Using data to improve quality of healthcare

使用数据提高医疗保健质量

• 批准号: nhmrc : 465129
• 负责人: A/Pr Peter Sprivulis
• 金额: $ 186.4万
• 依托单位: Monash University
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Strategic Awards
• 财政年份: 2007
• 资助国家: 澳大利亚
• 起止时间: 2007-01-01 至 2012-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/using-improve-quality-healthcare/78206
• 关键词: Using; data; improve; quality; healthcare

In virtually every major industry, quality improvement has been based on measuring and monitoring performance. There is good evidence to show that when processes and outcome data is measured and compared, improvements are made. Healthcare has been slow to introduce systematic measurement across the sector, however internationally this is rapidly changing. In Australia, we have data available to measure quality and safety; however it is not collected systematically or consistently between states and territories. Our aim is to develop a national set of high quality, credible indicators using existing data sources to measure healthcare performance in regard to safety and quality in clinical practice. We propose a “probes in the pudding” approach, where each probe measures the performance of one aspect of the healthcare system. Coded administrative hospital data collected mainly for financial reasons has potential to be used as quality indicators. However, to provide an accurate picture, indicators must take into account people’s risk factors over which the doctor has no control but which can influence outcome. For example, a hospital in an area surrounded by a principally elderly population would be more likely to have a higher death rate than a hospital admitting younger patients. In effect, indicators must compare apples with apples. We will further test ways in which clinical patient information databases can be linked to develop quality indicators. For example, by linking pharmacy data with hospital data we can monitor whether patients are receiving appropriate medication. The most reliable data for use in measuring quality exists in registries, which have been established for a number of procedures and conditions in Australia. We will investigate ways in which registries can be better standardised at a national level. We will compare registry data with administrative hospital data to investigate how quality indicators can be developed which provide an accurate picture of the health system. This program will succeed because it can be implemented at a low cost using data readily available in most Australian health settings. The group doing the research consists of consumer advocates and people with knowledge in the use of administrative data and registries, health policy, law, research design and statistics.

实际上，在每一个主要行业中，质量改进都是基于对绩效的测量和监控。有充分的证据表明，当测量和比较过程和结果数据时，就会取得改进。医疗保健行业在整个行业引入系统衡量方面进展缓慢，但在国际上，这种情况正在迅速改变。在澳大利亚，我们有数据来衡量质量和安全；然而，各州和各地区之间并没有系统地或一致地收集数据。我们的目标是利用现有的数据来源，开发一套全国性的高质量、可靠的指标，以衡量临床实践中有关安全和质量的医疗保健绩效。我们提出了一种“布丁中的探针”方法，其中每个探针测量医疗保健系统的一个方面的性能。主要出于财政原因收集的编码行政医院数据有可能用作质量指标。然而，为了提供准确的情况，指标必须考虑到医生无法控制但会影响结果的人们的风险因素。例如，在主要由老年人包围的地区，一家医院的死亡率可能比接纳年轻病人的医院高。实际上，指标必须对不同的苹果进行比较。我们将进一步试验如何将临床病人信息数据库连接起来，以制定质量指标。例如，通过将药房数据与医院数据联系起来，我们可以监测患者是否正在接受适当的药物治疗。用于衡量质量的最可靠数据存在于登记处，这些登记处是为澳大利亚的一些程序和条件建立的。我们将研究如何在国家一级更好地标准化登记处。我们将比较登记数据与医院行政数据，以研究如何制定质量指标，从而提供卫生系统的准确情况。该方案将取得成功，因为它可以利用大多数澳大利亚卫生机构现成的数据以低成本实施。进行这项研究的小组由消费者权益倡导者和具有使用行政数据和登记、卫生政策、法律、研究设计和统计方面知识的人员组成。