With QlikView, we are able to link directly to data sources that we use to collect our audit and survey information and report on the results in ‘real-time’. Having ‘real-time’ information means that our charge nurses and ward staff can act on any areas requiring attention immediately so that we can improve the care that we provide for our patients. Our staff can track how well their wards are doing as audits and surveys are completed for their ward, and they can compare their progress with other wards and learn from wards that are doing well.
What are we trying to achieve?
Regular audits and consumer feedback are important sources of information to tell us what we are doing well and how we can improve. We wanted to make sure that staff had easy access to this information to allow them to continuously improve the services we provide.
Historically, we used Microsoft Excel spreadsheets to capture our data as well as present results for our audits and surveys. This process was time-consuming as analysis of audit and survey data had to be done manually, resulting in a time delay in getting the results to staff.
With new databases and systems being used to capture our audit and survey data, we wanted a system that could display all of results in one place consistently and in ‘real-time’. We also needed to find a new system as our existing reporting tools did not have the flexibility to pull data from a variety of data sources and data source types (i.e. SQL database, Excel spreadsheets) into the one view without going through a data warehouse.
Our main aims were to:
- provide evidence to drive-decision making and changes to improve patient experience and quality-of-care
- provide wider visibility of information from a single source
- be able to drill into results to understand root cause of issues
- reduce staff time collating and analysing information
What have we done?
We have created a Nursing and Midwifery Quality portal in QlikView for our charge nurse managers, senior managers and quality team to access results on the following:
- Patient Experience (Friends & Family Test) surveys
- Falls audits
- Pressure Injury audits
- Commodes audits
- Infection Prevention & Control audits:
- Hand Hygiene – 5 Moments (part of the national audit programme)
- IP&C Facilities Standards
Working with our senior nursing management team and clinical lead for quality, we identified what information to report on from a ward level, right up to the organisational level for each audit and survey. Information is displayed in tables, in charts or both as appropriate.
We identified the key values / indicators and our targets to achieve – these results are highlighted based on how well we are doing against the targets (i.e. green = achieved target or higher; amber = close to target; red = well below target).
Examples of tables and charts created in QlikView
QlikView has allowed us to present all of these results in a format that is consistent and useful for our staff, and that is automatically updated daily from the source databases. We have also been able to create an overall Quality Scorecard to report the most important indicators from these audits and surveys in one view (e.g. the national quality and safety markers).
Example of results for our Nursing & Midwifery Quality Scorecard in QlikView
Report filters and bookmarks
We have set-up different filters to allow us to drill down or to view different cuts of the same information. For example, we can view results:
- by ward, division or organisational level
- by different time periods (i.e. by week, month, quarter or year) or filter to look at a particular period, e.g. last month
- by audit specific filters, e.g. by type of commode
Staff can set bookmarks for their preferred filters so that they can easily view these results without having to select these filters each time.
Data quality checks
Each audit has criteria that need to be met for the results to be valid. With QlikView we have created rules to exclude results that do not meet audit criteria (e.g. patients must be over 75 for the Falls audit), or to flag results that can be corrected (e.g. patient identified with a pressure injury but pressure injury has not been graded; incorrect date entered e.g. 20/03/2041).
Example of data quality results for our Infection Control Facilities audits in QlikView
Monitoring audit participation
We are able to track in ‘real-time’ whether our wards are completing their audits in a weekly / monthly / quarterly cycle as required.
Example of audit participation results for our Infection Control Facilities audits
Data exports and printable reports
QlikView also offers the ability to export our results should we need to include a graph in a document, or want to further analyse the data. We can also create PDF reports in QlikView for our staff to run that are automatically populated based on selected filters.
For example we have created a report for our Charge Nurse Managers so that they can print and display their audit and survey results on their ward Quality Boards. We have also created corrective action reports for our Infection Control Facilities audits.
Example of a printable report for our Infection Control Facilities Standards – Corrective Actions
Did we make a difference?
- We have significantly improved access to information across the organisation:
- Results available in QlikView are visible from a ward level or consolidated up to the organisational level.
- Charge nurses managers are able to view their own data at any time rather than having to wait for their results to be analysed and given to them.
- Visibility of performance beyond an individual department level had encouraged a culture of shared learning and healthy competition.
- Senior managers are able to track audit and survey participation for wards and are able to discuss the results with Charge Nurse Managers and ward staff.
- We have improved the quality of audit results:
- Only audits meeting criteria are included. Any queries about data are flagged for charge nurse managers to review.
- We have significantly reduced the amount of time required to collect and analyse data:
- Using QlikView for just three quality indicators, for our Falls and Pressure Injury audits and our Patient Experience survey, we estimate that we have saved at least 18 hours per month of senior staff time collecting and processing results
Feedback from staff:
“I have found QlikView to be a very flexible tool for developing reports, especially being able to pull data from multiple sources into a single view. One of the key benefits has been the ability to view raw data and be able to exclude data that does not meet audit criteria to ensure we only report on valid results.” - QlikView report developer
Where to from here?
We are working with the services to identify other areas of reporting that could benefit from being developed in QlikView, for example:
- Global Trigger Tools 
- Fractured neck-of-femur project [link to story]
- Patient reported outcome measures
- Clinical quality indicators at the specialty / clinical team level
- Global Trigger Tools is a method for identifying and measuring adverse events (harm) and generating qualitative metrics that measure harm over time as an indicator of effectiveness and safety within the organisation.