Project Summary

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Project Summary

<div class="ck-content" data-wrapper="true" dir="ltr" style="--ck-image-style-spacing: 1.5em; --ck-inline-image-style-spacing: calc(var(--ck-image-style-spacing) / 2); --ck-color-selector-caption-background: hsl(0, 0%, 97%); --ck-color-selector-caption-text: hsl(0, 0%, 20%); font-family: 'Segoe UI','Helvetica Neue',sans-serif; font-size: 9pt;"><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="color:#1f497d;font-family:Calibri,sans-serif;font-size:11pt;"><span style="line-height:115%;">We are carrying out a review of many of the methods and procedures we use in intensive care for the care of our patients.&nbsp;</span></span></div><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><br><span style="color:#1f497d;font-family:Calibri,sans-serif;font-size:11pt;"><span style="line-height:115%;">We hope that by a close analysis,&nbsp;we can bring changes and improvements, as technology and innovation is moving forward and is contributing to patient care.&nbsp;</span></span></div></div>

Detailed Project Description

<div class="ck-content" data-wrapper="true" dir="ltr" style="--ck-image-style-spacing: 1.5em; --ck-inline-image-style-spacing: calc(var(--ck-image-style-spacing) / 2); --ck-color-selector-caption-background: hsl(0, 0%, 97%); --ck-color-selector-caption-text: hsl(0, 0%, 20%); font-family: 'Segoe UI','Helvetica Neue',sans-serif; font-size: 9pt;"><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:black;font-family:&quot;Calibri&quot;,sans-serif;font-size:11.0pt;"><span style="line-height:115%;">This evaluation has two key objectives:</span></span></div><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:black;font-family:&quot;Calibri&quot;,sans-serif;font-size:11.0pt;"><span style="line-height:115%;">1) to evaluate the current quality of documentation of care delivery of seven key evidence based practices (EBPs) in Powerchart, including care process data and written documentation, to explore the possibility of using the daily Millennium data download to &nbsp;</span></span></div><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:black;font-family:&quot;Calibri&quot;,sans-serif;font-size:11.0pt;"><span style="line-height:115%;">2) evaluate the delivery of &nbsp;these EBPs (specifically key ICU standards of care) for patients on ACCU (4E only) using routinely collected data. This information will inform us of the presence and size of any care delivery issues we have on 4E and as to whether we need to undertake QI projects to improve care delivery of these EBPs.</span></span></div><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;">&nbsp;</div><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:black;font-family:&quot;Calibri&quot;,sans-serif;font-size:11.0pt;"><span style="line-height:115%;">The end goal of objective 2 (if possible based on objective 1) would be to build a critical care dashboard where senior nursing and medical staff could easily identify gaps in the previous days care delivery standards, with utility to rapidly make operational decisions (e.g. changing skill mix in certain areas that had underperformed the previous day) to improve patient care.&nbsp;</span></span></div><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:black;font-family:&quot;Calibri&quot;,sans-serif;font-size:11.0pt;"><span style="line-height:115%;">At this stage we would like to focus on objective 1, using historical data from September 2024 onwards to when the project starts (so potentially up to 31<sup>st</sup> Jan 2025) which would include several hundred patient episodes but more importantly five months of patient care (as it is patient care delivery rather than patient demographics or outcomes that are of interest).</span></span></div><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;">&nbsp;</div><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:black;font-family:&quot;Calibri&quot;,sans-serif;font-size:11.0pt;"><span style="line-height:115%;">The data requested will&nbsp;be outlined below but will initially be all Powerchart clinical event and encounter data, which we would then plan to strip down to only the specific codes and entries of interest to feed into a simple analysis model to identify if care delivery can be evaluated in this manner, including the incorporation of exclusions to accurately evaluate appropriate EBP delivery e.g. a patient with a traumatic brain injury may be ineligible for some of the seven EBPs (sedation hold, mobilisation etc) and we would plan to build such exclusions into our analysis model. The impact of this work for patients is that care delivery of key EBPs known to enhance outcomes could be improved to a highly reliable level, leading to better care and better patient outcomes. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</span></span></div></div>

