Velindre Cancer Centre
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Velindre Cancer Centre. 11 th May 2010. Velindre Cancer Centre Our Aims. To understand mortality in cancer patients and set appropriate measures To reduce harm in cancer patients within our care by 5%. Content Area. Drivers. Interventions. Tests of change. Measurement. - PowerPoint PPT Presentation
Transcript of Velindre Cancer Centre
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Velindre Cancer Centre11th May 2010
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Velindre Cancer Centre Our AimsTo understand mortality in cancer patients and set appropriate measures
To reduce harm in cancer patients within our care by 5%
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Our Content AreasMeasurementMedicines ManagementCare of Inpatients including rapid response to acute illness Infection ControlHarm from chemotherapy
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MEASUREMENT HarmOncology Global Trigger Tool15 months of DataDownward trend noticed over recent months
Next steps: Share tool with other Cancer Centres and Local Health boardsFig 1. showing VCCs average Adverse event rate at 103.3
Chart1
97.4025974026103.3075358819
103.2608695652103.3075358819
73.1707317073103.3075358819
114.7540983607103.3075358819
101.6949152542103.3075358819
131.9444444444103.3075358819
95.2380952381103.3075358819
177.7777777778103.3075358819
132.8671328671103.3075358819
107.7844311377103.3075358819
89.7435897436103.3075358819
102.3622047244103.3075358819
138.3647798742103.3075358819
84.8484848485103.3075358819
67.9012345679103.3075358819
65.0406504065103.3075358819
72.0720720721103.3075358819
Values
Average (103.3)
Rate
Adverse event rate per 1000 patient daysVelindre Cancer Centre
Contents
Velindre Cancer Centre GTT Analysis: Contents
Navigation bar:
SheetDescription
ContentsThis sheet. Enter your organisation name and the first month of data here.
Data entry
Bar chartsDisplay bar chart of selected analysis. Choose from list available
Run chartsDisplay run chart of selected analysis. Choose from list available
Database
Setup
Trust nameVelindre Cancer Centre
Start monthSeptember 2008
Contents
Data entry
Run charts
Bar charts
Database
How do I use this tool?1. Enter your organisation name and first month of data into the Setup area on this sheet.2. Perform the case note review and enter the relevant data into the Data Entry sheet.3. View your performance on the Bar charts or Run charts sheets. Note that the data required for the Extranet can be found in a table on the Run charts sheet. Scroll down to see it.
How do I move around?Use the Navigation bar at the top of each screen to move between sheets. Click on the button for the sheet you want such as:
How do I print charts?On the Charts sheet, click on the printer icon (see right) to print out the chart on A4 paper.
Data entry
Data
Velindre Cancer Centre GTT Analysis: Data entry
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Select month:
Is this the correct month?
Harm events found
Trigger codes foundEvent 1Event 2Event 3Event 4Event 5
Case Note numberLength of stay12345678910Event codeSeverityEvent codeSeverityEvent codeSeverityEvent codeSeverityEvent codeSeverityEvent present on admission?Event description
1v077222b5L2O4
2v069113v15O17O10L2
3v059206p2G1
4v079023g4
5v056422r26O4O5O4EO5E
6v078295m2O8
7v079509c5O5G6G6E
8v078108s6G4O1O9O10O1EO10F
9v073678g6L2L3O10O10F
10v075252s4G4O4O10O10F
11v079089L2L12L12E
12v041976v2G1
13v079101c2
14v072813u5
15v077664x3
16v069318f3
17v073966v4
18v078368y2
19v069221p8
20v079224c5
Store in database
Clear table
Contents
Data entry
Run charts
Bar charts
Database
Barchart
Velindre Cancer Centre GTT Analysis: Bar charts
Navigation bar:
Select measure:
Barchart
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Trigger code
Number
Events by trigger codeVelindre Cancer Centre from Sep 08 to Jan 10
Runchart
Velindre Cancer Centre GTT Analysis: Run charts
Navigation bar:
Select measure:
Scroll down for Extranet adverse event rate data
Data for Extranet adverse event rate
NrMonthNumber of adverse eventsBeddays
1Sep 200815154* Data not reported
2Oct 200819184* Data not reported
3Nov 200815205
4Dec 200814122
5Jan 200912118
6Feb 200919144
7Mar 200912126
8Apr 200924135
9May 200919143
10Jun 200918167
11Jul 200914156
12Aug 200913127
13Sep 200922159
14Oct 200914165
15Nov 200911162
16Dec 20098123
17Jan 20108111
18Feb 201000
19Mar 201000
20Apr 201000
21May 201000
22Jun 201000
23Jul 201000
24Aug 201000
25Sep 201000
26Oct 201000
27Nov 201000
28Dec 201000
29Jan 201100
30Feb 201100
31Mar 201100
32Apr 201100
33May 201100
34Jun 201100
35Jul 201100
36Aug 201100
37Sep 201100
38Oct 201100
39Nov 201100
40Dec 201100
41Jan 201200
42Feb 201200
43Mar 201200
44Apr 201200
45May 201200
46Jun 201200
47Jul 201200
48Aug 201200
49Sep 201200
50Dec 189900
51Dec 189900
52Dec 189900
53Dec 189900
54Dec 189900
55Dec 189900
56Dec 189900
57Dec 189900
58Dec 189900
59Dec 189900
60Dec 189900
Contents
Data entry
Run charts
Bar charts
Database
Runchart
97.4025974026103.3075358819
103.2608695652103.3075358819
73.1707317073103.3075358819
114.7540983607103.3075358819
101.6949152542103.3075358819
131.9444444444103.3075358819
95.2380952381103.3075358819
177.7777777778103.3075358819
132.8671328671103.3075358819
107.7844311377103.3075358819
89.7435897436103.3075358819
102.3622047244103.3075358819
138.3647798742103.3075358819
84.8484848485103.3075358819
67.9012345679103.3075358819
65.0406504065103.3075358819
72.0720720721103.3075358819
Values
Average (103.3)
Rate
Adverse event rate per 1000 patient daysVelindre Cancer Centre
DB
Velindre Cancer Centre GTT Analysis: Database
Navigation bar:
Harm events found
Trigger codes foundEvent 1Event 2Event 3Event 4Event 5
MonthCase Note numberLength of stay12345678910Event codeSeverityEvent codeSeverityEvent codeSeverityEvent codeSeverityEvent codeSeverityEvent present on admission?Event description
