Quality Data Collection - Essay Example

?Quality Data Collection Introduction Quality data collection involves enhanced recording, implementation, as well as feedback. In many community hospitals, much of the data collected is either irrelevant or too trivial , and most of it ends up unexploited. In critical data reporting some hospitals, lack the criteria for determining the critical results in some critical laboratory not getting to caregivers in time. Poor sample collection strategies result in contaminations of blood cultures in emergency departments since the sample handles are either ignorant or the hospitals lack apposite culture handling techniques resulting in the mix-ups. Lack of proper data collection strategies results in wastage of hospital and patients resources since some results done are insignificant while others are annihilated. This paper focuses on data collection tools in emergency departments for blood culturing and the tools used in critical value reporting. The paper also elucidates on how the tools operate and compares how the tools operate. Improvement in data collection is vital for apposite analysis, diagnosis, treatment, and running of health amenities. Patience in the emergency department is often febrile and thus blood cultures are often obtained devoid of following the guidelines. However, most blood cultures ordered from the emergency departments are rarely utilized in management of the patient’s health. They thus end up being a source of unnecessary costs to the patients as well as the hospital. Another factor that declines the services of most community hospitals is excessive delays in defining and reporting of critical value results. Critical laboratory values have imperative significance on determining prompt treatment or actions that health provider ought to undertake. Most decisions and patient diagnosis depend on analysis of laboratory reports thus improvement in organization of laboratory services can improve on service provision. It is therefore vital to improve on timelines of reporting critical values (Tintinalli, et al, 2004). Blood Culture Contamination Rate in the Emergency Department Blood cultures are crucial in detecting conditions such as sepsis in the emergency departments. However, various researches show that most hospitals do not use blood culture results efficiently in clinical management of patients. The main problem in blood culturing is the inability to differentiate between contaminated cultures with true bacteraemia (Hall, & Lyman, 2006). To reduce errors and increase utilization of blood culture results, it is important to improve on tools used in monitoring performance information. It is recommendable that culture be collected only when clinically required. It is also important to use proper sampling techniques to prevent contamination. Tools used in blood culturing in the emergency department include culture bottle and needles. Enhanced collection of uncontaminated blood cultures is vital and can be done by proper disinfection of surfaces before drawing blood samples as well as using sterilized culture bottles. Use of surgical needles for blood sampling leads to contamination especially if proper sterilization is not done on the patients skin (Tintinalli, et al, 2004). Proper management of the data obtained after blood culturing is fundamental in improving the significance of the samples in management of emergencies. Another tool used to collect blood culture in the emergency department is automated blood culture technology that is capable of differentiating between positive and negative culture (Tintinalli, et al, 2004; Hall & Lyman, 2006). Critical Value Reporting Clinical value reporting provides mechanism for determining and reporting critical laboratory reports requiring urgent response. Critical values are determined differently by different hospitals with most choosing to use published values. Others make use of non-laboratory medical staff advice while others use inter-laboratory comparison, manufacturer proposals, or conduct internal studies to come up with their own Critical values (Berner, 2007). Data analysis using the critical value are chiefly conducted in the laboratories such as haematology, microbiology, blood transfusion services, immunological laboratories, neurochemistry, diabetes just to mention but a few. Reporting entails making calls and callbacks between the different laboratories and the clinicians making use of devices such as telephones. To reduce costs spent on call as well as enhance documentation of critical values, analysis is important to determine the urgency of critical value reporting. Outpatient clinical reporting presents the greatest challenge to clinicians since it become hard to determine the clinician to contact. An improvement is therefore required in most community hospitals to improve communication between outpatient caregivers and laboratories to ensure that critical value reporting is improved (Berner, 2007). There is also need for improvement in the information technology to enable tracking and documentation of critical reports. Hospitals also require formulating of policies that can determine credibility of specimens collected to avoid erroneous results that may delay treatment or result in substandard diagnosis. Hospitals also require coming up with methods to incorporate new test results as well as to prioritise the reporting calls in order of their urgency (Berner, 2007). Most health facilities lack efficient apposite reporting systems since the available systems are inefficient resulting in overstraining of laboratory staff as well as the clinicians. Current reporting systems such as telephones are expensive and incompetent thus there is need for improve technological tools. This can be done by ensuring verification of data by the person receiving the information as well as appropriate recording of such data. There is also need for standardization of the language used throughout the community