va dataset national kidney care audit. the audit measures two distinct areas: 1. patient transport...
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VA Dataset
National Kidney Care Audit
The audit measures two distinct areas:
1. Patient Transport
Aim: To make visible the variation of provision and performance of patient transport services and to develop and communicate best practice guidelines to all those providing the service
2. Vascular Access
Aim: To provide visibility of current performance and to encourage theadoption of best practice, and so improve performance to meet national guidelines
National Kidney Care Audit
Patient Transport
Audit Scope:The Patient Transport survey was designed to make visible the variation of provision and performance of Patient Transport services and to develop and communicate best practice guidelines to all those providing the service
Audit questions:Does the proportion of patients starting haemodialysis with functioning permanent access meet the Renal Association and Vascular Society Guidelines for permanent vascular access?
What are the health care associated infection (HCAI) rates associated with vascular access in the maintenance haemodialysis population and how does this compare with the national average and the best performance?
Patient Transport
The survey was designed in two parts:
1. A patient questionnaire
A questionnaire which captures patients views directly in a paper form
2. An electronic survey
An electronic survey which was sent to HD unit managers and
commissioners for HD services
The first patient transport survey was carried out on 15th and 16thOctober
2008. The results have now been published in the 2008 NKCA Patient
Transport report.
Audit Scope:The Vascular Access audit will provide information on the timely and appropriate surgery for permanent vascular access based on the recommendations of the standards and quality requirements stated in the National Service Framework (NSF) for Renal Services
Audit questions:Does the proportion of patients starting haemodialysis with functioning permanent access meet the Renal Association and Vascular Society Guidelines for permanent vascular access?
What are the health care associated infection (HCAI) rates associated with vascular access in the maintenance haemodialysis population and how does this compare with the national average and the best performance?
Vascular Access
The following aspects of care will be measured:Outcome related
Percentage of Haemodialysis patients starting with permanent access
Percentage of Haemodialysis patients starting with catheter access
Percentage of Haemodialysis patients starting with catheter access due to late referral (known to the renal service for less than 3 months before starting dialysis)
Percentage of catheter starters who have a functioning permanent access established within three and twelve months
Number of operations and other interventions (e.g. angioplasty, revision surgery) to establish first functioning permanent access
Percentage of RRT patients diagnosed with HCAI, including complications relating to vascular access, e.g. line-related sepsis, endocarditis and osteomyelitis
Process related
Number of access theatre lists per incident and prevalent RRT population by type of list, e.g. general surgery, day case clinic etc.
Proportion referred before the time GFR is less than 15
Audit Data Flow
AuditUKRR Paediatric Units
Data Validation
Complication and Infection data linkage(HES and HPA)
Data Processing
Audit online reporting
Online Analysis toolPublished Annual report
Prevalent dataset collection
Incident eventsFirst Access
Access clinic timeline
Access events
Top part – defines an accessBottom part – defines events associated with access
Events
Drop down events
What is happening now?
Early Adopters
11 early adopter sites (including 1 paediatric unit) – each site at different stages of development.
2 units submitting test files to UKRR with other sites inputting required data and updating clinical systems as required
Roll out
A number of units registered interest to be part of the 1st Wave roll out
Communications with system suppliers continue as units register for the audit
Reporting
Reporting system under development to allow all submitting units to view their results online
How do I get involved or find out more?
To register your unit to participate in the VA audit roll out, gain a copy of the PT report or just to gain further information on the audit then please contact the audit team at:
Further information on the work of the audit can be found on the National Kidney Care Audit website at:
www.ic.nhs.uk/kidneycareaudit
How do I get involved or find out more?
Why not discuss any queries or knowledge regarding the audit with other colleagues using the NKCA forum?
Just register and away you go…..
http://www.renal.org/forum/index.php
Key Contacts
• Richard Fluck
VA Audit Clinical Lead
• NKCA audit team
