Indicators for publication in the 2011 Hospital Guide
Following feedback from customers and in line with Dr Foster’s Customer Promise, this year’s Hospital Guide will feature indicators currently used widely across Dr Foster’s tools and services. These fall into the following broad categories:
- Mortality
- Readmissions
- Spotlight on treatment of fractured neck of femur, stroke, repair of abdominal aortic aneurysm and orthopaedics
- Measures of efficiency
- Patient safety
In the appendix below, you will find the list of indicators currently being considered for inclusion in the Hospital Guide which may be published at an individual trust level. The final decision as to which indicators from this list will be featured is currently being taken by our editorial team and the full information for your trust will be available at the beginning of October (please see the timeline below).
We will be in contact nearer to the time of publication to let you all trusts know if they are identified as an outlier trust in the published guide. We will also publish data from the Hospital Guide questionnaire and published data from third-parties.
Summary Hospital Mortality Index (SHMI)
Dr Foster received notification from the NHS Information Centre that the final SHMI methodology will be published on 30th September. Further to the letter we sent to you on 9th August, we will be providing advice to trusts on the reasons for variation in their SHMI and will produce bespoke reports for NHS trusts for free. These reports will deliver the insight you need to understand the factors affecting your SHMI figures and a comparison with HSMR and will be sent to you within the next four weeks.
It is anticipated that the NHS Information Centre will be publishing its official SHMI figures in October:
- 10th October – trusts will be given access to their own SHMI score and banding by the NHS Information Centre
- 27th October – all trust SHMI scores will be published on the NHS Information Centre and NHS Choices websites.
We will be investigating SHMI within the wider context of mortality, and looking at how a range of indicators, including HSMR, SHMI and Deaths after Surgery, can be used to highlight and explain variation in mortality.
Hospital Guide questionnaire
The deadline for submission of the questionnaire (5th September 2011) has now passed. However for a limited time we are still able to accept your response so please submit this information as soon as possible. If you are unsure whether your trust has submitted the questionnaire please contact hospitalguide@drfoster.co.uk.
Once you have submitted your questionnaire online, trusts will be automatically issued with a copy of the reported data for final validation and any changes to answers can be amended. Dr Foster accepted changes to responses until 1st October 2011 on receipt of a letter from the trust medical director or staff member of appropriate seniority (as stated in ‘What’s in the Hospital Guide 2011’ issued on 06 July 2011). We reserve the right to publish all data included in the questionnaire after this date and it will not be possible to change responses. We may also mention, where appropriate, the fact your trust declined to submit information.
Timeline and data sharing
Key metrics about your organisation to be featured in the Hospital Guide will be available for you to preview from Wednesday 5th October 2011. We would prefer to do this via a face-to-face meeting and your regional representative will shortly be in touch to arrange this. We will also be publishing user guides, explaining how to interrogate the analysis in the Dr Foster suite of management information tools.
If your trust is to be featured as an ‘outlier’ you will also receive a formal communication to this effect from myself during October. The Hospital Guide itself we be published towards the end of November.
As part of our Dr Foster Promise, communicated to you in August, and based on the feedback of trusts, this year we will not be sending out regional press releases around the Hospital Guide. We would, however, encourage you to send out press releases about your performance in the guide to your local press and the Dr Foster team are available to support you in this if required. A Press Kit, developed by Dr Foster is also available on request from andrew.kliman@drfoster.co.uk.
Your regional representative will shortly be in touch with more information and to arrange to share your trust’s data but in the meantime if you have any further questions please email consultation@drfoster.co.uk.
Appendix – Hospital Guide Indicators
Short name / Long name
- HSMR / Hospital standardised mortality ratio
- HSMR weekend (elective) / HSMR for elective admissions on a weekend
- HSMR weekend (emergency) / HSMR for emergency admissions on a weekend
- Deaths after surgery / Deaths after surgery patient safety indicator
- Mortality in low risk diagnosis groups / Mortality in low risk diagnosis groups patient safety indicator
- Mortality in low risk diagnosis groups (age <75 years) / Mortality in low risk diagnosis groups patient safety indicator for patients aged < 75 years
- AMI – Mortality / Acute myocardial infarction standardised mortality ratio 2006 – 2010
- AMI – PCI / Rate of coronary angioplasty for AMI 2006 – 2010
- FNOF – Mortality / Fracture neck of femur standardised mortality ratio
- FNOF – LOS / Fracture neck of femur standardised rate of long length of stay (above national upper quartile)
- FNOF – Readmissions / Fracture neck of femur standardised 28 day emergency readmission rate
- FNOF – No operation within 2 days / Rate of patients not receiving an operation for fracture neck of femur within 2 days of admission
- FNOF – No operation within 2 days (Friday/Saturday) / Rate of patients not receiving an operation for fracture neck of femur within 2 days of admission on a Friday or a Saturday
- Stroke – Mortality / Stroke standardised mortality ratio
- Stroke – LOS / Stroke standardised rate of long length of stay (above national upper quartile)
- Stroke – Readmissions / Stroke standardised 28 day emergency readmission rate
- Stroke – Pneumonia / Stroke standardised rate of hospital acquired pneumonia due to swallowing difficulty
- Stroke – No discharge home / Stroke standardised rate of non-discharge to usual place of residence within 56 days of admission
- AAA – Mortality / Repair of abdominal aortic aneurysm standardised mortality ratio
- Elective Hip replacement – Mortality / Elective hip replacement standardised mortality ratio
- Elective Knee replacement – Mortality / Elective knee replacement standardised mortality ratio
- Elective Hip Replacement – LOS / Elective hip replacement standardised rate of long length of stay (above national upper quartile)
- Elective Knee Replacement – LOS / Elective knee replacement standardised rate of long length of stay (above national upper quartile)
- Elective Hip replacement – Readmissions / Elective hip replacement standardised 28 day emergency readmission rate
- Elective Knee replacement – Readmissions / Elective knee replacement standardised 28 day emergency readmission rate
- Elective Hip Replacement – Revisions / Elective hip replacement rate of revision or manipulation within 365 days
- Elective Knee Replacement – Revisions / Elective knee replacement rate of revision or manipulation within 365 days
- Elective Hip replacement – Average Tariff / Hip replacement average PbR tariff per spell
- Elective Knee replacement – Average Tariff / Knee replacement average PbR tariff per spell
- PSI – Obstetric trauma / Obstetric trauma following vaginal delivery without instrument
- Discharges – weekend / Proportion of total discharges which occur on a Saturday or Sunday
- Discharges – weekend (emergency) / Proportion of emergency spells with a discharge on a Saturday or Sunday