Abstract
Emergency departments need to continuously calculate quality indicators in order to perform structural improvements, improvements in the daily routine, and ad-hoc improvements in everyday life. However, many different actors across multiple disciplines collaborate to provide emergency care. Hence, patient-related data is stored in several information systems, which in turn makes the calculation of quality indicators more difficult. To address this issue, we aim to link and use routinely collected data of the different actors within the emergency care continuum. In order to assess the feasibility of linking and using routinely collected data for quality indicators and whether this approach adds value to the assessment of emergency care quality, we conducted a single case study in a German academic teaching hospital. We analyzed the available data of the existing information systems in the emergency continuum and linked and pre-processed the data. Based on this, we then calculated four quality indicators (Left Without Been Seen, Unplanned Reattendance, Diagnostic Efficiency, and Overload Closure). Lessons learned from the calculation and results of the discussions with staff members that had multiple years of work experience in the emergency department provide a better understanding of the quality of the emergency department, the related challenges during the calculation, and the added value of linking routinely collected data.
Highlights
Emergency departments (EDs) have the liability to deliver high-quality emergency care
We run into the issue that we were not able to determine the exact value of Left Without Being Seen (LWBS) but were able to identify a possible explanation for this and take appropriate measures
A staff member of the ED reported that some medical specialists are used to enter patient information into the hospital information systems (IS) and are not willing to document the full initial medical examination in the emergency department IS
Summary
Emergency departments (EDs) have the liability to deliver high-quality emergency care This requires continuously performing structural improvements, improvements in the daily routine, and ad-hoc improvements in everyday life. Most of the current QIs focus either on particular aspects of the ED (e.g., specific diagnosis or patient groups), have to be calculated manually, or require a collection of additional data [1]. To address this issue, we aim to link and use routinely collected data of the different actors within the ECC. The usage of this data is challenging due to various issues (e.g., data heterogeneity, lack of structured data, and fragmentation across various information systems)
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