Sep 08v056587r9G2G2O5G2EG2E
Sep 08v071016C2G1O4
Sep 08v002021d5O4O4E
Sep 08v071174j2G1G7G7F
Sep 08v070343j7G1M5M5E
Sep 08v066570y4
Sep 08v071520d2G1L2
Sep 08v002021d10
Sep 08v059947s15O5O12L10O9G1L2
Sep 08v071042L2
Sep 08v071969t13L10O4
Sep 08v047037v30G2O17O9G2EO9E
Sep 08v072286u14O1O12G3G2G1G2EG3E
Sep 08v070050v7G1G5L2L3O10O11L14O9O10F
Sep 08v057742b7G2G3O17L10O9G3EO17E
Sep 08v071846t6G1
Sep 08v071316t2
Sep 08v065960k6G1L13O5O5E
Sep 08v071620j5
Sep 08v071810m6G1O5O8O5EO8E
Oct 08v053447v8G1L2L3O4O10
Oct 08v063705v2G1L2
Oct 08v065960k7G1G4
Oct 08v063194w6G1L2O8
Oct 08v072503v22G1G3L13L14O9O5O8G3EL13EO9E
Oct 08v071379t5
Oct 08v072431t8G1G8O17O5
Oct 08v045378v3G1
Oct 08v070890u2G1
Oct 08v070447d2G1L2L3
Oct 08v062099m3G1L10L14O9O4O4F
Oct 08v069236v26G1G3G7L2L4L5L6L12O5O9G3EG7FL12EO9EO5E
Oct 08v072127d24G1G3G6L4G3E
Oct 08a396264p8G1L10L13L14O4O14
Oct 08v055780F12G1L10O4O8O8FL10F
Oct 08v071844y12G7M5O5O6O2G7F
Oct 08v072143e20G1G5L2L11L14O9O4O8O10L14EO4FO9F
Oct 08v071846t5G1L14O9
Oct 08v058388w3G2O1O1E
Oct 08v070888q6G1L3L9O1O4O8O1FO8F
Nov 08v070509x5O14G1G3O14E
Nov 08v052961b14G1G2O4O5O8O12O9G2EO12EO4EO8E
Nov 08v071794g30G3G3E
Nov 08v072757j2
Nov 08v072131c5
Nov 08v058748n4O4G1
Nov 08v073022c26O5O8
Nov 08v072576d7O4O10G1
Nov 08v045378v2G1
Nov 08v063277r2
Nov 08v072898e26
Nov 08v072066t30G1G3L2O9O4O5O10O2G3EO9EO5EO2F
Nov 08v071954m5G1O5O6O6FO5E
Nov 08v071393a6
Nov 08v071009y3O10O10E
Nov 08v065099w11
Nov 08v069674d7O5
Nov 08v065524w9G1L4O14O14F
Nov 08v065570v9
Nov 08v072478s2O10O10E
Dec 08v073432g3G3G4L2
Dec 08v071051J3G1G2O16O17L9O1O1EL9FO16F
Dec 08v072488a5O10G4G4F
Dec 08v069255b1G3L2
Dec 08v056672q4
Dec 08v064912n13G1O17L2O5
Dec 08v064324h14L4O8O8E
Dec 08v042874y2
Dec 08v072984n4O10O10E
Dec 08v072176g3G3O9O9E
Dec 08v070509x5G3G1
Dec 08v070630n6O14O14E
Dec 08v072739n23L2L6O4O4EL6FG2E
Dec 08v021106g7
Dec 08v073606j7L2O5O8
Dec 08v072380r4
Dec 08v072799j6
Dec 08v073171L6G1G7L12G7EL12E
Dec 08v071751w2G1G7L2G7E
Dec 08v000000k4G3
Jan 09v073815s6G1L12L12E
Jan 09v065683n5O8O8E
Jan 09v073219y6G1O6
Jan 09v072797p6
Jan 09v072413x10L2L2E
Jan 09v072350t3
Jan 09v072057P2L2
Jan 09v073006B5O5L2L2EO5E
Jan 09v074126a5O5
Jan 09v073423j4O4O4E
Jan 09a134745p4O8O8E
Jan 09v068789m1
Jan 09v061838w6
Jan 09v073074k8O1O4O8G1G4O8FO1F
Jan 09v073074k7O1G1G4O8G4F
Jan 09v072487q2G1
Jan 09v073156U3L14O9O10
Jan 09v052622p17G1L4O9O5O8O9EO8E
Jan 09v069727a10
Jan 09v057362u8G1L7O12O10
Feb 09V074174T2G1
Feb 09v070875D4
Feb 09v070783L4
Feb 09v048319u5O5
Feb 09v074021v6O4
Feb 09v000000n5O4O4E
Feb 09v074412u2
Feb 09v061039n7
Feb 09v073935n5
Feb 09v072593p8
Feb 09v074077s1
Feb 09v073751d15G3G6M2G6FM2E
Feb 09v074210p2G4O8O8F
Feb 09v071992x24G1O5O14O5EO14E
Feb 09v058722p14G3L10L14O9O5O8G3E
Feb 09v073259e5O14O5O8G1O5EO14E
Feb 09v072968m2G8L3O10G8EO10E
Feb 09v043448w4G1G3L2O1O10O1EO14E
Feb 09v074421S20G2G2G2EG2E
Feb 09V067192Q9O8G3G4G7L2O8EG3EG4EG7E
Mar 09v063445K5O10O10E
Mar 09v070812d13O5G2G6L2O5EG2EG6E
Mar 09v073173f3L2L4O9O9E
Mar 09v067015d5G1O8O8E
Mar 09v065813v8G1O4O8O8E
Mar 09v071159s2
Mar 09v050990h6
Mar 09v073514r2
Mar 09v074126a5G1
Mar 09v073993p6G1L13O9O11
Mar 09v064639f7G1O4O8O4E
Mar 09v075027h15G2L4L10O4O6G2EO6E
Mar 09v070361e12G1G2G2O9O9E
Mar 09v072533t12G1G1E
Mar 09v071037c2G1
Mar 09v061760l5O9O8
Mar 09v074503c2
Mar 09v074076h2G1L2L4
Mar 09v067015d9G1L2L14O9
Mar 09v073171L5G1O6
Apr 09v073656w3G1O1L12O1E
Apr 09v054109w17G1L2L6O1O5O8O10O7G1EO1EO5EO10FO7E
Apr 09v075007s6G1L2O5O8O10O5EO10F
Apr 09v073883b26G1G6L10L14O9O1O4O8G6EL10FL14EO9E
Apr 09v073514r2G1G4O7O1O1EO7EG4F
Apr 09v073195q4G1L2O10O10E
Apr 09v073514r15G1L2O1O4O8O10O2O1FO10FO2F
Apr 09v072443v3G1M5M5E
Apr 09v074832g10L2O4O10O10E
Apr 09v073820b2G1O10O10E
Apr 09v075531j14O7O7F
Apr 09v068136m5G1O12O12E
Apr 09v041976v2
Apr 09v074820e5G1
Apr 09v074820e5G1O6
Apr 09v072858y3
Apr 09v075263k6O5
Apr 09v074586s3G1L2O8
Apr 09v074234t2L12O4O8
Apr 09v074234t2G4L2
May 09v074831w2G1G4G4F
May 09v068181B2G4O3G4
May 09v075409j5O15O15E
May 09v075579s5
May 09v053447v14O5
May 09v075133g9G1G1L14O9L14EO9E
May 09v075867g9G1G2G6G2EG6I
May 09v074951s12O5G2G2E
May 09v046528w4
May 09v025963e30G1L2O12O5O8O11O7O12FO5EO8EO12E
May 09v066929v6G4O4G4FO4E
May 09v075367e7O14O14E
May 09v074712l2G1
May 09v074625s6G1L12O5
May 09v073994y7O8
May 09v074440x1
May 09v074332e2
May 09v073858c4
May 09v074347L4G1
May 09v075066d12G1L4O9M5O4O2L4FO9EO4EO2F
Jun 09v075491Y30L13O9M2O5L13EM2EO9EO5E
Jun 09v074622n3
Jun 09v009325g2
Jun 09v075194m3
Jun 09v074516p3
Jun 09v074712L2
Jun 09v068884t8
Jun 09v073924v14
Jun 09v075194m2
Jun 09v073807e2
Jun 09a203343a2
Jun 09v041309p28O5G2O5EG2G
Jun 09v076354v11O5O7O5EO7E
Jun 09v074625s2G1O1O1E
Jun 09v073727p15G1G1F
Jun 09v074861U18G2G2E
Jun 09v053991c9O5O8O5FO8E
Jun 09v074622n3G4O1O10G4FO1EO10E
Jun 09v000000k3O15O15E
Jun 09v003665J7O5O5E
Jul 09v074821P2G4O1O2O8
Jul 09v064109f9G4G5O9
Jul 09v066962H8O5
Jul 09v076866A5
Jul 09v069087H4L2
Jul 09v067697r5G1O14
Jul 09v076961g7G1L10O4O4O8
Jul 09v073228w2G1
Jul 09v076257u3G4G5L12O10
Jul 09v025675q2
Jul 09v046528w2O1
Jul 09v074050J13G1O8
Jul 09v076022m7L12L12E
Jul 09v026608u24L2L4L12O1O5O7O8O9L12EO1EO5EO9E
Jul 09v070592X9O4O11G4O4E
Jul 09v022291k8O4G1O9O12O12E
Jul 09v076897h7L6O5O17O5EO17E
Jul 09vv076976n17G3L2L9O5O9O4E
Jul 09v07546s20G1G5L2I2L13O4O5O6O8G1EL13FI2H
Jul 09v054853P2G4G5O16G5H
Aug 09V075999e2G1L2
Aug 09v067021w3G1O8
Aug 09v076555r5G1
Aug 09v076014y3G1
Aug 09v077121L7G1
Aug 09v070343J5
Aug 09v075977U3O4O8
Aug 09v076592S6G1
Aug 09v076592s5O5G1
Aug 09v076500e6G1
Aug 09v052112e2G1O8
Aug 09v076110q6G1G5O4O9G5EO9E
Aug 09v076561k5O5O12O12E
Aug 09v070257a22G3L2O4O5O8G3EO5E
Aug 09v014225t19G3L12O5O9G3EO5E
Aug 09v050776q4G1G4O10G4E
Aug 09v075977u3G4M5G4F
Aug 09v076377q12G1G4L2L2L11O4O10O11G4EO4E
Aug 09v062072d3G4L2G4E
Aug 09v076500e6O8O8E
Sep 09v052112e22G6O5O8O9G6EO5EO9E
Sep 09v026671e3G4O5O8O13O5EO8E
Sep 09v068988n6G1O8O8E
Sep 09v026671e6O9
Sep 09v069318f3G1
