Importance of nationally coordinated data collection and quality improvement networks

Abstract

There is an urgent need for a learning health care system that continuously and systematically draws from data to inform improvements in care. Hospital-based quality monitoring is unable to effectively track specialized care, each domain of care being performed by a handful of clinicians in each center, whose definition of standard of care comes from national professional associations and guidelines. In a myriad of domains that make up specialized care in Canada, data-driven quality improvement is hindered by a lack of nationally coordinated, practice-specific, dynamically alterable data collection. To address this deficiency, we suggest three immediately applicable, synergistic recommendations to improve real-time, patient and health system relevant, data-informed healthcare quality improvement and research. Namely, (1) add a small number of open “placeholder” fields to the Canadian Institutes of Health Information hospital discharge database, (2) create nationally coordinated strategic patient-level data collection and research for specific clinical problems and conditions of urgent health importance, and (3) support the creation and maintenance of perpetual national quality improvement and research collectives, enabling nationally-coordinated platforms for continuous standardized data collection, quality improvement and research. Examples of these initiatives within the domains of critical care medicine and thoracic surgery are presented. Continued adoption of a national standardized data-collection and data-driven quality improvement and research networks across a range of clinical disciplines would help deliver national transformation in both quality and efficiency of Canadian healthcare.