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: NHS Number Patient Name Age at Bed Day Current Ward Current LoS Admit Number Colour For clarity, the fields are: NHS Number Patient Name Age at Admit Bed Number Current Ward Current LoS Day Colour Delay Reason Gender Admit Date MFFD? Y/N MFFD Date Patient Area (CCG) Further Comments Delay Reason Gender Admit Date MFFD? Y/N MFFD Date Patient Area (CCG) Further Comments (to identify patients across platforms, if needed) (to identify patients on the ward) (patients age at point of admission) (to differentiate between patients of the same name, also to sort by walking order) (to facilitate staff in quickly identifying their own patient list) (to monitor length of the patient’s whole spell to date in hospital) (all default to Red on report creation) (a pre-determined list of ~35 items to cover all delay categories) (additional patient information) (to allow the calculation of current length of stay) (to demonstrate which patients are Medically Fit for Discharge each day) (for those that are medically fit, what date were they declared MFFD, or “Not MFFD”) (to identify patients from our local CCG against “Out of Area” patients) (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 AAA AAA AAAA BBB BBB BBBB CCC CCC CCCC DDD DDD DDDD EEE EEE EEEE FFF FFF FFFF GGG GGG GGGG HHH HHH HHHH III III IIII JJJ JJJ JJJJ Patient Name Patient A Patient B Patient C Patient D Patient E Patient F Patient G Patient H Patient I Patient J Age at Bed Admit Number 69 Bed 1 50 Bed 2 74 Bed 3 66 Bed 4 67 Bed 5 21 Bed 6 73 Bed 7 80 Bed 8 73 SR1 82 SR2 Gender Male Male Female Female Female Male Male Female Male Male Admit Date MFFD? Y/N 01/02/2017 13:42 Yes 11/03/2017 05:13 No 08/03/2017 13:05 No 11/02/2017 23:31 Yes 28/02/2017 22:13 No 12/03/2017 23:56 No 22/12/2016 17:52 Yes 14/03/2017 13:58 No 11/03/2017 12:20 No 28/02/2017 16:18 No Patient Area MFFD Date (CCG) 01/03/2017 14:00 Dudley Not MFFD Dudley Not MFFD Sandwell 21/02/2017 09:26 Dudley Not MFFD Dudley Not MFFD Sandwell 13/03/2017 22:00 Sandwell Not MFFD Seisdon&Staffs Not MFFD Dudley Not MFFD Sandwell Current Ward C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 Current Day LoS Colour 42 Red 4 Red 7 Green 32 Red 15 Red 3 Red 83 Red 1 Red 4 Green 15 Red Delay Reason R23 - Waiting for Care In Own Home R10 - Waiting For Blood Results - Required Whilst Inpatient Not Delayed Day R5 - Discharge Planned for Tomorrow R3 - No Clear Plan of Clinical Care and/or What is Needed for Discharge R6 - TTO's Not Written Up R29 - Waiting for Equipment/Adaptations R32 - Waiting for Clinical Procedure Not Delayed Day R31 - Waiting for Endoscopy Further Comments 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 Current Ward (All) Current Ward (All) Day Colour Green Red Black Grand Total Delay Reason Data Not Collected R3 - No Clear Plan of Clinical Care and/or What is Needed for Discharge R21 - Waiting for Care Package - Residential Home R14 - Waiting for Review by Other Speciality R6 - TTO's Not Written Up R4 - Waiting for Occupational Therapy/Physiotherapy input, ADL to be completed or needs Therapy Approval for Discharge R20 - Waiting for Patient/Family Choice Grand Total Reason Count 66 17 10 9 5 4 4 115 Day Count 79 126 66 271 Day Colour Black 24% Green 29% Delay Reasons 70 60 66 50 Red 47% 40 30 20 10 9 5 4 4 R14 - Waiting for Review by Other Speciality R6 - TTO's Not Written Up R4 - Waiting for Occupational Therapy/Physiotherapy input, ADL to be completed or needs Therapy Approval for Discharge R20 - Waiting for Patient/Family Choice 17 10 Red R21 - Waiting for Care Package - Residential Home Day Colour Red Days 14 12 14 18 40 28 126 45 40 40 35 30 25 28 R3 - No Clear Plan of Clinical Care and/or What is Needed for Discharge Ward C7 C8 A3 B6 C1 C3 Grand Total Data Not Collected 0 20 15 10 18 14 5 12 14 0 C7 C8 A3 B6 C1 C3 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. Appendix A NHS Number *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 Options Age at Bed Current Current Day Patient Name Delay Reason Admit Number Ward LoS Colour Click Here to Update Your Gender Admit Date MFFD? MFFD Date Y/N Patient Area (CCG) Further Comments Appendix B Use Select Distinct From Join Join Join Join Join Join Join Where And And Or Or Or Or Or Or Or Or Or Or Or Or Order By