Sep 09v069318f3G1
Sep 09v076555r5G1
Sep 09v021710n2
Sep 09a788922b2
Sep 09v067697r16O6
Sep 09v054298L18G3L2O5O8O9G3EO5E
Sep 09v052112e5O8O9G1G4G4FG1E
Sep 09v050894y6G1G4O10G4FO10E
Sep 09v000000l11G1G5G6L2L4O4O7O9G5FO4EO9E
Sep 09v001053S8O5O8O17O5E
Sep 09v036726e16L2O5O9O5E
Sep 09v056737p4G1L3O1O6G1IO1EO6E
Sep 09v06888n10G1O6O8O5O6FO8E
Sep 09v073876x5O4O15
Sep 09v073279u8O15
Oct 09v053851R7
Oct 09V039593C5O5O6O6EO5E
Oct 09v077893w5G1O5O6O5EO6E
Oct 09v048473m13G3O9G3EO9E
Oct 09v077935b30G6O9G6E
Oct 09v057941C6G1L2O5O5E
Oct 09v058597f8
Oct 09v077124q2G1
Oct 09v074979l2
Oct 09v066450D5
Oct 09v074445W2O8
Oct 09v077437t5G1O8
Oct 09v034917L10O1O4O4E
Oct 09v068738p15O5O5E
Oct 09v069128c6G5O5O15O15F
Oct 09v071157x8G4O5O8O9G4F
Oct 09v073022c7G4O5O8
Oct 09v057842g5G2G3G2EG3E
Oct 09v066147x10O8
Oct 09v072460g14
Nov 09V074445W7G1G5O4O8O15O8EO15F
Nov 09v077436j26G1G4G5L2L2O5O6O10O11G4FO6F
Nov 09v077453u3L2O8
Nov 09v077338x3L9
Nov 09v064936s7O4O14L2
Nov 09v064909y7
Nov 09v077599p14
Nov 09v056481c14G2G2L10O4O9G2EG2E
Nov 09v056481c12O1O5O8O9O16O9F
Nov 09v077713f5O4O10O11G1
Nov 09v032510p7G1G4L2O4O9
Nov 09v039593c6G1
Nov 09v071882k5O17O8O4L10
Nov 09v073966v5O8
Nov 09v073966v6G1M5O14M5EO14E
Nov 09v070321711L2L6O8
Nov 09v070737M8G1L2O4O8O9O9E
Nov 09v077437T7G1L2
Nov 09v077831g5G1
Nov 09v076551c4G4O4O10G4E
Dec 09V078178V2
Dec 09V058785P6G5O10O10F
Dec 09V072813U5G1
Dec 09V078018U8O5O8O8E
Dec 09V075218V5L4O3O4L4EO3FO4E
Dec 09V077020V8G2G3O5G2E
Dec 09V077818K6G1L14O10
Dec 09V075755Y8G1G1G1E
Dec 09V078349T5
Dec 09V068299S2G1O8O11
Dec 09V076975D5O8O14O14E
Dec 09V077933G5
Dec 09V077739E2O11O11
Dec 09A735487Q9O13G2
Dec 09V073966V6G1O9
Dec 09V076475B14G1O1O6
Dec 09V069631T4
Dec 09V078073R3O4
Dec 09V069286J8O5
Dec 09v078957P12G3G3O4O8
Jan 10v077222b5L2O4
Jan 10v069113v15O17O10L2
Jan 10v059206p2G1
Jan 10v079023g4
Jan 10v056422r26O4O5O4EO5E
Jan 10v078295m2O8
Jan 10v079509c5O5G6G6E
Jan 10v078108s6G4O1O9O10O1EO10F
Jan 10v073678g6L2L3O10O10F
Jan 10v075252s4G4O4O10O10F
Jan 10v079089L2L12L12E
Jan 10v041976v2G1
Jan 10v079101c2
Jan 10v072813u5
Jan 10v077664x3
Jan 10v069318f3
Jan 10v073966v4
Jan 10v078368y2
Jan 10v069221p8
Jan 10v079224c5
Contents
Data entry
Run charts
Bar charts
Database
Contents
Data entry
Run charts
Bar charts
Database
Lists
Velindre Cancer Centre GTT Analysis: Lists
Navigation bar:
Triggers listSeverity ListMonths ListRun chart measuresBar chart measuresModules
CodeTriggerXCodeSeverityMonthData present?MeasureColumnLabelMeasureX axis labelCodeNameNr
1G1Lack of early warning score, score/trigger requiring response or Dr calledGEcontributed to or resulted in temporary harm to the patient & required interventionSep 2008YesAdverse event rate per 1000 patient days1RateEvents by moduleModule codeGGeneral care8
2G2Any patient fallGFcontributed to or resulted in temporary harm to patients& required initial or prolonged hospitalisationOct 2008YesNumber of records reviewed2NumberEvents by trigger codeTrigger codeLLab test14
3G3Pressure ulcersGGcontributed to or resulted in permanent patient harmNov 2008YesBeddays3NumberTriggers by moduleModule codeIIntensive care2
4G4Unplanned readmission to hospital within 30 daysGHrequired intervention to sustain lifeDec 2008YesNumber of triggers4NumberTrigger by trigger codeTrigger codeMMedication5
5G5Sepsis, Shock (septic & anaphylactic) or cardiac arrestGIcontributed to the patients deathJan 2009YesNumber of adverse events5PercentageSeverity by categorySeverity codeSSurgical care3
6G6DVT/PE following admission evidenced by imaging &/or D DimersGFeb 2009YesMonthly conversion rate6RateSeverity E by moduleModule codeOOncology17
7G7Complication of procedureGMar 2009YesGeneral care events7NumberSeverity F by moduleModule code
8G8Transfer to a higher level of careGApr 2009YesLab test events8NumberSeverity G by moduleModule code
9L1High INR >5LMay 2009YesIntensive events9NumberSeverity H by moduleModule code
10L2TransfusionLJun 2009YesMedication events10NumberSeverity I by moduleModule code
11L3Abrupt drop in Hb or Hct >25%LJul 2009YesSurgical events11Number
12L4Rising urea creatinineTwice patients baselineLAug 2009YesOncology events12Number
13L5Electrolyte abnormalities NA 160LSep 2009YesGeneral care triggers13Number
14L6K < 2.5 or >6.5LOct 2009YesLab test triggers14Number
15L7Hypoglycaemia 1.5ng/mlLDec 2009YesMedication triggers16Number
17L9MRSA bacteraemiaLJan 2010YesSurgical care triggers17Number
18L10C. DifficileLFeb 2010NoOncology care triggers18Number
19L11VRELMar 2010No0
20L12Wound infectionLApr 2010No0
21L13Nosocomial pneumoniaLMay 2010No0
22L14Positive blood cultureLJun 2010No
23I1Readmission to ICU or HDUIJul 2010No
24I2Unplanned transfer to ICU or HDUIAug 2010No
25M1Vitamin KMSep 2010No
26M2Naloxone (Narcan, Nalone, Narcanti)MOct 2010No
27M3Flumazil (flumazepil, Anexate, Mazicon, Romazicon)MNov 2010No
28M4Glucagon or 50% glucoseMDec 2010No
29M5Abrupt medication stopMJan 2011No
30S1Return to theatreSFeb 2011No
31S2Change in planned procedureSMar 2011No
32S3Removal/injury or repair of organSApr 2011No
33O1Mucositis/stomatitisOMay 2011No
34O2Skin desquamationOJun 2011No
35O3Palmar plantar syndromeOJul 2011No
36O4DiarrhoeaOAug 2011No
37O5ConstipationOSep 2011No
38O6DysphagiaOOct 2011No
39O7AspirationONov 2011No
40O8VomitingODec 2011No
41O9UTIOJan 2012No
42O10Neutropaenia (neutrophils below 1)OFeb 2012No
43O11Thrombocytopaenia (platelets below ???)OMar 2012No
44O12Hyperglycaemia (above 18 mmols/l)OApr 2012No
45O13Hypercalcaemia.(Calcium above 2.6mmol/l)OMay 2012No
46O14ExtravasationOJun 2012No
47O15Vascular access infectionOJul 2012No
48O16Unexpected medical or surgical emergency/sudden deathOAug 2012No
49O17Sudden onset confusionOSep 2012No
O1Mucositis/stomatitis
O2Skin desquamation
O3Palmar plantar syndrome
O4Diarrhoea
O5Constipation
O6Dysphagia
O7Aspiration
O8Vomiting
O9UTI
O10Neutropaenia (neutrophils below 1)
O11Thrombocytopaenia (platelets below ???)
