pleased. When Will the powers that be, be they NHS management or government,realise that the only way to save the NHS is to leave nurses to nurse,cut the paperwork, and up the staffing patient ratio. In the long run this will work out cheaper, than all these ill thought out schemes that cause thousands to implement only to fail spectaculary later cost !

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  • Yes lets upset and scare the relatives and patients by seeing how we've done on a graph. How are they to know that the 3 falls on one day, was the same patient whose confused aggressive and difficult to keep safe even with a one to one .
    The last thing i want to see as a patient coming into a hospital as a patient , already worried by all the media hype is how poor the ward is doing,because to pass you would need to have model patients who never asked for anything or rang there bells,thus leaving staff to dots the I`s smile and do all the paperwork, and white boards . Why dont they have a time and motion study, done by independent outside staff , observing nursing staff doing there dutys in all lines of nursing work. Should throw up some interesting data .

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  • We are finding ways to improve patient care. In order to do so all staff should bare the responsiblities. Trust should reward staff with bonus to those that perform well. This will give incentive to staff. Nursing should be compete with other profession, when their staff reached their target they are rewarded with bonus. Why should only the chief executive get rewarded why trust is doing well?

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  • Anonymous | 1-Feb-2013 12:09 pm

    would a bonus system work?

    it seems that in any large organisation there is the risk of them going to some of the wrong people just like job promotion. those who quietly get on and provide the highest quality of care for their patients may be conveniently overlooked. in the competitive spirit often seen in organisations there is a race to reach the top and not always for the right reasons. There are often a few of a malicious nature at all levels from the very top down who may not be very competent at their jobs and hate to see others succeed and will do the best to prevent them from getting the rewards they deserve whilst making sure they get the maximum benefits for themselves.

    Studies have shown that money is not always the most effective motivator in organisations as in many other aspects of life.

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  • The PM said last night that nurses should be hired and promoted not by qualification but by compassion. This will not just give staff incentive but also give motivation to all staff and improve performance all round in the health care.
    All staff should also accountable for their action.

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