Mapping 4-hour A&E Targets

Tactix4 Performance Map

Tactix4 Map

I was recently rummaging around the internet when I came across a very cool map put together by healthcare software developers Tactix4. The map showed how hospitals were faring on their 4-hour Accident & Emergency targets by placing red, amber or green pins on an interactive map. (Acute Trusts release this information once a week.)

I dropped them an email saying that interactive maps are really my absolutely most favourite thing, and asking whether they could make this map a little more useful for LINks by showing a little bit of historical data on the map as well, so that we could compare the last week’s performance against previous weeks.  A lovely man called Dave Green replied and said he would give it a go! Dave is obviously the sort of chap who can’t quite resist fiddling with a good idea until he has cracked it, and two days later he’d produced the maps. And if there’s anything I love more than an interactive map, it’s an interactive healthcare software developer.

Cool Map 1: A&E 4 Hour Waiting Target Performance >>

Click on your local acute trust and see how it performed in the last week against the A&E 4 Hour Waiting Target. You will also see a link to the relevant page on Patient Opinion.

Cool Map 2: A&E 4 Hour Waiting Target Improvement >>

This map shows how your local acute trust’s performance compares to the previous four weeks. Green means it’s improved since last week, amber means it’s stayed the same, and red means that it’s got worse (it still might be within the targets, but it’s declined from the previous week). Hover over your local acute trust with your mouse and you will see the last 4 weeks’ performance, listed with dates.

What are these 4-hour waiting targets?
One of the key performance indicators set by the Department of Health for NHS hospitals over the last ten years has been ‘the 4-hour Target’.  This meant that a target percent of patients (originally 100% but rapidly revised to 98%) attending an A&E department must be seen, treated, admitted or discharged in under four hours.

Last year, the Department of Health announced that the 4 hour A&E target was to be scrapped, along with other targets – and immediately reduced the target from 98% to 95%.

From April 2011 the 4-hour target will be replaced with eight new “clinical quality indicators”. These new indicators will include ‘patient experience’, ‘effectiveness of care’ and ‘patient safety’ (and I am desperately wondering how many doughnuts I would need to send Tactix4 to persuade them to map those for us too…).

What is an Acute Trust exactly?
The figures on these maps are figures from ‘Acute Trusts’. Hospitals are managed by acute trusts. Acute trusts are responsible for hospitals’ services, finances, strategy, development, etc. and employ the staff that work in the hospital.

Most acute trusts will be responsible for just one hospital, and sometimes ‘acute trust’ and ‘hospital’ are used more of less interchangeably. Acute Trusts are also sometimes called ‘Hospital Trusts’. You will probably know what happens in your local area. Bear in mind, though, that some acute trusts are regional or national centres for more specialised care – and others are attached to universities, training healthcare professionals. They can also provide services in the community, for example through health centres, clinics or in people’s homes.

There is an excellent article summarising all the different sorts of trusts in the NHS on the NHS Choices website.

What to do with this data:
Have a look at your local area and compare the performance of your local trust against the 4-hour target. If you are receiving issues from members of the public about a particular hospital, this might be another indicator that things need looking into a bit more.

For the future, this sort of interactive mapping has huge potential for patient choice. For example, if Local Healthwatches have responsibility for giving information that facilitates patient choice, then a patient might want access to this sort of information in order to decide which A&E department to attend. ‘Do you want to be seen quickly?’ – then chose the hospital which meets waiting time targets. ‘Do you want a hospital with a good reputation?’ – then chose the hospital which has good reports on Patient Opinion. Of course, these specific targets won’t exist for much longer, but this gives you an idea of how the data might be useful for patients wanting to exercise choice.

So, while the 4-hour target might be on the way out, these figures are still useful for giving us an idea of current performance, and they’re definitely a great way of showcasing how useful interactive maps can be. Big thanks to Tactix4!


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