O12Hyperglycaemia (above 18 mmols/l)
O13Hypercalcaemia.(Calcium above 2.6mmol/l)
O14Extravasation
15Vascular access infection
O16Unexpected medical or surgical emergency/sudden death
O17Sudden onset confusion
Contents
Data entry
Run charts
Bar charts
Database
Calcs
Velindre Cancer Centre GTT Analysis: Calculations
Navigation bar:
This sheet performs the monthly calculations for charts
Run chart data123456123456TriggersHarm events
NrMonthAdverse event rate per 1000 patient daysNumber of records reviewedBeddaysNumber of triggersNumber of adverse eventsMonthly conversion rateGeneral care eventsLab test eventsIntensive eventsMedication eventsSurgical eventsOncology eventsGeneral care triggersLab test triggersIntensive care triggersMedication triggersSurgical care triggersOncology care triggersG1G2G3G4G5G6G7G8L1L2L3L4L5L6L7L8L9L10L11L12L13L14I1I2M1M2M3M4M5S1S2S3O1O2O3O4O5O6O7O8O9O10O11O12O13O14O15O16O17G1G2G3G4G5G6G7G8L1L2L3L4L5L6L7L8L9L10L11L12L13L14S1S2S3I1I2M1M2M3M4M5O1O2O3O4O5O6O7O8O9O10O11O12O13O14O15O16O17
1Sep 200897.4020154481531.370010719901019105201010031000000300110000001000100340014112000020420001000000000000000000000000100012001110000001
2Oct 2008103.2620184821923.2540008272601028171311121063211001311250000001000210641055200010010030002000000000010111000000000020021002300000000
3Nov 200873.1720205361541.730000111220002281300000010100000000000000000000010451022401020000120000000000000000000000000000001012101120102000
4Dec 2008114.7520122381436.843000615100001351520020060101001001000000000000100120021200010120101002000000100100100000000000010010001110001010
5Jan 2009101.6920118341235.3130007970001870020000030100100001010000000000200231052201000000001000002000000000100000000000010011004100000000
6Feb 2009131.9420144371951.48001091550101642420111021000000100010001000000100240041200020000221011100000000000000000000100010012002010003000
7Mar 200995.2420126431227.9400008161000017114000100040300000100110000000000000312045110000001200010000000000000000000000000000011102210000000
8Apr 2009177.7820135602440.03201013161201031130020100070001000102010000001000510431361601000001001010000000000010001000000000141002030160100000
9May 2009132.8720143371951.462000101540101792030100010100000001010000001000011240122011011000203010000010000000001000000000001021001200201100
10Jun 2009107.7820167191894.74101010510101222010000000000000000100001000000200050111100001001201000000000000000010000000100020005011110000100
11Jul 200989.7420156601423.323100716121003160154000040101001103100100000000310551154111010111000100000000000000210000010000010022000100100001
12Aug 2009102.3620127461328.370000619701019120241000050000000011000000001000000440052211000000024100000000000000000000000000000012001100100000
13Sep 2009138.3620159522242.370000141650003190131200031100000000000000000000100263176100102012012110000000000000000000000000010015203210000000
14Oct 200984.8520165321443.85000091110002041221100010000000000000000000000100172053000001000121010000000000000000000000000000014200100000100
15Nov 200967.9020162621117.740010616120103392032000080001001200000000001000100821074320021110202000000000000000000000000000100000101200001100
16Dec 200965.042012336822.22100041320002172301000000100000000010000000000101331041230110001100000000010000000000000000000000110001010001000
17Jan 201072.072011123834.8110005550001320020100031000000001000000000000100320011400000010000010000000000000100000000000010011000030000000
18Feb 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
19Mar 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
20Apr 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
21May 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
22Jun 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
23Jul 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
24Aug 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
25Sep 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
26Oct 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
27Nov 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
28Dec 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
29Jan 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
30Feb 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
31Mar 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
32Apr 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
33May 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
34Jun 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
35Jul 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
36Aug 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
37Sep 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
38Oct 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
39Nov 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
40Dec 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
41Jan 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
42Feb 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
43Mar 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
44Apr 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
45May 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
46Jun 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
47Jul 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
48Aug 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
49Sep 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
50Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
51Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
52Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
53Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
54Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
55Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
56Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
57Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
58Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
59Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
60Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
G1
G2
G3
G4
G5
G6
G7
G1G8
G2G9
G3G10
G4L1
G5L2
G6L3
G7L4
G8L5
G9L6
G10L7
L1L8
L2L9
L3L10
L4L11
L5L12
L6L13
L7L14
L8L15
L9L16
L10L17
L11I1
L12I2
L13M1
L14M2
L15M3
L16M4
L17M5
I1S1
I2S2
S1S3
S2O1
S3O2
M1O3
M2O4
M3O5
M4O6
M5O7
S1O8
S2O9
S3G3
O1G4
O2G5
O3G6
O4G7
O5G8
O6G9
O7G10
O8
O9
Contents
Data entry
Run charts
Bar charts
Database
ChartData
Velindre Cancer Centre GTT Analysis: Chart data
Navigation bar:
This sheet contains the data for the various charts
Bar chart data for:
Run chart data for:Bar chart data for:12345678910111111122222333334444455555
Adverse event rate per 1000 patient daysEvents by trigger codeEvents by moduleEvents by trigger codeTriggers by moduleTrigger by trigger codeSeverity by categorySeverity E by moduleSeverity F by moduleSeverity G by moduleSeverity H by moduleSeverity I by module0EEEEEFFFFFGGGGGHHHHHIIIIIEFGHI
NrMonthValuesAverage (103.3)NrAxisValuerank (0)Adjust for equalsFinal rankItem nrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrModule codeTrigger code1234512345123451234512345
1Sep 200897.40103.30753588191G171101137O5311G731G171G2451G11351E1951G121G171G11G11G21G15.18518518521GG1010001000000000000001000011001
2Oct 2008103.26103.30753588192G21840440O8212L202G2182L1302G2232F562L42L62L02L02L02G278.26086956522GG2041000000001000000000000050100
3Nov 200873.17103.30753588193G31480841O9203I13G3143I13G3263G13I03I03I03I13I03G353.84615384623GG3030000000000000000000000030000
4Dec 2008114.75103.30753588194G4176062G2184M54G4174M84G4324H24M24M04M04M04M04G453.1254GG400100100100000000000000000111000
5Jan 2009101.69103.30753588195G531901942O10185S05G535S05G5125I25S05S05S05S05S05G5255GG5000001000000000100000000001010
6Feb 2009131.94103.30753588196G67111124G4176O1406G676O3616G696O536O286O06O06O06G677.77777777786GG6001001000000000000000100011001
7Mar 200995.24103.30753588197G761401436O4177G767G767G71007GG7000102100000000000000000013000
8Apr 2009177.78103.30753588198G81280283G3148G818G828G8508GG8000000000000000000000000000000
9May 2009132.87103.30753588199L103403433O1149L109L109L109LL1000000000000000000000000000000
10Jun 2009107.78103.307535881910L222402446O14910L2210L25710L23.508771929810LL2000000000000000000000000000000
11Jul 200989.74103.307535881911L30341351G1711L3011L3711L3011LL3000000000000000000000000000000
12Aug 2009102.36103.307535881912L42241256G6712L4212L41212L416.666666666712LL4000001000000000000000000001000
13Sep 2009138.36103.307535881913L503423638O6713L5013L5113L5013LL5000000000000000000000000000000
14Oct 200984.85103.307535881914L61281297G7614L6114L6514L62014LL6000000100000000000000000001000
15Nov 200967.90103.307535881915L703433720L12615L7015L7115L7015LL7000000000000000000000000000000
16Dec 200965.04103.307535881916L803443844O12616L8016L8016L8016LL8000000000000000000000000000000
17Jan 201072.07103.307535881917L912823039O7417L9117L9417L92517LL9000000100000000000000000001000
18Feb 20100.00103.307535881918L1022422647O15418L10218L101218L1016.666666666718LL10000000200000000000000000002000
19Mar 20100.00103.307535881919L110345395G5319L11019L11219L11019LL11000000000000000000000000000000
20Apr 20100.00103.307535881920L1261411521L13320L12620L121120L1254.545454545520LL12011000000000000000000000020000
21May 20100.00103.307535881921L1331912022L14321L13321L13621L135021LL13010000100000000000000000011000
22Jun 20100.00103.307535881922L1431922132S3322L14322L141222L142522LL14001000000000000000000000010000
23Jul 20100.00103.307535881923I103464034O2323I1023I1023I1023II1000000000000000000000000000000
24Aug 20100.00103.307535881924I203474110L2224I2024I2124I2024II2000000000000000001000000000010
25Sep 20100.00103.307535881925M103484212L4225M1025M1025M1025MM1000000000000000000000000000000
26Oct 20100.00103.307535881926M203494318L10226M2026M2226M2026MM2020000000000000000000000020000
27Nov 20100.00103.307535881927M312833129M5227M3127M3027M3027MM3000000000000000000000000000000
28Dec 20100.00103.307535881928M403410448G8128M4028M4028M4028MM4000000000000000000000000000000
29Jan 20110.00103.307535881929M522432714L6129M5229M5629M533.333333333329MM5000000000000000000000000000000
30Feb 20110.00103.307535881930S1034114517L9130S1030S1030S1030SS1000000000000000000000000000000
31Mar 20110.00103.307535881931S2034124627M3131S2031S2031S2031SS2000000000000000000000000000000
32Apr 20110.00103.307535881932S331932235O3132S3332S3032S3032SS3000000000000000000000000000000
33May 20110.00103.307535881933O11481948O16133O11433O12233O163.636363636433OO1040002100000000000000000043000
34Jun 20110.00103.307535881934O23194239L1034O2334O2534O26034OO2000000012000000000000000003000
35Jul 20110.00103.307535881935O312843211L3035O3135O3235O35035OO3000000100000000000000000001000
36Aug 20110.00103.307535881936O41761713L5036O41736O45336O432.075471698136OO4033001100000000000000000062000
37Sep 20110.00103.307535881937O53110115L7037O53137O56437O548.437537OO50931110000000000000000000141000
38Oct 20110.00103.307535881938O671121316L8038O6738O61438O65038OO6021002100000000000000000033000
39Nov 20110.00103.307535881939O741701719L11039O7439O7739O757.142857142939OO7020011000000000000000000031000
40Dec 20110.00103.307535881940O82120223I1040O82140O86640O831.818181818240OO8051103100000000000000000074000
41Jan 20120.00103.307535881941O92030324I2041O92041O94541O944.444444444441OO90643010100000000000000000132000
42Feb 20120.00103.307535881942O101841525M1042O101842O103442O1052.941176470642OO10021004301000000000000000038000
43Mar 20120.00103.307535881943O11034134726M2043O11043O111043O11043OO11000000000000000000000000000000
44Apr 20120.00103.307535881944O1261421628M4044O12644O12844O127544OO12010101000000000000000000021000
45May 20120.00103.307535881945O13034144830S1045O13045O13245O13045OO13000000000000000000000000000000
46Jun 20120.00103.307535881946O1491001031S2046O14946O141146O1481.818181818246OO14040001000000000000000000041000
47Jul 20120.00103.307535881947O1541711843O11047O15447O15647O1566.666666666747OO15000001100000000000000000002000
48Aug 20120.00103.307535881948O1612853345O13048O16148O16348O1633.333333333348OO16000000010000000000000000001000
49Sep 20120.00103.307535881949OO17020000000000000000000000020000
50Dec 18990.00103.3075358819
51Dec 18990.00103.3075358819
52Dec 18990.00103.3075358819
53Dec 18990.00103.3075358819
54Dec 18990.00103.3075358819
55Dec 18990.00103.3075358819
56Dec 18990.00103.3075358819
57Dec 18990.00103.3075358819
58Dec 18990.00103.3075358819
59Dec 18990.00103.3075358819
60Dec 18990.00103.3075358819
Contents
Data entry
Run charts
Bar charts
Database
Working
Velindre Cancer Centre GTT Analysis: Working sheet
Navigation bar:
General variables
Subject nameGTT Analysis
Maximum months49Nr_Months
Months with Data present17Nr_DataPresent
Latest monthJan 2010Latest_Month
Data entry
Selected month17X_Month
Selected month as range ready to copy into database
Jan 20101
Jan 20102
Jan 20103
Jan 20104
Jan 20105
Jan 20106
Jan 20107
Jan 20108
Jan 20109
Jan 201010
Jan 201011
Jan 201012
Jan 201013
Jan 201014
Jan 201015
Jan 201016
Jan 201017
Jan 201018
Jan 201019
Jan 201020
Run chart variables
Number of measures18Nr_RunMeasures
Selected measure1X_Runchart
Chart titleAdverse event rate per 1000 patient daysVelindre Cancer Centre
Y axis labelRate
Bar chart variables
Number of measures10Nr_BarMeasures
Selected measure2X_Barchart
Chart titleEvents by trigger codeVelindre Cancer Centre from Sep 08 to Jan 10
Y axis labelNumber
X axis labelTrigger code
Number of data points48Nr_BarPoints
Number of non zeros33Nr_BarPlots
Version control
Version 1Initial version includes conversion rate as bar chart
Version 2Ammended Triggers Codes.
