{"id":719,"date":"2013-01-25T09:06:57","date_gmt":"2013-01-25T09:06:57","guid":{"rendered":"http:\/\/helpmeinvestigate.com\/health\/?p=719"},"modified":"2021-10-22T07:03:44","modified_gmt":"2021-10-22T07:03:44","slug":"recipe-whats-the-worst-time-to-go-to-ae","status":"publish","type":"post","link":"http:\/\/helpmeinvestigate.com\/health\/2013\/01\/25\/recipe-whats-the-worst-time-to-go-to-ae\/","title":{"rendered":"Recipe: what&#8217;s the worst time to go to A&#038;E?"},"content":{"rendered":"<p>Today we <a href=\"http:\/\/www.birminghammail.co.uk\/news\/local-news\/a--e-waiting-times-at-birmingham-1240594\">publish the first results of a collaboration with the Birmingham Mail<\/a>: when&#8217;s the worst time to go to A&amp;E in the West Midlands? (It&#8217;s 1am, by the way). \u00a0Or, to give it its print headline: &#8220;A&amp;E delays worst in the early hours&#8221;.<\/p>\n<p>The story could be repeated in any region. Here&#8217;s how you can do it yourself:<!--more--><\/p>\n<h2>1. Get the data<\/h2>\n<p>The most recent data for waiting times by hour, for 2010\/11, are published on\u00a0<a href=\"http:\/\/www.hesonline.nhs.uk\/Ease\/servlet\/ContentServer?siteID=1937&amp;categoryID=1834\">the Hospital Episode Statistics site, HESonline<\/a>. There is more recent data available on waiting times as a whole (the Department of Health publishes\u00a0<a href=\"http:\/\/www.dh.gov.uk\/en\/Publicationsandstatistics\/Statistics\/Performancedataandstatistics\/AccidentandEmergency\/DH_079085\">quarterly data<\/a>), but not broken down by hour. Put this to one side for more up to date context.<\/p>\n<p>Find the sheet in the HESonline data that breaks down waiting times by hour of arrival by hospital trust (it&#8217;s the 12th sheet, &#8216;Table 10&#8217;). Note that these are <em>average<\/em> waiting times: some people will spend less time, and some will wait longer. (<em>Table 7 actually breaks down patients by duration, but not by hour as well<\/em>).<\/p>\n<p>You may want to copy this sheet into a new spreadsheet, as spreadsheet operations should work more quickly. <strong>Always keep a copy of the raw, untouched data<\/strong> to refer back to.<\/p>\n<h2>2. Clean the data<\/h2>\n<p>To start to ask questions of this data, you&#8217;ll need to <strong>strip out extra rows and columns<\/strong> that aren&#8217;t needed. Like many health datasets, for example, this one has 8 rows of blurb and an image that you can just delete. The headers are also split between rows 9 and 10, but that&#8217;s not going to be a problem for us.<\/p>\n<p>For simplicity you might also want to strip out rows from other regions. Each region&#8217;s hospital trusts starts with a bold row for the strategic health authority (SHA) figures. Copy the section for those hospital trusts and paste into a new sheet.<\/p>\n<h2>3. Ask the questions with formulae<\/h2>\n<p>I always <strong>break down the process of getting an answer to my questions<\/strong>, which makes it quicker and easier to solve. Here, for example, our question is &#8216;Which is the worst hour to go to A&amp;E?&#8217; More specifically, we want to know this for each hospital, and probably the best hour too. How do we answer that question?<\/p>\n<ol>\n<li>Which is the largest number (waiting time) in each hospital trust&#8217;s row?<\/li>\n<li>What hour does that number relate to?<\/li>\n<\/ol>\n<p>To answer 1. you can use the MAX function in Excel or Google Docs. This tells you what is the highest value in a range of cells that you specify, like so: = MAX(C2:X2)<\/p>\n<p>Answering 2. is a little more difficult, and involves two functions: MATCH tells us where a value is (in this case, that highest value) and INDIRECT brings back the contents of a cell (in this case, the header).<\/p>\n<p>I&#8217;ve <a href=\"http:\/\/excelnotes.posterous.com\/the-longest-hour-finding-worst-waiting-times-6749\">detailed the process in a separate post at sister blog ExcelNotes<\/a>. You can also <a href=\"https:\/\/docs.google.com\/spreadsheet\/pub?key=0ApTo6f5Yj1iJdERXa3E5NkFQMXVBM1diM2Z6dU1nN0E&amp;output=html\">see a spreadsheet where the various formulae have been used here<\/a>. This also includes some other formulae, such as one which uses COUNTIF to check that the maximum waiting time only occurs once, and another which converts the time from a decimal figure to hours and minutes (divide by 1440 and format the cells as time).