Every hospital and facility has a local framework which supports the monitoring and analysis of clinical effectiveness, clinical incidents and clinical quality. We have an entrenched culture of reporting all untoward clinical and non-clinical incidents, and potential incidents. This data is entered onto the electronic reporting system, Sentinel, and each incident is investigated and action taken to prevent recurrence. The main sub-indicators of clinical effectiveness are:

• Adverse outcomes;
• Unplanned transfers out;
• Unplanned returns to theatre;
• Unplanned readmissions within 31 days; and
• Mortality.

Adverse outcomes

We have recorded a year-on-year reduction in the number of reported adverse outcome clinical incidents.

Adverse outcome clinical incidents

A training drive for incident reporting increased the number of non-adverse (near miss) reported incidents recorded. This has provided better data for hospitals to analyse trends and take action to address any issues identified that will lead to reduction in recurrence. This is helping to drive down the overall number of adverse incidents.

Medication errors

Medication errors – no adverse outcome

Hospital acquired infections

BMI hospitals report infection rates to the CQC and participate in the national Health Protection Agency infection surveillance projects. All staff attend mandatory training to ensure that the highest possible standards are maintained to minimise the risk of infection for all patients. GHG also participated in the national hand washing campaign with the use of light boxes to demonstrate effectiveness.

BMI rates for infections acquired in our hospitals is 0.6% of all admissions. This includes Surgical Site Infections (SSI), bacteraemias and catheter associated urine infections (September 2008 to August 2009). The UK National Audit Office reported NHS rates to be 8%. BMI has not had any MRSA bacteraemias acquired in any of our facilities in the last 12 months. The NHS rate is 0.79 per 10 000 bed days.

Clostridium difficile rates also remain very low with the average rate for all age groups at 0.09 per 1 000 bed days. The NHS rate is 0.52 per 1 000 bed days.

Return to theatre

All surgery carries a risk of complications and these may result in an unplanned return to theatre. We are pleased to report a reduction in the rate of unplanned returns to theatre which indicate that fewer complications occurred.

Unplanned return to theatre

Readmissions within 31 days

Unplanned readmissions are due to clinical complications relating to the original surgery. Again, we are pleased to report a decrease of around 40% between the periods 2007 and 2009.