Date post: | 22-Jan-2018 |
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Healthcare |
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But What Do These Numbers Represent?!?
Quality Forum 2016
Outline
• Purposes of measurement in health care
• Sources of data and their characteristics
• Key questions to ask of any indicators
• Some examples of indicators
Source: Solberg LI, Moser G, McDonald S. (1997) The three faces of performance measurement: Improvement, Accountability and Research. Journal of Quality Improvement, 23(3).
Source: Solberg LI, Moser G, McDonald S. (1997) The three faces of performance measurement: Improvement, Accountability and Research. Journal of Quality Improvement, 23(3).
Source: Solberg LI, Moser G, McDonald S. (1997) The three faces of performance measurement: Improvement, Accountability and Research. Journal of Quality Improvement, 23(3).
Source: Solberg LI, Moser G, McDonald S. (1997) The three faces of performance measurement: Improvement, Accountability and Research. Journal of Quality Improvement, 23(3).
Measurement systems
• It is not ideal to use a measurement system for a purpose other than for which it was designed.
Measurement source examples
• Manual data collection on a local unit
• EMR extract about the patient panel of a clinic
• Discharge abstract database
• Patient questionnaires
Data Quality
1. Accuracy
2. Timeliness
3. Comparability
4. Usability
5. Relevance
Canadian Institute for Health Information, The CIHI Data Quality Framework, 2009 (Ottawa, Ont.: CIHI, 2009)
Considerations for decision makers
1. Accuracy
2. Timeliness
3. Comparability
4. Usability
5. Relevance
Canadian Institute for Health Information, The CIHI Data Quality Framework, 2009 (Ottawa, Ont.: CIHI, 2009)
Key questions
–How was this data collected?
–How is the indicator defined and calculated?
–How are we performing?
How was this data collected?
• Why was it collected?
• What is the source?
• What is missing?
• What are the sources of error?
How is the indicator defined and calculated?
• Inclusions and exclusions?
• Risk adjustment?
• Aggregation?
How are we performing?
• Are we getting better or worse?
• Is our performance acceptable?
• Is the performance stable?
• Do we have more or less variability?
Hip Fracture within 48 hours
• Data source: DAD
• Level of aggregation – HA
• Inclusion – 65+
• Calculation – within 48/total number of fractures
• Performance – 80ish percent
• Data source: DAD
• Level of aggregation – HA
• Exclusion – Newborn, obstetric, and mental health
• Calculation – Number of any of the events per 1000 discharge
• Performance – 25ish percent
Nurse sensitive adverse event rate