Contents
Data entry
Run charts
Bar charts
Database
-
MEASUREMENT HarmDevelopment of Trigger Tool for Oncology Daycase Treatments
Current assessment methods for daycase related harm include:Incident reporting SCIF
Fig 2. shows a breakdown of events identified by module. The modified tool including specific Oncology triggers (module O) has allowed VCC to see a true reflection of the harm caused to oncology patients. We now want to emulate this for the daycase patients.
Chart2
140
73
20
5
1
Module code
Number
Events by moduleVelindre Cancer Centre from Sep 08 to Jan 10
Contents
Velindre Cancer Centre GTT Analysis: Contents
Navigation bar:
SheetDescription
ContentsThis sheet. Enter your organisation name and the first month of data here.
Data entry
Bar chartsDisplay bar chart of selected analysis. Choose from list available
Run chartsDisplay run chart of selected analysis. Choose from list available
Database
Setup
Trust nameVelindre Cancer Centre
Start monthSeptember 2008
Contents
Data entry
Run charts
Bar charts
Database
How do I use this tool?1. Enter your organisation name and first month of data into the Setup area on this sheet.2. Perform the case note review and enter the relevant data into the Data Entry sheet.3. View your performance on the Bar charts or Run charts sheets. Note that the data required for the Extranet can be found in a table on the Run charts sheet. Scroll down to see it.
How do I move around?Use the Navigation bar at the top of each screen to move between sheets. Click on the button for the sheet you want such as:
How do I print charts?On the Charts sheet, click on the printer icon (see right) to print out the chart on A4 paper.
Data entry
Data
Velindre Cancer Centre GTT Analysis: Data entry
Navigation bar:
Select month:
Is this the correct month?
Harm events found
Trigger codes foundEvent 1Event 2Event 3Event 4Event 5
Case Note numberLength of stay12345678910Event codeSeverityEvent codeSeverityEvent codeSeverityEvent codeSeverityEvent codeSeverityEvent present on admission?Event description
1v077222b5L2O4
2v069113v15O17O10L2
3v059206p2G1
4v079023g4
5v056422r26O4O5O4EO5E
6v078295m2O8
7v079509c5O5G6G6E
8v078108s6G4O1O9O10O1EO10F
9v073678g6L2L3O10O10F
10v075252s4G4O4O10O10F
11v079089L2L12L12E
12v041976v2G1
13v079101c2
14v072813u5
15v077664x3
16v069318f3
17v073966v4
18v078368y2
19v069221p8
20v079224c5
Store in database
Clear table
Contents
Data entry
Run charts
Bar charts
Database
Barchart
Velindre Cancer Centre GTT Analysis: Bar charts
Navigation bar:
Select measure:
Barchart
140
73
20
5
1
Module code
Number
Events by moduleVelindre Cancer Centre from Sep 08 to Jan 10
Runchart
Velindre Cancer Centre GTT Analysis: Run charts
Navigation bar:
Select measure:
Scroll down for Extranet adverse event rate data
Data for Extranet adverse event rate
NrMonthNumber of adverse eventsBeddays
1Sep 200815154* Data not reported
2Oct 200819184* Data not reported
3Nov 200815205
4Dec 200814122
5Jan 200912118
6Feb 200919144
7Mar 200912126
8Apr 200924135
9May 200919143
10Jun 200918167
11Jul 200914156
12Aug 200913127
13Sep 200922159
14Oct 200914165
15Nov 200911162
16Dec 20098123
17Jan 20108111
18Feb 201000
19Mar 201000
20Apr 201000
21May 201000
22Jun 201000
23Jul 201000
24Aug 201000
25Sep 201000
26Oct 201000
27Nov 201000
28Dec 201000
29Jan 201100
30Feb 201100
31Mar 201100
32Apr 201100
33May 201100
34Jun 201100
35Jul 201100
36Aug 201100
37Sep 201100
38Oct 201100
39Nov 201100
40Dec 201100
41Jan 201200
42Feb 201200
43Mar 201200
44Apr 201200
45May 201200
46Jun 201200
47Jul 201200
48Aug 201200
49Sep 201200
50Dec 189900
51Dec 189900
52Dec 189900
53Dec 189900
54Dec 189900
55Dec 189900
56Dec 189900
57Dec 189900
58Dec 189900
59Dec 189900
60Dec 189900
Contents
Data entry
Run charts
Bar charts
Database
Runchart
1515.1176470588
1915.1176470588
1515.1176470588
1415.1176470588
1215.1176470588
1915.1176470588
1215.1176470588
2415.1176470588
1915.1176470588
1815.1176470588
1415.1176470588
1315.1176470588
2215.1176470588
1415.1176470588
1115.1176470588
815.1176470588
815.1176470588
Values
Average (15.1)
Percentage
Number of adverse eventsVelindre Cancer Centre
DB
Velindre Cancer Centre GTT Analysis: Database
Navigation bar:
Harm events found
Trigger codes foundEvent 1Event 2Event 3Event 4Event 5
MonthCase Note numberLength of stay12345678910Event codeSeverityEvent codeSeverityEvent codeSeverityEvent codeSeverityEvent codeSeverityEvent present on admission?Event description
Sep 08v056587r9G2G2O5G2EG2E
Sep 08v071016C2G1O4
Sep 08v002021d5O4O4E
Sep 08v071174j2G1G7G7F
Sep 08v070343j7G1M5M5E
Sep 08v066570y4
Sep 08v071520d2G1L2
Sep 08v002021d10
Sep 08v059947s15O5O12L10O9G1L2
Sep 08v071042L2
Sep 08v071969t13L10O4
Sep 08v047037v30G2O17O9G2EO9E
Sep 08v072286u14O1O12G3G2G1G2EG3E
Sep 08v070050v7G1G5L2L3O10O11L14O9O10F
Sep 08v057742b7G2G3O17L10O9G3EO17E
Sep 08v071846t6G1
Sep 08v071316t2
Sep 08v065960k6G1L13O5O5E
Sep 08v071620j5
Sep 08v071810m6G1O5O8O5EO8E
Oct 08v053447v8G1L2L3O4O10
Oct 08v063705v2G1L2
Oct 08v065960k7G1G4
Oct 08v063194w6G1L2O8
Oct 08v072503v22G1G3L13L14O9O5O8G3EL13EO9E
Oct 08v071379t5
Oct 08v072431t8G1G8O17O5
Oct 08v045378v3G1
Oct 08v070890u2G1
Oct 08v070447d2G1L2L3
Oct 08v062099m3G1L10L14O9O4O4F
Oct 08v069236v26G1G3G7L2L4L5L6L12O5O9G3EG7FL12EO9EO5E
Oct 08v072127d24G1G3G6L4G3E
Oct 08a396264p8G1L10L13L14O4O14
Oct 08v055780F12G1L10O4O8O8FL10F
Oct 08v071844y12G7M5O5O6O2G7F
Oct 08v072143e20G1G5L2L11L14O9O4O8O10L14EO4FO9F
Oct 08v071846t5G1L14O9
Oct 08v058388w3G2O1O1E
Oct 08v070888q6G1L3L9O1O4O8O1FO8F
Nov 08v070509x5O14G1G3O14E
Nov 08v052961b14G1G2O4O5O8O12O9G2EO12EO4EO8E
Nov 08v071794g30G3G3E
Nov 08v072757j2
Nov 08v072131c5
Nov 08v058748n4O4G1
Nov 08v073022c26O5O8
Nov 08v072576d7O4O10G1
Nov 08v045378v2G1
Nov 08v063277r2
Nov 08v072898e26