<\/p>\n<p>You can adapt the process for maximum waiting times so that you see minimum waiting times, by replacing MAX with MIN.<\/p>\n<h2>4. Sort and analyse<\/h2>\n<p>Once you have the answers, you need to work out what the story is. There might be more than one to choose from: for example, topical issues like the <a href=\"http:\/\/blogs.channel4.com\/victoria-macdonald-on-health-and-social-care\/mid-staffordshire-scandal-day-of-reckoning-beckons\/682\">Mid Staffordshire report<\/a> might come into play (in this case, they had the worst waiting times across the region). There might be wide differences. Or there may be neighbouring hospitals where a patient could drive from one to another and still be seen sooner.<\/p>\n<p><strong>Choose one clear angle and go with that<\/strong> &#8211; it can be easy to bury your story in detail when you&#8217;re dealing with data. Don&#8217;t. Use the same editing skills you would with interviews: pick the most newsworthy, interesting angle and start with that. Keep it simple: you can always add further details in the background further down the article.<\/p>\n<p><strong>Speak to people<\/strong>. Call the hospital trusts that feature most strongly in the piece and ask if they can explain why the figures say what they say.\u00a0Quotes make a big difference to a piece, but also you might find there are details missing from the data (although if they question the data entirely don&#8217;t take them on their word: talk to other authorities such as the body that collected the statistics, as well as\u00a0patient groups and health workers&#8217; unions).<\/p>\n<p><strong>Explain potential limitations of the data<\/strong>. Make it clear that the data has limitations: for example, in this case, although it&#8217;s the most up to date data, it&#8217;s not very recent. In addition, it&#8217;s known that certain practices are used to manipulate what is counted in the data: for example, patients might be held on an ambulance (&#8216;stacking&#8217;) or moved out of A&amp;E while they&#8217;re still waiting.<\/p>\n<p>And that&#8217;s it. If you do write up this as a story in your area, let us know so we can link to it.<\/p>\n<div class=\"tweetthis\" style=\"text-align:left;\"><p> <a target=\"_blank\" rel=\"nofollow\" class=\"tt\" href=\"http:\/\/twitter.com\/intent\/tweet?text=Recipe%3A+what%E2%80%99s+the+worst+time+to+go+to+A%26E%3F+http%3A%2F%2Fhelpmeinvestigate.com%2Fhealth%2F%3Fp%3D719\" title=\"Post to Twitter\"><img class=\"nothumb\" src=\"http:\/\/helpmeinvestigate.com\/health\/wp-content\/plugins\/tweet-this\/icons\/en\/twitter\/tt-twitter.png\" alt=\"Post to Twitter\" \/><\/a> <a target=\"_blank\" rel=\"nofollow\" class=\"tt\" href=\"http:\/\/twitter.com\/intent\/tweet?text=Recipe%3A+what%E2%80%99s+the+worst+time+to+go+to+A%26E%3F+http%3A%2F%2Fhelpmeinvestigate.com%2Fhealth%2F%3Fp%3D719\" title=\"Post to Twitter\">Tweet This Post<\/a><\/p><\/div>","protected":false},"excerpt":{"rendered":"<p>Today we publish the first results of a collaboration with the Birmingham Mail: when&#8217;s the worst time to go to A&amp;E in the West Midlands? (It&#8217;s 1am, by the way). \u00a0Or, to give it its print headline: &#8220;A&amp;E delays worst &hellip; <a href=\"http:\/\/helpmeinvestigate.com\/health\/2013\/01\/25\/recipe-whats-the-worst-time-to-go-to-ae\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6,13],"tags":[349,367,58],"_links":{"self":[{"href":"http:\/\/helpmeinvestigate.com\/health\/wp-json\/wp\/v2\/posts\/719"}],"collection":[{"href":"http:\/\/helpmeinvestigate.com\/health\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/helpmeinvestigate.com\/health\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/helpmeinvestigate.com\/health\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/helpmeinvestigate.com\/health\/wp-json\/wp\/v2\/comments?post=719"}],"version-history":[{"count":6,"href":"http:\/\/helpmeinvestigate.com\/health\/wp-json\/wp\/v2\/posts\/719\/revisions"}],"predecessor-version":[{"id":938,"href":"http:\/\/helpmeinvestigate.com\/health\/wp-json\/wp\/v2\/posts\/719\/revisions\/938"}],"wp:attachment":[{"href":"http:\/\/helpmeinvestigate.com\/health\/wp-json\/wp\/v2\/media?parent=719"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/helpmeinvestigate.com\/health\/wp-json\/wp\/v2\/categories?post=719"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/helpmeinvestigate.com\/health\/wp-json\/wp\/v2\/tags?post=719"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}