Southern Health: Informed analytics from the ward to the board

Southern Health NHS Foundation Trust is one of the U.K.’s largest community and mental health trusts, providing high quality services that improve the health, wellbeing, and independence of its patients. Inpatient and community services are currently provided across Hampshire, Oxfordshire, and Buckinghamshire.

Southern Health collects huge volumes of data on its services, ranging from data on patients with mental health and learning difficulties to data associated with children’s services such as health visitors and school nurses.

The challenge for Southern Health was less associated with collecting the data, and more with helping the 7,000 staff understand data and improve healthcare provision. Almost 90 percent of the trust’s services are delivered in 150 centers across the South of England or by staff visiting patients in the home. As data is recorded by staff out on the frontline, the trust needed a way to get the reporting data back to the staff in an easily understandable format for quick decision making.

Simon Beaumont, Head of Information at Southern Health NHS Foundation Trust explains the business intelligence strategy: “We believe that our staff can achieve sustained excellence if they are able to easily understand what the data is telling them, take ownership, and learn from business intelligence. It’s not using data in a pejorative manner to find fault. It is about using data for improvement.”

One fundamental barrier stood in the way of this vision: the organization's reporting tools. These consisted of a vast array of fragmented spreadsheets and inflexible Microsoft reporting services.

“Our team of 13 analysts used to produce reports on a monthly basis and push them out to staff,” says Beaumont. “The reports were often out of date by the time they reached the clinicians and other healthcare professionals. The data in them was hard to understand and they were rigid: individuals couldn’t interrogate the data very easily. It was all reactive when it needed to be proactive.”

Staff subscribe to reports, receiving a regular email with the Tableau dashboard. That insight is used to make strategic process change decisions that help shorten patient waiting times, enhance the patient experience, and improve outcomes.

Selecting Tableau: Ease of use, flexibility, and Concentra consulting services

Southern Health turned to Tableau and its healthcare analytics consultancy partner, Concentra to tackle the problem. The organization evaluated Tableau against other business intelligence tools, selecting Tableau based on its ease of use, flexibility, and the quality of the consulting provided by Concentra. The first reports were available within a few months of the decision, with Concentra providing the Southern Health team with expert, deep-dive knowledge transfer throughout the organization.

Dashboards that are easy to use and easy to navigate

Tableau Desktop and Tableau Server present the data—integrated from different clinical and corporate systems—in a series of analytical dashboards that are easy to use, easy to navigate, and easy to understand. The first reports were available within four months of choosing Tableau, and 30 reports are now live—with many more in the pipeline. For example, staff can now view waiting times for particular clinical conditions, or for patients on clinical pathways.

The visual analytics approach enables them to quickly understand aggregate metrics, like average waiting time, or click though to an individual patient’s situation. An initial glance at the data might show, for example, that a patient has been waiting longer than anticipated for an appointment. In this case, Tableau may reveal that the patient’s medical condition has changed, they have moved to a different pathway, or moved locations.

“Staff subscribe to reports like these, receiving a regular email with the Tableau dashboard. That insight is used to make strategic process change decisions that help shorten patient waiting times, enhance the patient experience, and improve outcomes,” says Beaumont.

Visual analytics is also helping to proactively alert staff to issues before they turn into problems. For example, when a patient is about to be discharged from hospital, Tableau alerts the necessary team about the planned discharge and the community care requirements.

With Tableau dashboards, Southern Health staff can better understand a patient's situation and enhance the overall patient experience.

Metric evidence of the success of Tableau

Increased engagement with data: Previously, the organization had no ability to subscribe to reports. Now, there are 1,157 registered Tableau Server users, with 469 visualizations subscribed to on a daily, weekly, or monthly basis, across users from the board to the ward. More than 600 visualizations are being viewed on a daily basis, in addition to the 469 subscribed visualizations.

Improved data access: Visualizations are now available to all registered Tableau users, previously these would have been shared manually via email to a small number of users. For example, daily operational reports were previously emailed to a pre-defined list of 25 individuals, these are now viewed on a daily basis by more than 100 individuals—an increase of 400%.

Increased timeliness of data: Manual reports used to be available only five days a week and were updated by 11 a.m. Now they are available seven days a week and are updated at 5 a.m. every morning. This ensures the latest data is automatically available to Southern Health. For example, emergency admissions for all patients within Hampshire are now visualized through Tableau, processing more than 130,000 unplanned clinical interactions with patients.

Efficiency saving: Previous manual processes are now automated through daily Tableau extracts and visualizations. For example one daily report now available through Tableau is saving 45 minutes per day. In total, it is estimated the Information Team is achieving efficiency savings exceeding five working days per calendar month, a figure that is increasing week on week as new functionality is released.

After 12 months of using Tableau, the Information Team is expected to achieve efficiency savings of over 15 working days per calendar month. Within 24 months, this figure is expected to increase to an efficiency saving of over 30 working days per calendar month. This efficiency savings is used to transform the role of analysts to support cultural improvements in the use of data across the organization and complete more ad hoc analysis to facilitate service improvement and redesign.

Improvements to data quality: Tableau has resulted in increased visibility of data and performance and as such has facilitated improvements to data quality across a number of key performance metrics. For example, one mental health metric has experienced an improvement in data quality of over 23% with performance and data quality being sustained at between 99% and 100% for the last eight weeks.

Informed analytics improve [staff] motivation, gives them energy, and focuses a great sense of ownership.

Teamwork and continuous improvement

Tableau is also helping to adapt the culture at Southern Health: one associated with self-improvement, teamwork, and continuous improvement. Where reports used to be shared monthly, now they are shared daily—leading to a greater degree of agility and transparency to inform quicker decision making.

The team developed a series of ‘Fabulous Friday’ reports that are an example of this. These reports spotlight teams who have performed exceptionally or exceeded a particular metric. “This informed analytics improves their motivation, gives them energy and focuses a great sense of ownership,” says Beaumont.

While demand for the Tableau reporting is intense, Beaumont and his team have been cautious to prioritize reporting where it can make the greatest difference to front-line service provision. In time, reports will be available across the spectrum of Southern Health, including HR, patient experience, and governance.

“Superb” services from Concentra

Beaumont says that Concentra has played a vital role in this success due to their skills and expertise. “Some partners might simply develop a bunch of reports and walk away. Not Concentra—they have been superb and we trust them implicitly,” explains Beaumont. “They have delivered excellent knowledge transfer, allowing our team of analysts to quickly become productive on Tableau visual analytics. Concentra understands our vision for business intelligence, our objectives and of course the complex requirements of healthcare data provision.”

Based on his satisfaction with Tableau, Beaumont has recently set up (with support from Concentra) the NHS Tableau User Group. He also chairs it. “Tableau has made a fundamental difference to the way Southern Health delivers services and has enhanced patient outcomes. We want to see other NHS trusts and healthcare providers reap similar benefits of Tableau informed analytics.”

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