260 Recording of Syncope Presentations in Model 4 Hospital - Large Variations in Data Collection Systems

Abstract

Abstract Background Patients with unexplained falls, syncope and dizziness frequently present acutely. There are multiple IT systems in operation across the acute hospital network with varying functionality relating to activity capture. MAXIMS is an electronic healthcare record used to capture attendances in our ED. Within our department a digital patient management system Electronic Patient Management System (EPMS) records clinical information from admission through to discharge. The Hospital Inpatient Enquiry System (HIPE) is the principal national source of discharge information from acute hospitals. We aimed to look at this cohort of patients and compare the clinical data available on each of these information sources used in a Model 4 teaching hospital. Methods MAXIMS database was interrogated to examine patients who presented to the ED with the search terms “falls”, “syncope” and “dizziness”. We conducted a review of all patients who met our search terms over two non-consecutive weeks in 2018. For the same period EPMS was interrogated and HIPE data were requested and analysed. Results MAXIMS, EPMS and HIPE records over the two-week period captured 190, 104 and 24 patients respectively. Mean age was 62, 75 and 72 years. Of 190 records on MAXIMS, 107 (56%) were not coded on HIPE following discharge. Of these 107 patients, 93 (87%) did not require a hospital admission and 14 (13%) patients self-discharged. Conclusion Current available digital systems provide inconsistent information relating to patients presenting acutely with falls, dizziness and syncope. How these conditions are captured electronically can vary between systems due to which parameters are recorded. HIPE stats were lower than Maxims/EPMS which may reflect the fact that HIPE only captures discharge diagnosis as opposed to presenting symptoms. In order to get a clearer picture of these conditions, and for planning purposes, an approach amalgamating the data from all systems into one electronic source would be required.