The British Association of Cardiac Rehabilitation, the British Heart Foundation, the Healthcare Commission, the Central Cardiac Audit Dataset project, the Royal College of Physicians, the DOH Heart Team, the CHD Collaborative, clinicians and patients have worked together to develop a National Audit of Cardiac Rehabilitation Project.
What is it?
The audit consists of 2 parts – a Minimum Dataset and a special computer database
The Minimum Dataset consists of a set of questionnaires and information collected about each patient. It collects: all of the NSF data, the most relevant medical data, lifestyle data and psychological data (anxiety, depression, quality of life). It also collects ‘process data’ what the patient had as part of their programme, in this way we will be able to see how the best results are achieved. You can see all of the information that is collected by downloading this MDS Proforma. The patients complete most of the information themselves. It has been running for a year in a set of pilot sites and been found to be easy to collect and enter into the database. If you’d like to know more about how it was developed you can download this Pdf file. It has been improved yet further during the pilot study. The most up-to-date versions of everything are available from the download centre below, or by contacting the project administrator Corrinna Petre.
The Database is a specially written programme that collects the data and can also help you run your programme. It is linked to the computers at CCAD and the data automatically goes up to that system. You can see your performance (no one else can) compared to the other CR programmes in the country in real time online. The version on your desk or laptop PC also has the following features
- easy to use – most people can enter a patients data in a couple of minutes
- easy to find patients and track them through the ‘phases’ of rehab
- can link different workers in different locations over the internet or NHS net (this feature coming)
- can write letters about and to patients (this feature coming)
- new and improved versions updated to your computer overnight
- same system as MINAP which is installed in every acute trust in the UK
- simple 'report buttons' you can press to print out a variety of summaries
- simple search facilities to look for groups of patients
- the ability to output all or some of your data to excel or other programme for local reports
This programme will be improved by you, if you join the user group, over the next few years. It is free for you to use (one licence per programme, further licences around £90 each). You can also use any other programme as long as it collects the MDS and a number of existing ones do. You will have to get someone to write a ‘patch’ to get your data out of your programme and into the special CCAD one so that it can be uplifted.
Why should we audit CR?
- Because we have to, it is a requirement of the NSF-CHD and of the DoH that clinicians audit their results
- Because we need to demonstrate what we achieve and to have the evidence to demand better resources. We know that many of the people who should be getting CR do not have a service due to resource shortages. We know that some centres are properly staffed but most are not. The Audit will map these shortages across the UK, showing where resources are needed making a case that no-one can ignore.
- Because we want to improve our services. The Audit will show you how well you are doing compared to other programmes and it will suggest where you need more resources. In the longer term it will help us all by showing which practices are most important.
- Because we need to be included in the description of the patient journey – have a look below at how all of the other groups of clinicians dealing with cardiac patients are working with CCAD to describe and map the patient journey. If CR is left out it is an admission that what we do is not as important as other treatments, we know that it is more important.
What is CCAD?
At present CCAD (Central Cardiac Audit Project) currently covers six clinical "domains" These are:
MINAP | Myocardial infarction National Audit Project (all patients admitted to UK hospitals with a suspected or actual heart attack). Version number has been changed to 5, dataset is unchanged from version 3. |
BCIS | British Cardiac Intervention Society (all patients in UK hospitals undergoing coronary angioplasty) |
NPDB/ICD | National Pacing/Implantable Cardiac Defibrillators DataBase (all patients in UK/Eire hospitals receiving implanted pacemakers/Implantable Cardiac Defibrillators) |
PAEDS | Paediatrics (all children in UK hospitals undergoing surgery or catheter based intervention for heart disease) |
SCTS | Society of CardioThoracic Surgeons (all adults in UK hospitals undergoing cardiac surgery) |
EPS | Cardiac Ablation procedures (all patients in the UK receiving ablation treatment for arrhythmias) |
A Data Set for each clinical domain is collected when a patient undergoes an event or procedure. The data sets are defined by the projects or professional groups listed above. Data may be entered directly using the CCAD supplied tools or imported from 3rd party software using scripts in the CCAD databases. (Taken from WWW.CCAD.org.uk)
The potential benefits of being in the CCAD 'club' go far beyond simple acknowledgement that we are an important part of the patients treatment. It will be possible to link to data such as national mortality databases so you will be able to see if your patient is still alive at any time. Eventually it may be possible for all of the medical data about the MI or surgery to be automatically ‘filled in’ on your database. We will be able to see exactly where patients are not getting rehab are being treated. The dream is that one-day the whole patient journey will be available on-line.
Who is supporting it?
All of the organisations listed at the top of this page have endorsed this project. It is being paid for by the British Heart Foundation.
How can I find out more?
If you would like further information please contact me, Corinna Petre: email cbp1@york.ac.uk (0)1904 321336.
|