Oasis_Import 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' Patient_Ad PA Patient_IDs PI on PA.Patient_ID = PI.Patient_ID and PI.ID_Type_Code = 56970 Patient_Master PM on PA.Patient_ID = PM.Patient_ID Bed_Details BD on PA.Admission_No = BD.Admission_No and BD.Current_Record = 'Y' Patient_Care_Episodes PCE on BD.Care_Episode_ID = PCE.Care_Episode_ID Work_Entity_Data WED on BD.Work_Entity = WED.Work_Entity GP_Practice_Master GP on PM.Practice_ID = GP.Practice_ID Codes C on GP.PCG_Code = C.Code PA.Physical_Discharge_Date Is Null PA.Admit_Type = 'I' (WED.Description like '%A3%' WED.Description like '%B6%' WED.Description like '%C1%' WED.Description like '%C3%' WED.Description like '%C4%' WED.Description like '%C5%' WED.Description like '%C7%' WED.Description like '%C8%' WED.Description like '%B2%' WED.Description like '%C6%' WED.Description like '%B3%' WED.Description like '%A2%' WED.Description like '%P%CCU%') 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 Sun Mon Red Red Red Red Red Red Red Red Red Red Red Red Red Red Green Red Red Black Black Black Black Black Black Black Black Black Black Black Black Black Black Black Black Black Green Red Black Green Green Black Green Green Black Red Red Red Red Black Red Green Black Green Red Black Green Green Black Green Green Black Red Red Black Red Red Black Green Black 27/03/2017 Sat Red Green Green Red Red Red Red Red Red Red Red Red Red Red Green Red Red 26/03/2017 Fri Black Black 25/03/2017 Thu Black Black 24/03/2017 Wed Tue Red Wed Thu Fri Sat Sun Mon Red Green Red Red Green Red Green Red Red Green Red Red Red Red Black Black Black Black Black Black Red Red Red Red Red Red Red Red Red Red Red Red Black Black Black Black Red Red Red Red Red Red Green Red Red Red Red Red Red Red Black Black Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Green Black Red Black Black Black Red Red Red Red Red Red Red Red Red Black Black Black Black Black Black Green Green Green Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Red Black Black Black Black Black Black Black Black Red Red Red Green Green Green Red Red Red Green Black Red Black Green Black Black Black Black Red Red Red Red Red Red Red Red Red Red Black Black Green Green Green Red Red Red Black Black Black Black Black Red Red Red Red Black Black Red Red Red Red Green Green Red Green Red Green Red Green Red Red Red Green Red Red Red Red Red Red Green Red Green Red Red Red Black Black Green Green Red 21/03/2017 Tue Black Black 23/03/2017 Filter 20/03/2017 Filter 5 Discharged 4 Discharged 4 Discharged 3 Discharged 91 Discharged 71 Discharged 61 Still Admitted 55 Still Admitted 51 Still Admitted 44 Still Admitted 35 Still Admitted 32 Discharged 32 Discharged 29 Discharged 28 Still Admitted 27 Still Admitted 26 Discharged 24 Discharged 24 Still Admitted 24 Still Admitted 23 Discharged 23 Still Admitted 22 Still Admitted 20 Discharged 19 Still Admitted 19 Discharged 17 Still Admitted 17 Still Admitted 17 Still Admitted 17 Discharged 17 Still Admitted 16 Discharged 16 Still Admitted 16 Discharged 15 Discharged 15 Discharged 14 Still Admitted 19/03/2017 Filter 22/03/2017 B6 B6 B6 B6 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 C1 18/03/2017 Filter 1111111111 A Bloggs 1111111112 B Bloggs 1111111113 C Bloggs 1111111114 D Bloggs 1111111115 E Bloggs 1111111116 F Bloggs 1111111117 G Bloggs 1111111118 H Bloggs 1111111119 I Bloggs 1111111120 J Bloggs 1111111121 K Bloggs 1111111122 L Bloggs 1111111123 M Bloggs 1111111124 N Bloggs 1111111125 O Bloggs 1111111126 P Bloggs 1111111127 Q Bloggs 1111111128 R Bloggs 1111111129 S Bloggs 1111111130 T Bloggs 1111111131 U Bloggs 1111111132 V Bloggs 1111111133 W Bloggs 1111111134 X Bloggs 1111111135 Y Bloggs 1111111136 Z Bloggs 1111111137 A Doe 1111111138 B Doe 1111111139 C Doe 1111111140 D Doe 1111111141 E Doe 1111111142 F Doe 1111111143 G Doe 1111111144 H Doe 1111111145 I Doe 1111111146 J Doe 1111111147 K Doe 17/03/2017 Current Ward Current LoS Patient Status 7 Day Review Comments 16/03/2017 Patient Name 15/03/2017 NHS Number 14/03/2017 14 Day Pathway At A Glance Red Green Red Red Red Red Green Green Green Green Green Red Green Green Green Green Green Green Red Red Red Red Green Red Red Red Red Red Red Red Red Red Green Red Red Red Red Red Green Red Red Red Red
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