New v11 dataset for 2018
Following the annual review of the NHFD dataset by colleagues in both surgery and anaesthesia, working in collaboration with NHFD clinical leads, a new version 11 dataset (v11) has been determined and will apply to all new patients admitted from 1 January 2018.
New theatre data collection pro forma
Since the NHFD started data collection we have been looking for ways to make accurate data entry easier and this current review of the dataset will introduce a new NHFD data collection pro forma for use in operating theatres by theatre staff. The dataset items collected on this form are mostly unchanged from previous datasets, except:
a) Fracture type has been simplified - some options removed
b) Anaesthesia is now a 'tick all' with a new 'local anaesthetic' option added
c) Reasons for delay now include warfarin and DOAC reversal options
d) Operation performed - some uncemented/uncoated (Bipolar/THR) options removed
e) Staff seniority have a new 'staff grade/speciality doctor' options.
While in 85% of hospitals at least some of the data is collected by qualified medical and nursing staff, only 36% of hospitals currently capture theatre data in theatre, which may account for some of the casemix variation between hospitals. Poor data quality for the clinical indicators used in casemix adjustment may also exacerbate random fluctuations in mortality rates. This may cause a false positive mortality outlier alert to appear during our analysis of mortality data. Good data quality will allow NHS trusts to be much more confident that their data accurately reflects their performance.
The NHFD surgical pro forma should only be completed by theatre staff and prior to the patient leaving theatre. In future all hospitals should adopt the use of the surgical pro forma and hip fracture teams should familiarise themselves with the layout and the changes that will take effect from January 2018. (The theatre sheet pro forma is contained in section 4 of the main dataset pro forma and as a separate document).
Other dataset changes
> EQ5D - Units using EQ5D assessments can report EQ5D post surgery and at 120 day follow up (a new 'optional' tab on website - only available upon request).
> Reoperations - A new option added: 'Were any of the the above operations for infection?' and are now 'tick all that apply' options.
> V10A - Five fields that were marked 'optional' in V10A have been removed.
Full details of these changes and the dataset specification details are attached below.
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