Requested Data Summary

<div class="ck-content" data-wrapper="true" dir="ltr" style="--ck-image-style-spacing: 1.5em; --ck-inline-image-style-spacing: calc(var(--ck-image-style-spacing) / 2); --ck-color-selector-caption-background: hsl(0, 0%, 97%); --ck-color-selector-caption-text: hsl(0, 0%, 20%); font-family: 'Segoe UI','Helvetica Neue',sans-serif; font-size: 9pt;"><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:#2b579a;font-family:&quot;Calibri&quot;,sans-serif;font-size:11.0pt;"><span style="line-height:115%;">Having &nbsp;spoken with Ben Eaton, we think we need:</span></span></div><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:#2b579a;font-family:&quot;Calibri&quot;,sans-serif;font-size:11.0pt;"><span style="line-height:115%;">1) Clinical events and&nbsp;</span></span></div><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:#2b579a;font-family:&quot;Calibri&quot;,sans-serif;font-size:11.0pt;"><span style="line-height:115%;">2) Clinical encounters &nbsp;data from Power Chart for the period Sept 1<sup>st</sup> 2024 to January 31<sup>st</sup> 2025.</span></span></div></div>

Technical Description

<div data-wrapper="true" style="font-family:'Segoe UI','Helvetica Neue',sans-serif; font-size:9pt"><div><span style="font-size:11.0pt"><span style="background-color:#e6e6e6"><span style="line-height:115%"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">We plan at this stage to use simple descriptive statistics model to calculate the number (out of 7) EBPs a patient could have been eligible to receive and how many they DID receive to provide a daily % EBP delivery for 4E patients. As data will be anonymous we believe this analysis could be done on Barts Health computers and does not need the use of a safe IG secure data environment. If we find that we cannot accurately identify care delivery through the use of event data only we may request&nbsp;support with NLP software from yourselves to search keywords with medical, nursing and physiotherapy notes. Having discussed with Ben he felt this phased approach, with text identification requirement being assessed first through use of event data completeness was the best and most pragmatic option. &nbsp;&nbsp;</span></span></span></span></span></div></div>

Public and Patient Involvement and Engagement Summary

<div class="ck-content" data-wrapper="true" dir="ltr" style="--ck-image-style-spacing: 1.5em; --ck-inline-image-style-spacing: calc(var(--ck-image-style-spacing) / 2); --ck-color-selector-caption-background: hsl(0, 0%, 97%); --ck-color-selector-caption-text: hsl(0, 0%, 20%); font-family: 'Segoe UI','Helvetica Neue',sans-serif; font-size: 9pt;"><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:black;font-family:&quot;Calibri&quot;,sans-serif;font-size:11.0pt;"><span style="line-height:115%;">No PPIE at this stage. As the possibilities&nbsp;of using this data become clearer we would then plan to involve patients in any future QI or research proposals but that would be via a separate application.</span></span></div></div>

Reporting

<div class="ck-content" data-wrapper="true" dir="ltr" style="--ck-image-style-spacing: 1.5em; --ck-inline-image-style-spacing: calc(var(--ck-image-style-spacing) / 2); --ck-color-selector-caption-background: hsl(0, 0%, 97%); --ck-color-selector-caption-text: hsl(0, 0%, 20%); font-family: 'Segoe UI','Helvetica Neue',sans-serif; font-size: 9pt;"><div style="font-family:'Segoe UI','Helvetica Neue',sans-serif;font-size:9pt;"><span style="background-color:#e6e6e6;color:#5a5a5a;font-family:Calibri,sans-serif;font-size:11pt;"><span style="letter-spacing:.75pt;line-height:115%;">Reporting would be internal at this stage (ACCU team) but as the possibilities of using this data become clearer we would then plan a research proposal (e.g. evaluation of using said data model to improve care delivery) which would lead to academic output but that would be via a separate, future, application.&nbsp;&nbsp;</span></span></div></div>

Contact Points

Project Lead Name

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Lead Organisation Address

The Royal London Hospital

Secure Data Environment (SDE)

Will you be using the BH SDE

NoYes

Details of the location and IT system (the SDE) where the data extract will be kept and processed.