National audits, local partnerships: creative
reporting for successful partnerships
Sara Kavanagh, SSNAP Programme Manager
James Campbell, SSNAP Intelligence Programme Manager
www.hqip.org.uk
SSNAP
• SSNAP aims to be the single source of stroke
data
• Local teams can make use of a wide range of
outputs to identify areas for improvement
• We hope to use this workshop to demonstrate
how national audit reporting can be used at
local level, easily and effectively
SSNAP reporting
• SSNAP has a number of outputs which can be used
by everyone involved in improving stroke care
• The outputs enable quick identification of issues,
followed by detailed investigation by drilling-down
• We would like each table to work as a group to
make use of SSNAP data to identify issues and
suggest solutions/actions
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Full results portfolio
Reference document
Very technical
Includes analysis of every data item collected by SSNAP
Patient centred / team centred results
Details of patient cohorts, casemix and pathways (transfer
tree)
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Summary
results
spreadsheet
Overview of performance
44 key indicators within 10 domains
Basis of SSNAP scoring
Public Tables
Group work
• Each table has a number of samples of SSNAP
reporting for the same team
• Looking in particular at thrombolysis, please
come up with the following:
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What issues can you identify?
Are there any associated issues with other aspects of care?
What are potential solutions?
What goals would you set?
What actions would you put in place?
Group work
• Please write down ideas as you go
• At five minutes intervals we will ask you to
come and place ideas on the board
• Please come up with both issues/challenges
and solutions/actions
• As group work goes on we will come round to
highlight aspects of reporting you could be
looking at
Info to help with this task
• Only around 15-20% of all stroke patients can be
thrombolysed
• Thrombolysis is most effective when administered
within 1 hour
• The NIHSS score is a measure of stroke severity and
is important to collect on admission and 24h after
thrombolysis (patient safety)
• Audit compliance is SSNAP’s way of assessing
whether a team is answering all of the questions it
should and to full extent
Discussion
• What issues and solutions were identified?
• Were there different approaches to using the
information within SSNAP reporting?
• How can SSNAP reporting be used locally?
• How can national audit data be used more
effectively locally?
Issues for this team to address
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Audit compliance score is low
NIHSS on arrival well below national average
NIHSS 24h after thrombolysis is low and declining
Not all patients who could be thrombolysed are
receiving it
• Proportion of patients thrombolysed within 1 hour
should be improved
• Median ‘door to needle’ time could improve (and
recently has declined rather than improved)
Issues for this team to address
• Proportion of patients being scanned within one
hour is lower than it could be and this might affect
thrombolysis rates and speed
• Median door to scan is higher than national
average
• Door to stroke nurse could be improved and
inconsistencies investigated
Slides to aid discussion
SSNAP Webtool
• Easy to use
webtool
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Commitment to constantly improving the webtool
features throughout the audit
Can be used on tablets (e.g. iPads) where wifi is available
Extensive online support section
Illustration of SSNAP Transfer Tree
Blue: Teams that transfer patients to your team
Red: Your Team
Green: Teams to which your team transfers patients
DIY Data Analysis Tool
Thrombolysis breakdown
• Allows in-depth exploration of thrombolysis at
individual patient level
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Real
time
indicators
Reports and tools already mentioned can be used to make data-driven
goals for improving quality – this can be celebrated within the team
and trust and with patients when improvements are shown in the
quarterly results
As well as this, the nature of the prospective audit means that if data
are entered in real time, the audit itself can be used to monitor
adherence to standards using our automated indicators feature: