Red2Green Tracker and Dashboard

In order to track and monitor the areas and patients that are utilising the Red2Green methodology, we first needed to capture the data. A simple two-tab worksheet was designed for an analyst to populate with ward and patient information, and make available for staff on the included areas to update with a patients Red or Green status, along with a reason.

A blank template (Appendix A) was designed on the first tab, as below:

For clarity, the fields are: NHS Number (to identify patients across platforms, if needed) Patient Name (to identify patients on the ward) Age at Admit (patients age at point of admission) Bed Number (to differentiate between patients of the same name, also to sort by walking order) Current Ward (to facilitate staff in quickly identifying their own patient list) Current LoS (to monitor length of the patient’s whole spell to date in hospital) Day Colour (all default to Red on report creation) Delay Reason (a pre-determined list of ~35 items to cover all delay categories) Gender (additional patient information) Admit Date (to allow the calculation of current length of stay) MFFD? Y/N (to demonstrate which patients are Medically Fit for Discharge each day) MFFD Date (for those that are medically fit, what date were they declared MFFD, or “Not MFFD”) Patient Area (CCG) (to identify patients from our local CCG against “Out of Area” patients) Further Comments (to clarify if a delay reason is too broad in a specific situation)

An SQL script (Appendix B) extracts data for the above items (except for Delay Reason and Further Comments). The script is run each morning between 8am and 8:30am each morning, and the script queries the database as at midnight the previous night to see which patients were still admitted overnight. This patient list, and the accompanying data items listed above, form the basis of the Red2Green report for that day.

Towards the end of the day, the completed data is finalised to correct any data gaps or errors. A completed dataset (with patient identifiable data removed) looks like the below:

NHS Number Patient NameAge at Admit

Bed Number

Current Ward Current LoSDay

ColourDelay Reason Gender Admit Date MFFD? Y/N MFFD Date Patient Area (CCG) Further Comments

NHS NumberPatient Name

Age at Admit

Bed Number

Gender Admit Date MFFD? Y/N MFFD DatePatient Area

(CCG)Current

WardCurrent

LoSDay

ColourDelay Reason Further Comments

AAA AAA AAAA Patient A 69 Bed 1 Male 01/02/2017 13:42 Yes 01/03/2017 14:00 Dudley C1 42 Red R23 - Waiting for Care In Own HomeBBB BBB BBBB Patient B 50 Bed 2 Male 11/03/2017 05:13 No Not MFFD Dudley C1 4 Red R10 - Waiting For Blood Results - Required Whilst InpatientCCC CCC CCCC Patient C 74 Bed 3 Female 08/03/2017 13:05 No Not MFFD Sandwell C1 7 Green Not Delayed DayDDD DDD DDDD Patient D 66 Bed 4 Female 11/02/2017 23:31 Yes 21/02/2017 09:26 Dudley C1 32 Red R5 - Discharge Planned for TomorrowEEE EEE EEEE Patient E 67 Bed 5 Female 28/02/2017 22:13 No Not MFFD Dudley C1 15 Red R3 - No Clear Plan of Clinical Care and/or What is Needed for DischargeFFF FFF FFFF Patient F 21 Bed 6 Male 12/03/2017 23:56 No Not MFFD Sandwell C1 3 Red R6 - TTO's Not Written UpGGG GGG GGGG Patient G 73 Bed 7 Male 22/12/2016 17:52 Yes 13/03/2017 22:00 Sandwell C1 83 Red R29 - Waiting for Equipment/AdaptationsHHH HHH HHHH Patient H 80 Bed 8 Female 14/03/2017 13:58 No Not MFFD Seisdon&Staffs C1 1 Red R32 - Waiting for Clinical ProcedureIII III IIII Patient I 73 SR1 Male 11/03/2017 12:20 No Not MFFD Dudley C1 4 Green Not Delayed DayJJJ JJJ JJJJ Patient J 82 SR2 Male 28/02/2017 16:18 No Not MFFD Sandwell C1 15 Red R31 - Waiting for Endoscopy

On the second tab, a dashboard has been developed (Appendix C). This dashboard is comprised of three indicators that can be filtered down to a ward level:

Pie Chart showing percentage split of Red, Green, and where data has been unavailable for inclusion, Black Column Chart showing the total number of Red days per ward Table and Column Chart showing the total number of each of the pre-determined Delay Reasons

The dashboards are a set of pivot tables and pivot charts based on the data collected earlier by the ward staff. Pivot tables and charts will not automatically update when new data is added, and people not familiar with pivoting data may not be comfortable with the process of updating tables manually, so a button was coded and added to the top of the data collection worksheet. Once the data is collected and inputted, a user only needs to click this button, and a coded macro module (Appendix D) will automatically run the process for updating all tables and charts.

Once a week, all of the daily sheets are combined into one master version, and from this, we produce a 14-Day Pathway ‘at a glance’ for all patients, highlighting their status each day (Appendix E). This is done by coding a reference key field against each record in the master sheet, and running a VLOOKUP formula to pull each patients Red, Green or Black status for each day. These daily status’ are colour coded for ease of viewing, and a status is also added against each patient to say whether they are currently still admitted, or have been discharged.

Please Note: This Pathway At A Glance is currently in the process of being automated, so that end users will be able to perform all the above actions for themselves. This development is expected to take approximately two weeks.

Current Ward (All) Current Ward (All)

Day Colour Day Count Delay Reason Reason CountGreen 79 Data Not Collected 66Red 126 R3 - No Clear Plan of Clinical Care and/or What is Needed for Discharge 17Black 66 R21 - Waiting for Care Package - Residential Home 10Grand Total 271 R14 - Waiting for Review by Other Speciality 9

R6 - TTO's Not Written Up 5R4 - Waiting for Occupational Therapy/Physiotherapy input, ADL to be completed or needs Therapy Approval for Discharge 4R20 - Waiting for Patient/Family Choice 4Grand Total 115

Day Colour Red

Ward Red DaysC7 14C8 12A3 14B6 18C1 40C3 28Grand Total 126

Green29%

Red47%

Black24%

Day Colour

66

1710 9 5 4 4

0

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70

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Appendix A

NHS Number Patient NameAge at Admit

Bed Number

Current Ward

Current LoS

Day Colour

Delay Reason Gender Admit DateMFFD?

Y/NMFFD Date Patient Area (CCG) Further Comments

*Please only enter the information in the columns with BLUE headers (Day Colour, Delay Reason).**All Patients begin the day as Red - please update to Green where necessary.

***For Green Patients, Select 'Not Delayed Day'; For Red Patients, Select Appropriate Delay Reason from List of 30 OptionsClick Here to Update Your

Appendix B

Use Oasis_ImportSelect Distinct PI.ID_Number as 'NHS Number',

PM.Pat_Name_1 + ' ' + PM.Pat_Name_Family as 'Patient Name',DateDiff(YY, PM.Date_Of_Birth, PA.Admit_Date) as 'Age at Admit','Bed' + ' ' + BD.Bed_Location as 'Bed Number',Case When WED.Description like '%A3%' Then 'A3'When WED.Description like '%B6%' Then 'B6'When WED.Description like '%C1%' Then 'C1'When WED.Description like '%C3%' Then 'C3'When WED.Description like '%C4%' Then 'C4'When WED.Description like '%C5%' Then 'C5'When WED.Description like '%C7%' Then 'C7'When WED.Description like '%C8%' Then 'C8' When WED.Description like '%B2%' Then 'B2' When WED.Description like '%C6%' Then 'C6' When WED.Description like '%B3%' Then 'B3' When WED.Description like '%A2%' Then 'A2' When WED.Description like '%P%CCU%' Then 'Post CCU' Else '' End as 'Current Ward',DateDiff(DD, PA.Admit_Date, GetDate()) as 'Current LoS','Red' as 'Day Colour','' as 'Delay Reason',Case When PM.Sex = 'M' Then 'Male' Else 'Female' End as 'Gender',PA.Admit_Date as 'Admit Date',Case When PA.Clinical_Discharge_Date Is Null Then 'No' Else 'Yes' End as 'MFFD? Y/N',Case When PA.Clinical_Discharge_Date Is Null Then '' Else PA.Clinical_Discharge_Date End as 'MFFD Date',Case When C.Description like '%Dudley%' Then 'Dudley'When C.Description like '%Wolverhampton%' Then 'Wolves'When C.Description like '%Walsall%' Then 'Walsall'When C.Description like '%Sandwell%West Birm%' Then 'Sandwell'When C.Description like '%Cross%' Then 'Birm CC'When C.Description like '%Bromsgrove%' Then 'Redd&Broms'When C.Description like '%Wyre Forest%' Then 'Wyre Forest'When C.Description like '%Seisdon%' Then 'Seisdon&Staffs'When C.Description like '%Birmingham South%' Then 'Birm S&C'When C.Description like '%Shropshire%' Then 'Shropshire' Else 'Other CCG' End as 'Patient Area (CCG)','' as 'Further Comments'

From Patient_Ad PAJoin Patient_IDs PI on PA.Patient_ID = PI.Patient_ID and PI.ID_Type_Code = 56970Join Patient_Master PM on PA.Patient_ID = PM.Patient_IDJoin Bed_Details BD on PA.Admission_No = BD.Admission_No and BD.Current_Record = 'Y'Join Patient_Care_Episodes PCE on BD.Care_Episode_ID = PCE.Care_Episode_IDJoin Work_Entity_Data WED on BD.Work_Entity = WED.Work_EntityJoin GP_Practice_Master GP on PM.Practice_ID = GP.Practice_IDJoin Codes C on GP.PCG_Code = C.CodeWhere PA.Physical_Discharge_Date Is NullAnd PA.Admit_Type = 'I'And (WED.Description like '%A3%'Or WED.Description like '%B6%'Or WED.Description like '%C1%'Or WED.Description like '%C3%'Or WED.Description like '%C4%'Or WED.Description like '%C5%'Or WED.Description like '%C7%'Or WED.Description like '%C8%'Or WED.Description like '%B2%'Or WED.Description like '%C6%'Or WED.Description like '%B3%'Or WED.Description like '%A2%'Or WED.Description like '%P%CCU%')Order By Case When WED.Description like '%A3%' Then 'A3'

