Improving the Quality of Data in Your Database: Lessons from a Cardiovascular Center

Constance K. Haan M.D. (Senior Medical Director of System Outcomes and Effectiveness), Mark Adams B.S.H. (Cardiology Data Manager), Ray Cook R.N. (Cardiac Surgery Data Manager)
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引用次数: 8

Abstract

Background

Creating and having a database should not be an end goal but rather a source of valid data and a means for generating information by which to assess process, performance, and outcome quality. The Cardiovascular Center at Shands Jacksonville (Florida) made measurable improvements in the quality of data in national registries and internally available software tools for collection of patient care data.

Methods

The process of data flow was mapped from source to report submission to identify input timing and process gaps, data sources, and responsible individuals. Cycles of change in data collection and entry were developed and the improvements were tracked.

Results

Data accuracy was improved by involving all caregivers in datasheet completion and assisting them with data-field definitions. Using hospital electronic databases decreased the need for manual retrospective review of medical records for datasheet completion. The number of fields with missing values decreased by 83.6%, and the number of missing values decreased from 31.2% to 1.9%. Data accuracy rose dramatically by real-time data entry at point of care.

Discussion

Key components to ensuring data quality for process and outcome improvement are (1) education of the caregiver team, (2) process supervision by a database manager, (3) commitment and explicit support from leadership,(4) increased and improved use of electronic data sources, and (5) data entry at point of care.

提高数据库中的数据质量:来自心血管中心的经验教训
创建和拥有数据库不应该是最终目标,而应该是有效数据的来源和生成信息的手段,通过这些信息来评估过程、性能和结果质量。尚兹杰克逊维尔心血管中心(佛罗里达州)在国家登记和内部可用的收集病人护理数据的软件工具的数据质量方面取得了可衡量的改进。方法从数据来源到报告提交的数据流过程进行映射,以确定输入时间和过程差距、数据来源和责任人。开发了数据收集和输入的变化周期,并跟踪了改进情况。结果通过让所有护理人员参与数据表的填写并协助他们定义数据字段,提高了数据的准确性。使用医院电子数据库减少了手工回顾性审查医疗记录以完成数据表的需要。缺失值字段数减少83.6%,缺失值字段数从31.2%下降到1.9%。通过在护理点实时输入数据,数据准确性显著提高。确保过程和结果改进的数据质量的关键组成部分是(1)护理人员团队的教育,(2)数据库管理人员的过程监督,(3)领导的承诺和明确支持,(4)增加和改进电子数据源的使用,以及(5)在护理点输入数据。
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