Quarterly Quality Report (QQR)

The QQR is the Case Mix Programme (CMP) unit report and is the main product of the CMP. The QQR provides cumulative comparative analysis of individual critical care unit data for local quality improvement initiatives.

Data are only analysed once they have passed a rigorous validation process to ensure they are of high quality.
 
Cumulative reports are run each quarter of the financial year (April-June/April-September/April-December/April-March).

QQR Webinar 

Professor David Harrison recently hosted a webinar explaining how to interpret a CMP QQR. The full video can be viewed here:

https://www.youtube.com/watch?v=beGKZqcrYPc 

 

Content

The QQR is focused on potential quality indicators and they are sequenced in order of the patients stay during the critical care unit. The quality indicators are summarised in a dashboard at the beginning of the report.

The quality indicators are then presented individually. Here the unit's value is displayed with predicted ranges, based on the expected value, and compared with similar units, along with a trend graph and a quarterly results table showing the unit’s result for each quarter. 
 
The quality indicators in the QQR are:
  • High-risk admissions from the ward
  • High-risk sepsis admissions from the ward 
  • Unit-acquired infections in blood
  • Out-of-hours discharges to the ward (not delayed)
  • Bed days of care post 8-hour delay
  • Bed days of care post 24-hour delay
  • Discharges direct to home
  • Non-clinical transfers to another unit
  • Unplanned readmissions within 48 hours
  • Risk-adjusted acute hospital mortality
  • Risk-adjusted acute hospital mortality – predicted risk <20%  
A key feature is the reporting of risk-adjusted acute hospital mortality. This takes the case mix of admissions into account to provide valid, accurate comparisons of outcomes between critical care units.
 
These analyses are produced for the ICNARCH-2018 model (the most accurate predictor of mortality for critical care admissions in the UK). Please see the related files for a summary of the model.
 
Along with the potential quality indicators the QQR also contains patient management information tables reporting on: 
  • Case Mix
  • Outcome
  • Admissions groups 
  • Infection 
  • Length of stay 
  • Organ monitoring and support
  • End-of-life care

Each unit will also receive a Data appendix spreadsheet along with their QQR containing all the relevant data for the period. The derived Data appendix can be used to drill further down into the data for local quality improvement purposes using the data sort tools in Microsoft Excel.  

Further analysis 

If you would you further analysis of your units data you can make a Local Quality Improvement request to our Statistics Team. See Access our data.

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