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Abby Crocker & Steve Kappell
Data Update Abby Crocker & Steve Kappell
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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
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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
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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?
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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
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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
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Shared Data System Standardize variable definitions across hospitals
Diagnostic Related Group (DRG) Admission date & timestamp Patient type
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Standardize Variable Definitions: DRG
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Standardize Variable Definitions: Patient Type
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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
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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
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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)
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Process & Data Validation
File upload process File transfer process File opening process Analysis capabilities Data structure of files received Export functionality
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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
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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
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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
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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!
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Data Cleaning Results: HGB rates (UVMMC, CVMC, BMH)
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Data Cleaning Results: CREA rates (UVMMC, CVMC, BMH)
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