1. Abby Crocker & Steve Kappell
Data Update
Abby Crocker & Steve Kappell

2. Data Update
VMS Foundation QI Collaborative Measurement & Evaluation Strategy
Value of Standardization
Shared learning from our development & validation process
Data Hosting and Management Plan
Planning for a successful, sustainable future
Snapshot of initial results from data cleaning process
collaborative comparison lab rates HGB and CREA

3. Measurement and Evaluation Strategy
3 armed approach
Individual Site PDSA cycles: primary data collection, internal data warehouse, process measures
Collaborative Metrics: team members, number of trainings, shared learning
Shared data system using “standardized” EMR data

4. Measurement and Evaluation Strategy
Shared data system using “standardized” EMR data
Evaluate the impact of the QI collaborative initiatives
How do lab rates compare across hospital?
What’s the “right” lab rate?
How do you change systems to get to the “right” lab rate?
How do you measure change to see if you got to the “right” lab rate?
How do you adjust for differences in patient populations?

5. Shared Data System Identify common data elements
Inpatient admission information
Billing data
Laboratory results
Obtain “buy-in” from institutions
Time to develop extract
Commitment to upload the extract on a continuous basis
HIPAA compliance and BAA agreements

6. Shared Data System Identify a place to store shared data
Secure data upload process
Secure and supportive analytic platform
Timely data access
Develop a data management strategy
Naming and storing files
Checking for structure changes
Checking for “invalid” data

7. Shared Data System Standardize variable definitions across hospitals
Diagnostic Related Group (DRG)
Admission date & timestamp
Patient type

8. Standardize Variable Definitions: DRG

9. Standardize Variable Definitions: Patient Type

10. Standardize Variable Definitions: Admit timestamp
Registration date & time
Arrival date & time
ER admission date & time
Transfer to bed date & time
Observation status date & time
Inpatient admission date & time

11. Shared Data System Identify measures of interest
Lab rates per patient day: what labs are of interest? What will we use as our numerator and denominator?
Plan a reporting process
Develop an analytic plan
Develop a reporting template
Disseminate information

12. Shared Data System Learn from mistakes and keep improving the process
Validate the process, the data and the measures
Expect glitches (i.e. server upgrades)

13. Process & Data Validation
File upload process
File transfer process
File opening process
Analysis capabilities
Data structure of files received
Export functionality

14. Process & Data Validation
Subject inclusion and exclusion criteria
Adults, >18yo
Length of stay >24 hours
Exclude: maternity, inpatient psych, inpatient rehab and swing beds
Clarify the admit date & time
Clarify the lab codes
Check the expected counts of # discharges, # lab counts
Check complete lab profiles
Compare with VT 2014 hospital discharge data

15. Data Hosting & Management Plan
Continue with current system through June
At least? At most?
Work with current extracts
Use the NORC system
data management HEAVY

16. Data Hosting & Management Plan
Looking ahead….
Sustainable, secure, trusted system
Data management to be more systematized
Focus on analytics and putting the data in the hands of the users
Leverage known standardized datasets with all the experiential knowledge from this collaborative
Expand to incorporate additional data elements and define additional measures

17. Participating Sites: Data Validation & Update Status
CVMC ✔✔ thank you Kevin!
BMH ✔✔ thank you Frank!
SWVMC ✔ thank you Beth!
NVRH ✔ thank you Ryan!
DHMC thank you Diane, Susanne and Carol!
RRMC ✔ thank you Denise, Daniel and Joe!
PMC on hold
UVMMC ✔✔ thank you Melissa!

18. Data Cleaning Results: HGB rates (UVMMC, CVMC, BMH)

19. Data Cleaning Results: CREA rates (UVMMC, CVMC, BMH)