hospitals to avoid misunderstandings (Berner, 2007). Another critical values reporting method used in community hospitals is verbal communication. Both verbal and telephone reporting are quite cumbersome thus, there is need for community hospitals to adopt communication technologies such as automating critical value alerting systems also known as paging. The system also has its risks such as locating appropriate physicians but this can be resolved through installation of notification systems to ensure timely reporting of critical results. However, it is crucial that the laboratory staff learn to differentiate critical results to avoid unnecessary overburdening of clinicians (Berner, 2007). Tools Used to Collect Performance Information Tools used by hospitals to collect performance information include Q- probes, Q-tracks and ATLAS. The Q-probes focus on diminishing laboratory errors by providing evaluation processes for key laboratory procedures. They are used for in-depth assessments and are very efficient in data collection and analysis as well as identification of errors. It enables statistical scrutiny of data of lab reports, discussion on results, and comparison with data from other institutions (Nakhleh, 2012). On the other hand, Q-tracks are used for continuous assessment of the quality of data. They monitor performance over a period and pinpoint areas that require modification. The analysis is done quaternary thus Q-tracks are better in assessing diagnostic performance. Q-tracks allow comparison of various variables. They help monitor routine laboratory processes such as wristband patient recognition, Blood culture contamination as well as suitability of laboratory samples. (Nakhleh, 2012). Assessment Tool for Laboratory Services and Supply Chain (ATLAS) is tool used either at national level or by individual laboratories to monitor performance of laboratory services as well as in setting relevant goals to enhance service improvement. ATLAS is conducted a short period before work scheduling and it gives an indication of how laboratory supply chain functions and how it can be improved. After using ATLAS to suggest the appropriate intervention, implementation follows. The ATLAS tool is repetitive depending on results. Comparison of Data Collection Tools Both Q-track and Q-probe try to gather information linked with improved performance. Q-track is used to complement Q-probe. Q-tracks are modelled to monitor information continuously over some time while Q-probes are designed to monitor progress over a short period of about three months. Use of Q-probe requires determination of other practices connected to improved results while use of Q-track does not require relating activities that could be associated to improved outcome. Just like the Q-probe, ATLAS can be used over an extended period. Unlike the Q-monitors that are only used for monitoring purpose, the ATLAS tool enables monitoring, improvement and maintenance of laboratory performance (USAID, 2010). Importance of Information Collection Tools to Health Care Organizations Tools for collection of performance information are important since they help medical practitioners as well as Health care organizations monitor laboratory information and detect areas that require modification. They also help monitor diagnostic performance and efficiency. Q-monitors help in quality assurance as they enable comparison of a laboratory performance with other databases hence determine if the performance is of the required standards. They are used to enhance quality care for patients as well as monitoring the results (Nakhleh, 2012). ATLAS is important in deciding on appropriate to consider in deciding the appropriate intervention required in laboratory procedures (USAID, 2010). Tools Used to Measure and Display QI Data Quality improvement (QI) helps in analysis of data and presentation in a simplified but complete style. Types of tools used to measure QI include process measures, outcome measures and national quality measures. Tools used to display QI data include trend charts, which display results. Flow charts can be used to delineate processes or factors that may affect outcome. Graphs can also be used for displaying data involving dependent and independent variables (Nakhleh, 2012). Conclusion Health caregivers require to access accurate data and in good time to ensure diagnoses are done in good time. Most community hospitals lack apposite data collection tools, which results in increased costs of disease management. Critical value reports are test results that require to be communicated urgently so that caregivers to enhance treatment of urgent situations. Most hospitals lack uniform critical value catalogue, which hampers rapid addressing of laboratory reports. Data needed to monitor improvement in critical value reporting is obtained laboratory and the critical values obtained using the different methods described above. It is crucial that community hospitals use laboratory resources maximally and set critical value limits. A good communication framework between medical staff in the different departments is inevitable for prompt critical data reporting. Q-monitors are used for conversion and customization of data. ATLAS helps in assessment and improvement of laboratory information. References Berner, E. (2007). “Clinical Decision Support Systems: Theory and Practice.” Oklahoma: Springer. Hall, K. & Lyman, J. (2006). “Updated Review of Blood Culture Contamination.” Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1592696/ Nakhleh, R. (2012). “Quality Management Tools.” Retrieved from http://www.cap.org/apps/docs/proficiency_testing/qmt_catalog/2012_qmt_catalog.pdf Tintinalli, J. et al. (2004). “Emergency Medicine: A Comprehensive Study Guide.” New York: McGraw-Hill. USAID. (2010) “Assessment Tool for Laboratory Services and Supply Chains (ATLAS).” Retrieved from http://deliver.jsi.com/dlvr_content/resources/allpubs/guidelines/AsseToolLab_ATLAS.pdf Read More