It is important that leaders and staff identify and agree the relevant data to record for decision-making and make recording part of their daily tasks using digital tools. Standardised policies will need to be agreed upon and adhered to, ensuring consistent data definition and recording across the system.
Key actions
- Ensure leadership gives priority to support improving data quality and training on best practice.
- Collectively identify key decisions that need to be made and underpinning KPIs to understand achievement of the benefits, including better outcomes, linking to the system’s vision and shared goal at the following levels: patient/individual, service, and system. This is an iterative process of developing and shaping the questions to be asked and being clear what relevant data can provide the insights needed.
- Map out the relevant data required, working with what you have rather than seeking the perfect dataset, and being clear where data no longer needs to be collected. Some of this data will be nationally collected, and some will be collected a local level, including relevant financial data.
- Make it easy to record the data in a timely manner by using relevant digital tools in day-to-day practice, removing duplication, and collecting data automatically where possible.
- Ensure standardised collection of the relevant data by developing agreed definitions, using language that engages staff and is meaningful at operational level, and ensuring there are clear system data collection policies.
- Prioritise data quality, including ensuring that appropriate checks and validation processes are in place. Technology can be used to support this, for example building in AI mechanisms for filtering impossible data (see High Impact Change 7).
Ambition level actions
Foundational
- System partners are discussing and identifying relevant data to record to support decision making and are committed to making it digital and as straightforward as possible to record it in a standardised way, with agreed data policies and definitions.
Developing
- Leaders and staff are regularly discussing and identifying relevant data to record to support decision making, as well as agreeing where it needs recording. It is as straightforward as possible to record for most staff, some still using paper format but most using digital tools.
- The data is starting to be used to demonstrate relevant outcomes as set out in the vision.
- Relevant policies have been developed and agreed to ensure data is recorded in a standardised way across the system (including agreed definitions, codes, relevant fields and fewer free-text opportunities) but are not yet widely adhered to.
Established
- Leaders and staff have identified relevant data to record to support decision making, and recording is now part of their daily tasks using digital tools.
- KPIs have been developed, and the data is routinely used to demonstrate relevant benefits and outcomes as set out in the vision.
- Relevant policies have been agreed, and are largely adhered to, to ensure data is recorded in a standardised way across the system (including agreed definitions, codes, relevant fields and fewer free-text opportunities).
- There is a strategy in place to improve data quality using technology.
Exemplar
- Leaders and staff have identified relevant data to record to support decision making, and recording it is routine using digital tools, including free text sections.
- The data and KPIs demonstrate better outcomes and benefits as set out in the vision.
- Relevant policies have been agreed to ensure data is recorded in a standardised way across the system (including agreed definitions, codes, relevant fields and fewer free-text opportunities).
- Data quality is being regularly improved using technology and AI.
Example of how a health and social care system could use metrics to track the delivery of outcomes to support timely hospital discharge
| Outcomes | Question/Decision | Relevant metric(s) |
|---|---|---|
| People are supported in the community and are only admitted to hospital if they need acute care, no corridor care. |
How can we maximise our admission avoidance activity? How do we measure capacity in community services, recognising that we are not counting beds and capacity impacted by needs of people receiving services. |
Referrals to community health services (demand) Waiting times to start service (demand) Admission and discharge to community services (capacity) Rate of avoidable admissions |
| Minimise delay for people leaving hospital, with people feeling supported and listened to. |
What should we do to reduce discharge delays and occupancy? How do we work better together across all teams? How do we ensure good communication with people and families? |
Length of Stay by pathway Length of Stay post Discharge Ready Date (DRD)* Reasons for discharge delay for those with DRD* Patient/individual/family feedback |
| People’s needs are met on discharge through the most independent pathway decision. Staff feel valued and empowered. |
How many different pathway spaces should we fund? What settings should we try to discharge more people to? How can we avoid over prescription of care? |
Number and per cent of Pathway 1, 2 and 3 discharges. Staff feedback |
| People benefit from home-based recovery and reablement wherever possible. | Are we seeing as many people in recovery and reablement as we can? |
Referrals to reablement and community rehab (demand). Reablement/community rehab admissions, discharges and LoS (capacity) Per cent of people with no care or reduced care (outcomes) |
| People are supported to recover and regain their independence wherever possible. | Are people leaving community bedded services as independent as they could be? | Referrals to bedded provision (demand) |
| Our services are efficient and effective to promote independence in the long-term and. we use data to continuously drive quality and staff feel valued. | Are we getting the best outcomes from intermediate care? |
Admissions to residential and nursing care homes.** Number home care packages commissioned per month Average size of care package (hours per week) Staff feedback Readmissions to hospital following discharge*** |
National collections in bold
*Statistics: Discharge ready date
**The adult social care outcomes framework: handbook of definitions - GOV.UK