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But What Do These Numbers Represent?!?

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This presentation was delivered at the Quality Forum 2016 by Andrew Wray.

For more information, visit www.QualityForum.ca

Published in: Healthcare
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But What Do These Numbers Represent?!?

  1. 1. But What Do These Numbers Represent?!? Quality Forum 2016
  2. 2. Outline • Purposes of measurement in health care • Sources of data and their characteristics • Key questions to ask of any indicators • Some examples of indicators
  3. 3. Source: Solberg LI, Moser G, McDonald S. (1997) The three faces of performance measurement: Improvement, Accountability and Research. Journal of Quality Improvement, 23(3).
  4. 4. Source: Solberg LI, Moser G, McDonald S. (1997) The three faces of performance measurement: Improvement, Accountability and Research. Journal of Quality Improvement, 23(3).
  5. 5. Source: Solberg LI, Moser G, McDonald S. (1997) The three faces of performance measurement: Improvement, Accountability and Research. Journal of Quality Improvement, 23(3).
  6. 6. Source: Solberg LI, Moser G, McDonald S. (1997) The three faces of performance measurement: Improvement, Accountability and Research. Journal of Quality Improvement, 23(3).
  7. 7. Measurement systems • It is not ideal to use a measurement system for a purpose other than for which it was designed.
  8. 8. Measurement source examples • Manual data collection on a local unit • EMR extract about the patient panel of a clinic • Discharge abstract database • Patient questionnaires
  9. 9. Data Quality 1. Accuracy 2. Timeliness 3. Comparability 4. Usability 5. Relevance Canadian Institute for Health Information, The CIHI Data Quality Framework, 2009 (Ottawa, Ont.: CIHI, 2009)
  10. 10. Considerations for decision makers 1. Accuracy 2. Timeliness 3. Comparability 4. Usability 5. Relevance Canadian Institute for Health Information, The CIHI Data Quality Framework, 2009 (Ottawa, Ont.: CIHI, 2009)
  11. 11. Key questions –How was this data collected? –How is the indicator defined and calculated? –How are we performing?
  12. 12. How was this data collected? • Why was it collected? • What is the source? • What is missing? • What are the sources of error?
  13. 13. How is the indicator defined and calculated? • Inclusions and exclusions? • Risk adjustment? • Aggregation?
  14. 14. How are we performing? • Are we getting better or worse? • Is our performance acceptable? • Is the performance stable? • Do we have more or less variability?
  15. 15. Hip Fracture within 48 hours • Data source: DAD • Level of aggregation – HA • Inclusion – 65+ • Calculation – within 48/total number of fractures • Performance – 80ish percent
  16. 16. • Data source: DAD • Level of aggregation – HA • Exclusion – Newborn, obstetric, and mental health • Calculation – Number of any of the events per 1000 discharge • Performance – 25ish percent Nurse sensitive adverse event rate

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