Rotamap

Cross-department Benchmarking Data

April 2022

In this article:

• Analysis of departmental performance over the last two years
• The benchmarks

Analysis of departmental performance over the last two years

Rotamap provides twice-yearly benchmarks for our client hospital organisations. At our Spring 2022 forum, we used this benchmark data to look at how COVID-19 has affected departmental service delivery over the last two years. We examined the data from several departments in a large UK hospital Trust and used their data to illustrate some of the trends we have also seen in other departments. The narratives supporting our analysis of these example departments came from departments themselves so we were able to represent their first hand experiences which many other departments may find interesting and relatable.

We have included some of the analysis from our event talk below.

All UK CLWRota departments

Figure 1. Stacking graph showing the average composition of work achieved (above) and leave taken (below) by CLWRota departments in the UK

The above graph displays the average delivery of all UK CLWRota departments from November 2019 to March 2022. Here we have graphed the average number of sessions per week delivered by CLWRota departments from before the pandemic to March 2022. The amount of work done is represented by the area below the lines down to the x-axis. Here, red is used to represent the amount of normal work. Solo usage is the difference between the red and yellow lines and extra usage is the area between the yellow and green lines. This shows how work was delivered.

Conversely, the amount of leave taken is represented by the area the above the lines up to the x-axis. Planned leave is represented in black. The difference between the black and grey lines is the amount of unplanned leave. Study leave is the difference between the grey line and the purple line. This allows us to visualise the different types of leave taken.

This graph shows some of the common patterns which we also see at a department level

• A dip in service delivery in March 2020 at the start of COVID, followed by a gradual increase in service delivery.
• A second dip in early 2021, due to COVID's second wave.
• Three similar dips. These fall on the week of Christmas and New Year and reflect the drop in service delivery due to bank holidays.
• On average the service delivery in UK anaesthetics departments has not fully recovered. At the start of 2020 (pre-pandemic) the average number of sessions delivered in a given week was around 230 compared to 210-220 sessions in February 2022.

Example CLWRota department

Figure 2. Sessions delivered by example CLWRota department

In March 2020, as a result of COVID-19, this department cancelled most of their work. They switched to a much more flexible service delivery model, templating staff on an ad hoc basis to a limited number of locations. They also cancelled all leave and we can see this reflected in the graph with planned leave (black line) dropping to zero between May and June 2020.

The department did not get back to normal elective work until May 2021. However, their service delivery was still adversely affected by the presence and treatment of COVID which resulted in procedure cancellations due to isolation requirements. In addition to these factors, service delivery was reduced by the second COVID wave.

Interestingly this department is delivering more sessions than pre-COVID which deviates from the typical trend of the average CLWRota department in the UK. Additionally, we can see a noticeable drop in extra work and trainee-led solo work. This was a result of increased staffing and new post-COVID job plans.

Lastly, unplanned leave (light grey line) continues to be a problem around new waves, especially as a result of the stricter isolation guidelines which were in force towards the end of the reporting period. The effect of isolation is visible during the second wave of COVID in early 2021 and also towards the end of March 2022 where we can see that unplanned leave is on the rise.

Example Medirota department

During the presentation we discussed three Medirota departments. This article will highlight one; a dental department.

Below are two graphs.

Figure 3. Sessions delivered by example Medirota department

The top line graph shows how many sessions in absolute terms this department planned to deliver (grey line) versus how many they actually delivered (blue line).

For a large portion of the period the two lines are close together. This indicates the department achieved most of the work they had planned and sometimes more.

The bottom line graph plots achieved sessions as a fraction of planned sessions. If the department were to deliver 100% of their planned work then the line would sit at 1 on this graph. If they delivered 50% the line would sit at 0.5.

In April 2020, this dental department had a total shutdown. The missing data from March 2020 to August 2020 reflects that period of closure. Once they re-opened, trainees rotated out of their department and as a result, the department's planned sessions in August 2020 drop to a much lower level of service delivery than pre-COVID.

By January 2021, the department advised they were back to full capacity and operating as normal. However, interestingly, the number of delivered sessions is lower than pre-COVID by several sessions a week. This is largely due to reduced staffing as the department was working with three fewer trainees. This reiterates the importance of accounting for staffing levels when looking at delivered sessions.

If you are interested in analysing this type of data for your own department please see our reports guide for Medirota and CLWRota which will walk you through creating and analysing your data.

To see the full analysis of these example departments, please watch our event talk video below.

Watch Benchmarks and Service Reports talk

Benchmarks

Medirota and CLWRota Benchmarking

Rotamap provides twice-yearly benchmarks for our client hospital organisations. The Spring 2022 editions have now been sent out to our client departments covering the period of 20th February 2021 to 30th March 2022. These packs allow departments using our services to examine their service delivery.

In addition to sending out these packs to our clients we also review them at our Autumn and Spring events where we discuss interesting questions and themes that have emerged from operational data.

Benchmark Boxplots

Boxplots allow us to compare all departments on their week-to-week distribution of a given metric. Each box represents one department and aggregates up to 52 points of weekly data, showing outlier weeks as dots above or below the box.

Benchmarks

The benchmarking data for this set of benchmarks is below. The date range for this data was from 20th February 2021 to 30th March 2022.

Medirota

Since Medirota is used by teams across many different specialties, we split departments into three groups: Surgical, Medical and Other. For these specialties we show the proportion of sessions that are covered as extra, as well as those that are cancelled.

Questions

If you have any questions about your pack or about the data above, please contact the Rotamap support team at support@rotamap.net or +44 (0) 20 7631 1555.