Accessing the dashboard
1. The RST is accessible via the PSMU website http://psmu.improvement.nhs.uk 2. Click on the workstreams menu option and select ‘Risk stratification tool’ 3. That should lead you to the Landing page which has a welcome message and a summary of key information: 4. To access the dashboard, please click the access button or select any of the hyperlinks to go straight to the part that is useful to you
Candlestick Charts
The Risk stratification tool makes use of candle stick charts to provide summarised analyses of data at practice, CCG, STP and AHSN level. Each candle stick displays the maximum rate, minimum rate, middle range for each indicator used in the dashboard analysed by month or quarter as shown above: The blue candle sticks display an overview of the data for the indicator in question. The orange dots show the rates for the selected organisations such as a practice/CCG/STP or AHSN. If the dot is in the lower quartile, that shows that the organisations is in the lower 25% compared to highest rate reported in that period. If the dot is next to the thick blue line, it means that the rate reported that month is greater than 25% but less than 75% of the maximum rate reported that month. If the orange dot is next to the upper quartile, that means the rate reported for that period is greater than or equal to 75% of the highest rate. Organisations that are in this upper quartile can be classed as outliers for those indicators. Improvement leads may choose to prioritise improvement efforts to reduce these rates to lower levels if possible. Users of the dashboard can also observe change over time for the indicators that they are measuring.
Practice
This version of the dashboard displays polypharmacy and respiratory indicators at Practice level. Gastrointestinal bleed risk indicators are not available from ePACT2 at practice level. Polypharmacy data is available at national level but respiratory data is only available at AHSN level (through agregration).. Respiratory Indicators. Each candle stick for respiratory indicators under the practice tab tells us:. • The minimum rate reported by practices in the whole AHSN (lower quartile). • The maximum rate reported by practices in the whole AHSN (upper quartile). • The middle range of rates reported by practices in the whole AHSN (between the upper and lower quartlie). • Please see below extracts of the SQL code behind each respiratory chart . Polypharmacy Indicators. Each candle stick for polypharmacy indicators under the practice tab tells us:. • The minimum rate reported by practices in England (lower quartile). • The maximum rate reported by practices in England (upper quartile). • The middle range of rates reported by practices in England (between the upper and lower quartlie).
CCG
Respiratory, polypharmacy and gastrointestinal bleed risk indicators are all available at CCG through aggregation of practice level data. Respiratory Indicators Each candle stick for respiratory indicators under the CCG tab tells us: • The minimum rate reported by CCGs in the whole AHSN (lower quartile) • The maximum rate reported by CCGs in the whole AHSN (upper quartile) • The middle range of rates reported by CCGs in the whole AHSN (between the upper and lower quartlie) Polypharmacy Indicators Each candle stick for polypharmacy indicators under the CCG tab tells us: • The minimum rate reported by CCGs in England (lower quartile) • The maximum rate reported by CCGs in England (upper quartile) • The middle range of rates reported by CCGs in England (between the upper and lower quartlie) Gastrointestinal Bleed Risk Indicators Each candle stick for gastrointestinal bleed risk indicators under the CCG tab tells us: • The minimum rate reported by CCGs in England (lower quartile) • The maximum rate reported by CCGs in England (upper quartile) • The middle range of rates reported by CCGs in England (between the upper and lower quartlie) • Data for indicator S6 was not available at national level. We aggregated it for the 5 CCGs in West of England AHSN from practice level data.
STP
Respiratory, polypharmacy and gastrointestinal bleed risk indicators are all available at STP level through aggregation of CCG level data. Respiratory Indicators Each candle stick for respiratory indicators under the STP tab tells us: • The minimum rate reported by STPs in the whole AHSN (lower quartile) • The maximum rate reported by STP s in the whole AHSN (upper quartile) • The middle range of rates reported by STP s in the whole AHSN (between the upper and lower quartlie) Polypharmacy Indicators Each candle stick for polypharmacy indicators under the STP tab tells us: • The minimum rate reported by STPs in England (lower quartile) • The maximum rate reported by STPs in England (upper quartile) • The middle range of rates reported by STPs in England (between the upper and lower quartlie) Gastrointestinal Bleed Risk Indicators Each candle stick for gastrointestinal bleed risk indicators under the STP tab tells us: • The minimum rate reported by STPs in England (lower quartile) • The maximum rate reported by STPs in England (upper quartile) • The middle range of rates reported by STPs in England (between the upper and lower quartlie) • Data for indicator S6 was not available at national level. We aggregated it for the 3 STPs in West of England AHSN from CCG level data.
AHSN
level data for polypharmacy and gastrointestinal bleed risk indicators was agreegated from STP level data. Respiratory data extracted from ePACT2 at CCG level and also aggregated to reflect the AHSN picture. Respiratory Indicators • At AHSN level, respiratory charts present self explanatory trend analysis line charts and bar charts against the national average. Polypharmacy Indicators Each candle stick for polypharmacy indicators under the AHSN tab tells us: • The minimum rate reported by AHSNs in England (lower quartile) • The maximum rate reported by AHSNs in England (upper quartile) • The middle range of rates reported by AHSNs in England (between the upper and lower quartlie) Gastrointestinal Bleed Risk Indicators Each candle stick for gastrointestinal bleed risk indicators under the AHSN tab tells us: • The minimum rate reported by AHSNs in England (lower quartile) • The maximum rate reported by AHSNs in England (upper quartile) • The middle range of rates reported by AHSNs in England (between the upper and lower quartlie) • Data for indicator S6 was not available at national level. We aggregated it for the 3 STPs in West of England AHSN from CCG level data.
Practice benchmarking
This menu option allows you to choose a CCG and a practice using the drop-down filters. The system then highlights the selected practice and benchmarks it against the other practices within the selected CCG enabling the user to easily see how relate to other practices within their CCG geography for each of the polypharmacy and respiratory indicators used in the dashboard. Users are also able to benchmark against the CCG average to provide a richer picture of where the CCG lies in its improvement journey. NB:-National benchmarking is possible for polypharmacy only at practice level. In the current version of the dashboard, respiratory data is only available for the five CCGs within West of England AHSN. Please see below, one example of the charts generated under this menu option:
Similar 10 CCGs
Using the RightCare groupings of similar CCGs, the dashboard benchmarks a chosen West of England CCG against its closest grouping of 10 similar CCGs. This provides insight into how the CCG ranks in relation to its most similar peers for each of the indicators that have national data within the dashboard. Users are able to spot CCGs nationally that they can share best practice with. Below is an example of one of the similar 10 CCG benchmarks available in the tool: NB: This type of benchmarking is not possible for respiratory indicators because they only have data for West of England CCGs in the current version of the dashboard. Other Features of the Dashboard • Users can download any of the charts in the medication dashboard individually and paste into their presentations or reports • Raw data is readily available in excel format by the click of a button below each of the charts • There is an option of print or email a full page of the dashboard if users find that useful • Useful links and additional resources are available for users to get the best from the dashboard including: o Links to the ePACT2, Open Prescribing, Medicines optimisation and National Medication Safety websites and many more • The dashboard is accessible on mobile devices and support is available from the Patient Safety Measurement Unit (PSMU) help desk