The workload for all burn services is broken down into burn centre (BC), burn unit (BU) and burn facility (BF) level activity. Cases which fall below the burn facility level are termed sub-burn facility (sBF) and are reported separately. Acute injury activity can be separately reported to reconstruction or rehabilitation activity.
Using statistical process control (SPC) methods the almost random demand on burn services can be mapped over time and the onsequences of remodelling services understood in reliable detail. This technique now uses bespoke software developed by one of the industry partners, which enables the rapid analysis of large datasets and simultaneous multiple variable modelling.
Quality assurance is provided to healthcare commissioners by way of the NHS Quality Dashboard which is entirely driven by data from the iBID, in addition to ad hoc and specifically commissioned reports on a wide range of subject matters.
So as to improve the access to the central database by commissioners and burn service personnel, a web based iBID Information Service has been developed and was released in early 2017. This allows user defined reports to be generated directly from the near real-time central database of burn service activity.
The reporting of services that have inadequate data flows into the iBID as well as those that provide inadequately complete records is routinely reported.The identification of outlier services from clinical pathway and outcomes points of view
The identification of outlier services from clinical pathway and outcomes points of view is also routinely undertaken.
This also includes the ability to assess the impact of burn service periods of closure to combat outbreaks of multi-resistant bacterial infections.
One element of data quality assurance includes a report on the completeness of those data items necessary for the linkage of the iBID data with other healthcare datasets. This specifically includes the ability to link with HES or Secondary Users Service (SUS) data.
One of the last major sources of inequity between burn services is the differing levels of financial remuneration provided by commissioners for undertaking similar work. The continued use of local tariffs in
the absence of an agreed national tariff for burn care is the reason for this. Understanding how and why this happens is crucial to sustainable service provision and required the development of an evidence-based and objective means for comparing the true cost of burn care.
A significant development programme has evolved to provide a gold standard patient level costing (PLC) system embedded within the iBID analysis process. This now has immense utility and power in
understanding the consequences of different forms of service provision and the different pathways for patient groups as well as a means for comparing the utility of differing payment methods for burn care.
One consequence of the PLC development is the ability to develop a system of burn care remuneration based on iBID data and analysis. No other healthcare data source can provide the necessary detailed information to support this.
Patient level costing data from the iBID has demonstrated that even the most recent version of Health Resource Groups (HRG) does not adequately reflect the cost of burn care. As a consequence, the
development of a national tariff for burn care is likely to be a combination of using HRG and PLC methodologies.
This work also supports the NHS Improvement programme for introducing PLC across all NHS acute trusts by 2018/19.
The ability to comply with GS1 guidance is currently being designed into future releases of the iBID software.