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Derbyshire NHS Trust takes simple BI approach to secure patient safety

Derbyshire NHS Foundation Trust opts for a simple, clinician and business-led approach to business intelligence to secure patient safety, using MicroStrategy

Derbyshire Community Health Services has adopted a “keep it simple” approach to a revamp of its business intelligence (BI) programme, part of the point of which is to improve its social care capacity.

James Chisholm, head of information and performance at Derbyshire Community Health Services NHS Foundation Trust, describes how a Care Quality Commission visit in 2013 led to a McKinsey engagement and an overhaul of the trust’s business intelligence activity.

The idea has been to make BI as simple as possible to be consumed by clinicians and management staff, with a particular focus on patient safety. After consulting strategy advice firm McKinsey, the organisation chose software company MicroStrategy over a few other data visualisation alternatives.

“The way [MicroStrategy] approached the demonstration impressed us. It was more in tune [than the two other shortlisted candidates] with what we were focused on, which was patient safety and quality care rather than referral patterns or finance – although those things are important to us,” says Chisholm.

“Secondly, their visualisations were very simple to understand. We’ve got a lot of clinical leaders who are not BI specialists, and the way MicroStrategy’s visualisations worked in a mobile environment was a key advantage, because we are working towards being an agile organisation.

“The write-back functionality was a real advantage, too. We want clinical leads and directors to be able to annotate there and then, and get feedback from, say, a ward manager or a clinical team leader straightaway, by way of explanation or understanding.

“Ultimately, it was a collective decision taken by our clinical leaders and our board. It wasn’t just a case of an IT systemn being thrown at an organisation,” he says.

Chisholm declined to name the two other short-listed data visualisation contenders.

Trust gains visibility into data sources

The programme had its origins in the 2013 Care Quality Commission visit at a time when Derbyshire Community Health Services was aspiring to be a trust, with more autonomy over budgets, says Chisholm. He adds that the visit flagged a number of improvements to be made, which prompted the board to engage McKinsey.

From the strategy firm they got a set of recommendations about gaining more visibility into what was happening on wards and in community services in an orchestrated way, says Chisholm. 

“At that time we had siloes of information about staff and patient complaints and clinical audits. There was no real bringing together of those sporadic and static data sources,” he says.

The trust was accorded Foundation Trust status in October 2014. It now has, says Chisholm, “a programme of projects to deliver through MicroStrategy, under our business intelligence change control board, which includes our assistant chief executive, our medical director and chief operating officer. They decide on the priority of projects, and then we work to deliver those”. The BI delivery team is made up of around 17 people.

Behind the MicroStrategy BI set up sits an SQL data warehouse, from which they had previously run reports using Microsoft Sequel Server Reporting Services, rendered through Sharepoint.

Read more about business intelligence in healthcare

That system had provided some dashboards, but it lacked agility and two-way reporting, says Chisholm. The new set up is a web portal that is divided up into tiles, where each project is a tile.

In respect of projects queued up to be delivered, he cites a primary care dashboard in operation at three GP practices of which the trust has recently taken over the management.

“We are also looking to develop dashboards around delayed transfers of care. That’s about reducing the time people are in our beds after they are medically discharged and ready to move on to social care. We’ve got challenging targets there and we will be using BI to provide a real-time analysis on where our patients are, and what the delays are,” says Chisholm.

“Another key one is how we are managing variation of clinical practice across our geography. We’ve got such a rich data set now to do analysis on, and to move on to more predictive analytics, available in MicroStrategy 10.

“The key piece for me is that it has taken a long time to create the culture needed to embrace the BI technology. This is why we went down the route of making the dashboards as user friendly and as simple as possible. There has been a cultural shift around the organisation about the value of BI,” he says.

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