When WED.Description like '%B6%' Then 'B6'When WED.Description like '%C1%' Then 'C1'When WED.Description like '%C3%' Then 'C3'When WED.Description like '%C4%' Then 'C4'When WED.Description like '%C5%' Then 'C5'When WED.Description like '%C7%' Then 'C7'When WED.Description like '%C8%' Then 'C8' When WED.Description like '%B2%' Then 'B2' When WED.Description like '%C6%' Then 'C6' When WED.Description like '%B3%' Then 'B3' When WED.Description like '%A2%' Then 'A2' When WED.Description like '%P%CCU%' Then 'Post CCU' Else '' End,PM.Pat_Name_1 + ' ' + PM.Pat_Name_Family Asc

Appendix C

Appendix D

Appendix E

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Filter Filter Filter Filter Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon1111111111 A Bloggs B6 5 Discharged Red1111111112 B Bloggs B6 4 Discharged Black Black Black1111111113 C Bloggs B6 4 Discharged Black Black Black1111111114 D Bloggs B6 3 Discharged Green Green Black1111111115 E Bloggs C1 91 Discharged Red Red Black Red Red Red Red Red Red Black1111111116 F Bloggs C1 71 Discharged Green Red Black Green Green Green Green Green Red1111111117 G Bloggs C1 61 Still Admitted Green Red Black Green Red Red Red Red Red Black Black Red Red Red1111111118 H Bloggs C1 55 Still Admitted Red Red Black Red Red Red Red Red Red Black Black Red Red Red1111111119 I Bloggs C1 51 Still Admitted Red Red Black Green Green1111111120 J Bloggs C1 44 Still Admitted Red Red Black Red Red Red Red Red Red Black Black Red Red Red1111111121 K Bloggs C1 35 Still Admitted Red Red Black Green Red Red Red Red Red Black Black Red Red Red1111111122 L Bloggs C1 32 Discharged Red Red1111111123 M Bloggs C1 32 Discharged Red Red Black Red Red Red Red Red Red Black Black1111111124 N Bloggs C1 29 Discharged Red Red Black Red1111111125 O Bloggs C1 28 Still Admitted Red Red Black Green Red Red Red Red Green Black Black Red Red Red1111111126 P Bloggs C1 27 Still Admitted Red Red Black Red Red Red Red Red Red Black Black Red Red Red1111111127 Q Bloggs C1 26 Discharged Red Red Black Green Red Red Red Red1111111128 R Bloggs C1 24 Discharged Red Red Black Red Red Red Red Red Red Black Black1111111129 S Bloggs C1 24 Still Admitted Green Green Black Red Red Red Red Red Red Black Black Green Green Green1111111130 T Bloggs C1 24 Still Admitted Red Red Black Red Red Red Red Red Red Black Black Red Red Red1111111131 U Bloggs C1 23 Discharged Red Red Black Black1111111132 V Bloggs C1 23 Still Admitted Black Black Black Black Red Red Red1111111133 W Bloggs C1 22 Still Admitted Green Red Black Green Red Red Red Red Red Black Black Green Green Green1111111134 X Bloggs C1 20 Discharged Green Green Black Green Red Red Red Red Red Black Black1111111135 Y Bloggs C1 19 Still Admitted Green Green Black Red Red Red Red Red Red Black Black Red Red Red1111111136 Z Bloggs C1 19 Discharged Red Red1111111137 A Doe C1 17 Still Admitted Red Green Black Black Red Red Red1111111138 B Doe C1 17 Still Admitted Red Red Black Green Red Red Red Red Red Black Black Red Red Red1111111139 C Doe C1 17 Still Admitted Red Green Black Green Green Green Green Green Green Black Black Red Red Red1111111140 D Doe C1 17 Discharged Green Red Black Red Green Green Green Green1111111141 E Doe C1 17 Still Admitted Green Red Black Black Green Green Green1111111142 F Doe C1 16 Discharged Green Green Black Green Red Red Red Red1111111143 G Doe C1 16 Still Admitted Green Green Black Green Red Red Red Red Red Black Black Red Red Red1111111144 H Doe C1 16 Discharged Red Red Black Red Red Red Red Red Red Black Black1111111145 I Doe C1 15 Discharged Green Red Red Red Red Red Black1111111146 J Doe C1 15 Discharged Red Red Black Red1111111147 K Doe C1 14 Still Admitted Green Black Green Red Red Red Red Red Black Black Red Red Red

14 Day Pathway At A Glance

NHS Number Patient Name Current Ward Current LoS Patient Status 7 Day Review Comments