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Jul 09v026608u24L2L4L12O1O5O7O8O9L12EO1EO5EO9E
Jul 09v070592X9O4O11G4O4E
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Jul 09v076897h7L6O5O17O5EO17E
Jul 09vv076976n17G3L2L9O5O9O4E
Jul 09v07546s20G1G5L2I2L13O4O5O6O8G1EL13FI2H
Jul 09v054853P2G4G5O16G5H
Aug 09V075999e2G1L2
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Sep 09v000000l11G1G5G6L2L4O4O7O9G5FO4EO9E
Sep 09v001053S8O5O8O17O5E
Sep 09v036726e16L2O5O9O5E
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Sep 09v06888n10G1O6O8O5O6FO8E
Sep 09v073876x5O4O15
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Oct 09v066147x10O8
Oct 09v072460g14
Nov 09V074445W7G1G5O4O8O15O8EO15F
Nov 09v077436j26G1G4G5L2L2O5O6O10O11G4FO6F
Nov 09v077453u3L2O8
Nov 09v077338x3L9
Nov 09v064936s7O4O14L2
Nov 09v064909y7
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Nov 09v056481c14G2G2L10O4O9G2EG2E
Nov 09v056481c12O1O5O8O9O16O9F
Nov 09v077713f5O4O10O11G1
Nov 09v032510p7G1G4L2O4O9
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Nov 09v070321711L2L6O8
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Nov 09v077437T7G1L2
Nov 09v077831g5G1
Nov 09v076551c4G4O4O10G4E
Dec 09V078178V2
Dec 09V058785P6G5O10O10F
Dec 09V072813U5G1
Dec 09V078018U8O5O8O8E
Dec 09V075218V5L4O3O4L4EO3FO4E
Dec 09V077020V8G2G3O5G2E
Dec 09V077818K6G1L14O10
Dec 09V075755Y8G1G1G1E
Dec 09V078349T5
Dec 09V068299S2G1O8O11
Dec 09V076975D5O8O14O14E
Dec 09V077933G5
Dec 09V077739E2O11O11
Dec 09A735487Q9O13G2
Dec 09V073966V6G1O9
Dec 09V076475B14G1O1O6
Dec 09V069631T4
Dec 09V078073R3O4
Dec 09V069286J8O5
Dec 09v078957P12G3G3O4O8
Jan 10v077222b5L2O4
Jan 10v069113v15O17O10L2
Jan 10v059206p2G1
Jan 10v079023g4
Jan 10v056422r26O4O5O4EO5E
Jan 10v078295m2O8
Jan 10v079509c5O5G6G6E
Jan 10v078108s6G4O1O9O10O1EO10F
Jan 10v073678g6L2L3O10O10F
Jan 10v075252s4G4O4O10O10F
Jan 10v079089L2L12L12E
Jan 10v041976v2G1
Jan 10v079101c2
Jan 10v072813u5
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Jan 10v073966v4
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Contents
Data entry
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Database
Contents
Data entry
Run charts
Bar charts
Database
Lists
Velindre Cancer Centre GTT Analysis: Lists
Navigation bar:
Triggers listSeverity ListMonths ListRun chart measuresBar chart measuresModules
CodeTriggerXCodeSeverityMonthData present?MeasureColumnLabelMeasureX axis labelCodeNameNr
1G1Lack of early warning score, score/trigger requiring response or Dr calledGEcontributed to or resulted in temporary harm to the patient & required interventionSep 2008YesAdverse event rate per 1000 patient days1RateEvents by moduleModule codeGGeneral care8
2G2Any patient fallGFcontributed to or resulted in temporary harm to patients& required initial or prolonged hospitalisationOct 2008YesNumber of records reviewed2NumberEvents by trigger codeTrigger codeLLab test14
3G3Pressure ulcersGGcontributed to or resulted in permanent patient harmNov 2008YesBeddays3NumberTriggers by moduleModule codeIIntensive care2
4G4Unplanned readmission to hospital within 30 daysGHrequired intervention to sustain lifeDec 2008YesNumber of triggers4NumberTrigger by trigger codeTrigger codeMMedication5
5G5Sepsis, Shock (septic & anaphylactic) or cardiac arrestGIcontributed to the patients deathJan 2009YesNumber of adverse events5PercentageSeverity by categorySeverity codeSSurgical care3
6G6DVT/PE following admission evidenced by imaging &/or D DimersGFeb 2009YesMonthly conversion rate6RateSeverity E by moduleModule codeOOncology17
7G7Complication of procedureGMar 2009YesGeneral care events7NumberSeverity F by moduleModule code
8G8Transfer to a higher level of careGApr 2009YesLab test events8NumberSeverity G by moduleModule code
9L1High INR >5LMay 2009YesIntensive events9NumberSeverity H by moduleModule code
10L2TransfusionLJun 2009YesMedication events10NumberSeverity I by moduleModule code
11L3Abrupt drop in Hb or Hct >25%LJul 2009YesSurgical events11Number
12L4Rising urea creatinineTwice patients baselineLAug 2009YesOncology events12Number
13L5Electrolyte abnormalities NA 160LSep 2009YesGeneral care triggers13Number
14L6K < 2.5 or >6.5LOct 2009YesLab test triggers14Number
15L7Hypoglycaemia 1.5ng/mlLDec 2009YesMedication triggers16Number
17L9MRSA bacteraemiaLJan 2010YesSurgical care triggers17Number
18L10C. DifficileLFeb 2010NoOncology care triggers18Number
19L11VRELMar 2010No0
20L12Wound infectionLApr 2010No0
21L13Nosocomial pneumoniaLMay 2010No0
22L14Positive blood cultureLJun 2010No
23I1Readmission to ICU or HDUIJul 2010No
24I2Unplanned transfer to ICU or HDUIAug 2010No
25M1Vitamin KMSep 2010No
26M2Naloxone (Narcan, Nalone, Narcanti)MOct 2010No
27M3Flumazil (flumazepil, Anexate, Mazicon, Romazicon)MNov 2010No
28M4Glucagon or 50% glucoseMDec 2010No
29M5Abrupt medication stopMJan 2011No
30S1Return to theatreSFeb 2011No
31S2Change in planned procedureSMar 2011No
32S3Removal/injury or repair of organSApr 2011No
33O1Mucositis/stomatitisOMay 2011No
34O2Skin desquamationOJun 2011No
35O3Palmar plantar syndromeOJul 2011No
36O4DiarrhoeaOAug 2011No
37O5ConstipationOSep 2011No
38O6DysphagiaOOct 2011No
39O7AspirationONov 2011No
40O8VomitingODec 2011No
41O9UTIOJan 2012No
42O10Neutropaenia (neutrophils below 1)OFeb 2012No
43O11Thrombocytopaenia (platelets below ???)OMar 2012No
44O12Hyperglycaemia (above 18 mmols/l)OApr 2012No
45O13Hypercalcaemia.(Calcium above 2.6mmol/l)OMay 2012No
46O14ExtravasationOJun 2012No
47O15Vascular access infectionOJul 2012No
48O16Unexpected medical or surgical emergency/sudden deathOAug 2012No
49O17Sudden onset confusionOSep 2012No
O1Mucositis/stomatitis
O2Skin desquamation
O3Palmar plantar syndrome
O4Diarrhoea
O5Constipation
O6Dysphagia
O7Aspiration
O8Vomiting
O9UTI
O10Neutropaenia (neutrophils below 1)
O11Thrombocytopaenia (platelets below ???)
