NJR Clinician Feedback – a secure, surgeon-only website – benefited from several enhancements
In 14/15, a pre-formatted Consultant Level Report was implemented which summarises a consultant’s clinical practice. The report provides indicators of data quality, the number and type of procedures undertaken, revision rates, and funnel plots showing standardised revision ratios and standardised mortality ratios. The report was designed to assist surgeons in the processes of annual appraisal and re-validation and is similar to that provided in the Annual Clinical Report for Trusts and independent groups.
The report will be moved within the application from its current position to a ‘Reports’ tab. The ‘Reports’ tab will provide a single repository for the Consultant Level Report, the Annual Clinical Report for those hospitals in which the surgeons has practiced during the latest reporting period, and a consultant-level Price Benchmarking report. Important to note: this latter report will only be available if the surgeon’s organisation has subscribed to the new EMBED service.
An additional report was also implemented, enabling surgeons to access information about primaries that have been revised, including the reasons for revision and the time to revision. Importantly, revisions carried out at different centres or by different surgeons will be included, although the identity of the revising surgeon is withheld. This report is due to be extended in 2015/16 to a report which shows the current status of all primaries undertaken by a surgeon.
This ‘Primary Procedure Status Report’ will use three endpoints: ‘Still viable’, ‘Revised’, and ‘Patient deceased’. Users will be able to apply a number of filters to the data. The report replaces the current functionality within NJR ReportsOnline which requires a surgeon to download all procedure data but without inclusion of the current endpoint. This report will enable surgeons to more easily review the data held by the NJR about their own procedures and to assist in ongoing data checking and auditing activity.
Another enhancement to Clinician Feedback was an improvement to the functionality through which consultants can validate their data prior to its publication as part of the Consultants Outcome Publication. An initial copy of the data for publication is placed into Clinician Feedback and displayed exactly as it will be on the NJR Surgeon and Hospital Profile website. Surgeons have the opportunity to check their data using the website and correct it prior to the extract of data being taken later in the year and used for publication. Consultants can now either complete or edit a personal profile for inclusion on the website. Additionally, any consultant whose data would not automatically be included in the COP can opt in to have their data published. This includes consultants in Wales and Northern Ireland or those whose practice is entirely in the independent sector.
NJR Supplier Feedback – a secure, manufacturer-only website –was further enhanced and given new reporting features
NJR Supplier Feedback provides information about component use to device manufacturers and suppliers. It was originally provided as a free service to industry but, as part of the new economic model adopted by the NJR, became a subscription service. At the same time, the service was enhanced to provide a variety of information, based on different levels of subscription.
In addition to providing data about the use of implants in primary procedures, NJR Supplier Feedback enables suppliers to access data about the use of their own implants in primary, revision, and revision of revision procedures. Data about ankle, elbow and shoulder implant use is now available in addition to hip and knee implant use.
An Implant Quality Monitoring service is also available which provides pre-formatted reports on individual implants, including patient reported outcomes. Another part of the service is the provision of PROMs studies, capturing the patient report of outcome following surgery.
Any device supplier wishing to register for a subscription service or simply find out more about what the service provides should contact the NJR Service Desk.
NJR Management Feedback – a hospital-focused feedback system – continues to develop
NJR Management Feedback currently provides the Annual Clinical Report and Implant price-benchmarking reports. The reports provided will depend upon which of the services a Trust has subscribed to (either INFORM or EMBED).
The third publication of Annual Clinical Reports, for 2013/14, were originally published online in October 2014 and, due to an error, were re-published in January 2015. Following publication and feedback from stakeholders, a number of changes to the current content have been proposed which may be implemented in time for next year’s reports. The proposed changes include the following:
- An additional funnel plot for a standardised revision ratio using the last five years of data, rather than all the NJR data
- A new funnel plot for the standardised revision ratio but with withdrawn implants (e.g. the ASR) removed
- Dividing the hip metal-on-metal funnel plot into metal-on-metal and resurfacing
Next year, consideration will be given to making NJR Management Feedback an interactive service, similar to NJR Clinician Feedback, with more regular updates of the data and information currently provided in the Annual Clinical Report.