O12Hyperglycaemia (above 18 mmols/l)
O13Hypercalcaemia.(Calcium above 2.6mmol/l)
O14Extravasation
15Vascular access infection
O16Unexpected medical or surgical emergency/sudden death
O17Sudden onset confusion
Contents
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Calcs
Velindre Cancer Centre GTT Analysis: Calculations
Navigation bar:
This sheet performs the monthly calculations for charts
Run chart data123456123456TriggersHarm events
NrMonthAdverse event rate per 1000 patient daysNumber of records reviewedBeddaysNumber of triggersNumber of adverse eventsMonthly conversion rateGeneral care eventsLab test eventsIntensive eventsMedication eventsSurgical eventsOncology eventsGeneral care triggersLab test triggersIntensive care triggersMedication triggersSurgical care triggersOncology care triggersG1G2G3G4G5G6G7G8L1L2L3L4L5L6L7L8L9L10L11L12L13L14I1I2M1M2M3M4M5S1S2S3O1O2O3O4O5O6O7O8O9O10O11O12O13O14O15O16O17G1G2G3G4G5G6G7G8L1L2L3L4L5L6L7L8L9L10L11L12L13L14S1S2S3I1I2M1M2M3M4M5O1O2O3O4O5O6O7O8O9O10O11O12O13O14O15O16O17
1Sep 200897.4020154481531.370010719901019105201010031000000300110000001000100340014112000020420001000000000000000000000000100012001110000001
2Oct 2008103.2620184821923.2540008272601028171311121063211001311250000001000210641055200010010030002000000000010111000000000020021002300000000
3Nov 200873.1720205361541.730000111220002281300000010100000000000000000000010451022401020000120000000000000000000000000000001012101120102000
4Dec 2008114.7520122381436.843000615100001351520020060101001001000000000000100120021200010120101002000000100100100000000000010010001110001010
5Jan 2009101.6920118341235.3130007970001870020000030100100001010000000000200231052201000000001000002000000000100000000000010011004100000000
6Feb 2009131.9420144371951.48001091550101642420111021000000100010001000000100240041200020000221011100000000000000000000100010012002010003000
7Mar 200995.2420126431227.9400008161000017114000100040300000100110000000000000312045110000001200010000000000000000000000000000011102210000000
8Apr 2009177.7820135602440.03201013161201031130020100070001000102010000001000510431361601000001001010000000000010001000000000141002030160100000
9May 2009132.8720143371951.462000101540101792030100010100000001010000001000011240122011011000203010000010000000001000000000001021001200201100
10Jun 2009107.7820167191894.74101010510101222010000000000000000100001000000200050111100001001201000000000000000010000000100020005011110000100
11Jul 200989.7420156601423.323100716121003160154000040101001103100100000000310551154111010111000100000000000000210000010000010022000100100001
12Aug 2009102.3620127461328.370000619701019120241000050000000011000000001000000440052211000000024100000000000000000000000000000012001100100000
13Sep 2009138.3620159522242.370000141650003190131200031100000000000000000000100263176100102012012110000000000000000000000000010015203210000000
14Oct 200984.8520165321443.85000091110002041221100010000000000000000000000100172053000001000121010000000000000000000000000000014200100000100
15Nov 200967.9020162621117.740010616120103392032000080001001200000000001000100821074320021110202000000000000000000000000000100000101200001100
16Dec 200965.042012336822.22100041320002172301000000100000000010000000000101331041230110001100000000010000000000000000000000110001010001000
17Jan 201072.072011123834.8110005550001320020100031000000001000000000000100320011400000010000010000000000000100000000000010011000030000000
18Feb 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
19Mar 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
20Apr 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
21May 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
22Jun 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
23Jul 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
24Aug 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
25Sep 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
26Oct 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
27Nov 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
28Dec 20100.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
29Jan 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
30Feb 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
31Mar 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
32Apr 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
33May 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
34Jun 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
35Jul 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
36Aug 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
37Sep 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
38Oct 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
39Nov 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
40Dec 20110.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
41Jan 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
42Feb 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
43Mar 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
44Apr 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
45May 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
46Jun 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
47Jul 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
48Aug 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
49Sep 20120.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
50Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
51Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
52Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
53Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
54Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
55Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
56Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
57Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
58Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
59Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
60Dec 18990.0000000.000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
G1
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G1G8
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G3G10
G4L1
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I1S1
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S2O1
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M1O3
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S1O8
S2O9
S3G3
O1G4
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O6G9
O7G10
O8
O9
Contents
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ChartData
Velindre Cancer Centre GTT Analysis: Chart data
Navigation bar:
This sheet contains the data for the various charts
Bar chart data for:
Run chart data for:Bar chart data for:12345678910111111122222333334444455555
Number of adverse eventsEvents by moduleEvents by moduleEvents by trigger codeTriggers by moduleTrigger by trigger codeSeverity by categorySeverity E by moduleSeverity F by moduleSeverity G by moduleSeverity H by moduleSeverity I by module0EEEEEFFFFFGGGGGHHHHHIIIIIEFGHI
NrMonthValuesAverage (15.1)NrAxisValuerank (0)Adjust for equalsFinal rankItem nrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrAxisValueNrModule codeTrigger code1234512345123451234512345
1Sep 200815.0015.11764705881G732026O1401G731G171G2451G11351E1951G121G171G11G11G21G15.18518518521GG1010001000000000000001000011001
2Oct 200819.0015.11764705882L203031G732L202G2182L1302G2232F562L42L62L02L02L02G278.26086956522GG2041000000001000000000000050100
3Nov 200815.0015.11764705883I15052L203I13G3143I13G3263G13I03I03I03I13I03G353.84615384623GG3030000000000000000000000030000
4Dec 200814.0015.11764705884M54044M54M54G4174M84G4324H24M24M04M04M04M04G453.1254GG400100100100000000000000000111000
5Jan 200912.0015.11764705885S06063I15S05G535S05G5125I25S05S05S05S05S05G5255GG5000001000000000100000000001010
6Feb 200919.0015.11764705886O1401015S06O1406G676O3616G696O536O286O06O06O06G677.77777777786GG6001001000000000000000100011001
7Mar 200912.0015.11764705887006177007G767G767G71007GG7000102100000000000000000013000
8Apr 200924.0015.11764705888006288008G818G828G8508GG8000000000000000000000000000000
9May 200919.0015.11764705889006399009L109L109L109LL1000000000000000000000000000000
10Jun 200918.0015.117647058810006410100010L2210L25710L23.508771929810LL2000000000000000000000000000000
11Jul 200914.0015.117647058811006511110011L3011L3711L3011LL3000000000000000000000000000000
12Aug 200913.0015.117647058812006612120012L4212L41212L416.666666666712LL4000001000000000000000000001000
13Sep 200922.0015.117647058813006713130013L5013L5113L5013LL5000000000000000000000000000000
14Oct 200914.0015.117647058814006814140014L6114L6514L62014LL6000000100000000000000000001000
15Nov 200911.0015.117647058815006915150015L7015L7115L7015LL7000000000000000000000000000000
16Dec 20098.0015.1176470588160061016160016L8016L8016L8016LL8000000000000000000000000000000
17Jan 20108.0015.1176470588170061117170017L9117L9417L92517LL9000000100000000000000000001000
18Feb 20100.0015.1176470588180061218180018L10218L101218L1016.666666666718LL10000000200000000000000000002000
19Mar 20100.0015.1176470588190061319190019L11019L11219L11019LL11000000000000000000000000000000
20Apr 20100.0015.1176470588200061420200020L12620L121120L1254.545454545520LL12011000000000000000000000020000
21May 20100.0015.1176470588210061521210021L13321L13621L135021LL13010000100000000000000000011000
22Jun 20100.0015.1176470588220061622220022L14322L141222L142522LL14001000000000000000000000010000
23Jul 20100.0015.1176470588230061723230023I1023I1023I1023II1000000000000000000000000000000
24Aug 20100.0015.1176470588240061824240024I2024I2124I2024II2000000000000000001000000000010
25Sep 20100.0015.1176470588250061925250025M1025M1025M1025MM1000000000000000000000000000000
26Oct 20100.0015.1176470588260062026260026M2026M2226M2026MM2020000000000000000000000020000
27Nov 20100.0015.1176470588270062127270027M3127M3027M3027MM3000000000000000000000000000000
28Dec 20100.0015.1176470588280062228280028M4028M4028M4028MM4000000000000000000000000000000
29Jan 20110.0015.1176470588290062329290029M5229M5629M533.333333333329MM5000000000000000000000000000000
30Feb 20110.0015.1176470588300062430300030S1030S1030S1030SS1000000000000000000000000000000
31Mar 20110.0015.1176470588310062531310031S2031S2031S2031SS2000000000000000000000000000000
32Apr 20110.0015.1176470588320062632320032S3332S3032S3032SS3000000000000000000000000000000
33May 20110.0015.1176470588330062733330033O11433O12233O163.636363636433OO1040002100000000000000000043000
34Jun 20110.0015.1176470588340062834340034O2334O2534O26034OO2000000012000000000000000003000
35Jul 20110.0015.1176470588350062935350035O3135O3235O35035OO3000000100000000000000000001000
36Aug 20110.0015.1176470588360063036360036O41736O45336O432.075471698136OO4033001100000000000000000062000
37Sep 20110.0015.1176470588370063137370037O53137O56437O548.437537OO50931110000000000000000000141000
38Oct 20110.0015.1176470588380063238380038O6738O61438O65038OO6021002100000000000000000033000
39Nov 20110.0015.1176470588390063339390039O7439O7739O757.142857142939OO7020011000000000000000000031000
40Dec 20110.0015.1176470588400063440400040O82140O86640O831.818181818240OO8051103100000000000000000074000
41Jan 20120.0015.1176470588410063541410041O92041O94541O944.444444444441OO90643010100000000000000000132000
42Feb 20120.0015.1176470588420063642420042O101842O103442O1052.941176470642OO10021004301000000000000000038000
43Mar 20120.0015.1176470588430063743430043O11043O111043O11043OO11000000000000000000000000000000
44Apr 20120.0015.1176470588440063844440044O12644O12844O127544OO12010101000000000000000000021000
45May 20120.0015.1176470588450063945450045O13045O13245O13045OO13000000000000000000000000000000
46Jun 20120.0015.1176470588460064046460046O14946O141146O1481.818181818246OO14040001000000000000000000041000
47Jul 20120.0015.1176470588470064147470047O15447O15647O1566.666666666747OO15000001100000000000000000002000
48Aug 20120.0015.1176470588480064248480048O16148O16348O1633.333333333348OO16000000010000000000000000001000
49Sep 20120.0015.117647058849OO17020000000000000000000000020000
50Dec 18990.0015.1176470588
51Dec 18990.0015.1176470588
52Dec 18990.0015.1176470588
53Dec 18990.0015.1176470588
54Dec 18990.0015.1176470588
55Dec 18990.0015.1176470588
56Dec 18990.0015.1176470588
57Dec 18990.0015.1176470588
58Dec 18990.0015.1176470588
59Dec 18990.0015.1176470588
60Dec 18990.0015.1176470588
Contents
Data entry
Run charts
Bar charts
Database
Working
Velindre Cancer Centre GTT Analysis: Working sheet
Navigation bar:
General variables
Subject nameGTT Analysis
Maximum months49Nr_Months
Months with Data present17Nr_DataPresent
Latest monthJan 2010Latest_Month
Data entry
Selected month17X_Month
Selected month as range ready to copy into database
Jan 20101
Jan 20102
Jan 20103
Jan 20104
Jan 20105
Jan 20106
Jan 20107
Jan 20108
Jan 20109
Jan 201010
Jan 201011
Jan 201012
Jan 201013
Jan 201014
Jan 201015
Jan 201016
Jan 201017
Jan 201018
Jan 201019
Jan 201020
Run chart variables
Number of measures18Nr_RunMeasures
Selected measure5X_Runchart
Chart titleNumber of adverse eventsVelindre Cancer Centre
Y axis labelPercentage
Bar chart variables
Number of measures10Nr_BarMeasures
Selected measure1X_Barchart
Chart titleEvents by moduleVelindre Cancer Centre from Sep 08 to Jan 10
Y axis labelNumber
X axis labelModule code
Number of data points6Nr_BarPoints
Number of non zeros5Nr_BarPlots
Version control
Version 1Initial version includes conversion rate as bar chart
Version 2Ammended Triggers Codes.
Contents
Data entry
Run charts
Bar charts
Database
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MEASUREMENT MortalityTo investigate the use of HSMR in an oncology treatment setting review VCC coding practice for palliative careTo analyse cancer survival outcomes by tumour or sub-tumour siteAll Clinical Process Teams to agree one survival measure for tumour groupTo implement systems for mortality case note reviewsTo establish a system for regular mortality reviews
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MEDICINES MANAGEMENTIdentifying measures appropriate for improvement in a Cancer Centre Pain Control measures include:1. Ensuring that regular opioid analgesia is being administered as prescribed2. Effectiveness of breakthrough pain relief3. Determining an early indicator of opiate toxicity in patients
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Early indications of opiate toxicity in patients
Baseline data on number of patients affected by opioid toxicity 57 patients were identified as having received opiate medication during the month of September 2009.Notes were obtained for 43 patients.9 patients were identified as being highly likely or definitely opiate toxic by 1 or more investigators.The notes were then assessed for chronological and clinical data from the notes/drug charts/ISCO as to the sequence of events.Thus approximately 20% of patients have had signs of opioid toxicity during the data collection period. Although this figure will not reach zero, it is considered too high.Palliative care and Pharmacy have discussed and a preliminary action plan developed
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Rapid Response to Acute IllnessAdaptation of the National Sepsis Six Screening tool for Oncology Standardised patient care with the Survive sepsis care pathwayIntroducing MEWS chart
Future Plans Ensure sustainabilityFully embed use of Sepsis Screening tool and pathway within the chemotherapy wardRoll out to other inpatient ward areas in Velindre Cancer Centre
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Rapid Response to Acute IllnessLessons LearntStart small and use the PDSA methodology to test changeInvolvement of a wider multidisciplinary team to develop documentationInvolving clinical champions has been an essential element of implementing change and embedding a new culture at ward level.The need for a comprehensive evaluation mechanism at the beginning of the project.The need for ongoing communication of information to all stakeholders.
Above: results from Aprils chart checker audit completed on the pilot ward.
% complience by month
55.7142857143
34.2857142857
40.7894736842
78.5714285714
0
0
0
0
0
0
0
0
% complient
Month
Percentage complience
% complient PMW (Charts scoring Yes)
Data
MonthJanFebMarAprMayJuneJulAugSeptOctNovDec
Number of Charts scoring Yes394862110
Total number of Charts checked70140152140
% complient5634417900000000
Week1/18/101/25/102/1/102/8/102/15/102/22/103/1/103/8/103/15/103/22/103/29/104/5/104/12/104/19/104/26/10
Number of Charts scoring Yes2217141010141112972327302627
Total number of Charts checked353535353535352235253535353535
% complient634940292940315526286677867477
WeekCharts complient for:1Charts complient for:2Charts complient for:3Charts complient for:4Charts complient for:5Charts compliant for 6.WeekDocumentationObservation recordingsUse of EWS24 hour balanceReferralsPatient Weight
1/18/10223535353533Jan week 36310010010010094
1/25/10173433353535Jan week 4499794100100100
2/1/10173421353535Feb week 1499760100100100
2/8/10173225313535Feb week 249917189100100
2/15/10143523283535Feb week 3401006680100100
2/22/10143528353535Feb week 44010080100100100
3/1/10133529313535Mar week 1371008389100100
3/8/10132220222222Mar week 25910091100100100
3/15/10123532333334Mar week 33410091949497
3/22/10182519152524Mar week 472100766010096
3/29/10273431353535Mar week 5779789100100100
4/5/10273532323535Apr week 1771009191100100
4/12/10303535343535Apr week 28610010097100100
4/19/10273533353535Apr week 37710094100100100
4/26/10313530353535Apr week 48910086100100100
Ceri's Comments
JanuaryComments
Omissions for component 1 included lack of addressograph or patient ID, no consultant or ward and frequency of observations not stated.
Component 3 all but 2 correct EWS charts were in place so this has been ticked as complient, however the auditor has since realsied that this section needs to incorporate the actual scoring system has been used and therfore the results may not be a true r
FebruaryOmissions for Component 1 as previous month
Componet 3 for this month complience needed to ensure that EWS were added up and included on chart therefore this is different from January as this was not taken into account.
Jan10
62.857142857148.5714285714
10097.1428571429
10094.2857142857
100100
100100
94.2857142857100
Jan week 3
Jan week 4
%
January Analysis of Chart Checker Audit on PMW
Feb10
48.571428571448.57142857144040
97.142857142991.4285714286100100
6071.428571428665.714285714380
10088.571428571480100
100100100100
100100100100
Feb week 1
Feb week 2
Feb week 3
Feb week 4
% complience
February Anaylsis of chart checker audit on PMW
March 10
37.142857142959.090909090934.28571428577277.1428571429
10010010010097
82.857142857190.909090909191.42857142867688.5714285714
88.571428571410094.285714285760100
10010094.2857142857100100
10010097.142857142996100
Mar week 1
Mar week 2
Mar week 3
Mar week 4
Mar week 5
% complience
March Anaylsis of chart checker audit on PMW
April 10
77.142857142985.714285714377.142857142988.5714285714
100100100100
91.428571428610094.285714285785.7142857143
91.428571428697.1428571429100100
100100100100
100100100100
Apr week 1
Apr week 2
Apr week 3
Apr week 4
% compliance
April Anaysis of Chart Checker data
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INFECTIONSContinue with successful interventions like the Hand Hygiene audits on all wards.Results displayed for staff and patients in ward areas and in main hospital entrance promoting an open and honest approach to reducing hospital acquired infections.Use of days between safety cross on all wards Praise for Hand Hygiene champions and successful awareness days Right: data from October 08 to March 10
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Infection focus for 1000 Lives plusTo continue with existing measuresImprove compliance with antibiotic prescribing policy Custom measures now added to the extranet and data collected from May 10 Reduce incidence of UTIs
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LEADERSHIPPatient Involvement Patient Chair, Lesley Radley not only chairs Velindres 1000 Lives Project Board but also our Patient Liaison Group. Lesley provides an invaluable patient opinion to all areas of Velindres 1000 Lives work. Develop patient involvement with all aspects of the 5 year programme
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PATIENT STORIESDevelop the current patient story work to include: Regular training sessions for Velindre staffPatient and Staff stories used proactively throughout the organisation Support a centralised all Wales story depository
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Reducing Surgical Complications Successful implementation of the WHO safer Surgery Checklist Above: The Velindre surgical teamRight: achieving 100% compliance with the WHO checklist
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Contact Leads
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CELEBRATING SUCCESS!Velindre Cancer Centre has been a committed organisation within the 1000 Lives Campaign from the start. You have developed a good structure to deliver the quality and safety including strong leadership in all content areasDr Jonathon Gray, organisational briefing April 2010
