Table of Contents
The management and personnel at Davis Health Care have integrated the improvement of patient safety as one of the long-term organizational goals. However, there has been a gradual rise in the number of cases since the institution increased the volume of inpatients it could absorb at a particular time. Many of the cases are associated with patient falls and delivery of the wrong medications, which has the management very concerned. As a result, a process improvement project has been commissioned with the reduction of patient falls and errors in medication being the primary goal. This document evaluates the tools that will be used in the collection of data during the improvement process.
Part 1: Data Collection Tools
Data Requirements
Ideally, the most important data in the process improvement project will be that concerning the number of falls and cases where wrong medication has been administered. While this data has been collected before, a more refined collection model will be required. For instance, it will be critical that the day and time of the incidents are recorded. In addition, data should be collected on a ward level such that information about the particular ward and bed where the incident has occurred is available. Using such data, it will be possible to handle the improvement process more objectively considering that the minor and most critical details are understood (Spath, 2012). Data on the type or subcategory of patient falls and medication errors will be imperative considering that falls can include fainting, staff-assisted falls, and those caused by factors such as wetness on the floor or mechanical failure of equipment. On the other hand, it will be imperative to note whether the incidents caused injuries or not.
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Data Collection Tools: Description, Strengths, and Weaknesses
- Patient Safety Indictors: Developed by the Agency of Healthcare Research and Quality (AHRQ), the tool provides information about the level of patient safety in a facility. They can provide details on the particular geographic areas that require more focus in a bid to avoid potential complications. Ideally, the tool has three indicators that shows incidents that could have been avoided, medical conditions, and potentially avoidable cases of pediatric hospitalization (AHRQ, 2017). The Quality Indicators SAS QI 5.0 software can be easily integrated into the hospital’s electronic health records (EHR), which can be treated as a strength. One of the tool’s weakness is the fact that it requires relatively high levels of knowledge and skills to utilize.
- Root Cause Analysis: It is mainly used in the evaluation of the problems that contributed to the occurrence of an incident or error. The tool can be used to collect data on both patient falls and medication errors. Ideally, the tool is critical in the recreation of the incident and all the circumstances in a bid to evaluate the contributing factors. The primary strength of the tool is that it give highly insightful details about a case that can be directly used to prevent possible future incidents. However, it is important to note that the tool will rely on data and information collected through other means such as census.
- Census: The tools will collect the most primary data in the improvement process. Census will be utilized in collecting data at each unit in the facility, particularly the criteria discussed in the preceding section. Numbers of the incidents of falls, cases of medication errors, injuries or adverse implications sustained, and time will be collected using this tool. The tool does not necessarily require the user to have extensive knowledge in data collection, which makes is quite appropriate for data collection at the unit level. The tool is weak on providing explanations and inferences about a particular case as it requires refined analysis through the aforementioned tools.
Comparing the Tools
The three tools can be applied at the same time considering that each has its unique strengths, which can compensate for the weaknesses of the other. Census is the simplest tool to use while the Patient Safety Indicators is quite sophisticated. However, it is important to note that both Patient Safety Indicators and Root Cause Analysis will require data collected from the census to function effectively, which makes the later the presumptive superior. Nevertheless, the two tools provide more actionable information about the incidences than the census. It is also important to note that the Patient Safety Indicators provide a broader picture on the level of patient safety at the facility while the Root Cause Analysis focuses on evaluating one case at a time although the outcome can be combined to give a bigger picture.
Part 2: Data Display, Measurement and Reporting
Measurement and Display Tools: Description, Strengths, and Weaknesses
- Charts and Graphs: They are some of the simplest measurement and display tools that can be used to show changes in the variables defined by identified data collection tools. The raw data acquired through the collection methods can be fed into tables that can be used to generate graphs. Generally, the most important measurement made by the tools is the horizontal analysis, commonly referred to as a trend analysis. The vertical analysis will give information on the changes in the occurrence of incidences along a timeline. The primary strength of the approach is the ease of use in the essence that data input is quite simple besides the display being easy to understand. On the downside, graphs may consume considerable time to develop, especially when it comes to preplanning (Hall, 2010).
- Tables: Tables provide data and information at quite defined and precise levels, which makes them highly appropriate for the measurement and display of information acquired from the root cause analysis. In addition, the information gathered through the census requires to be filled in tables before it is processes any further. As mentioned, tables are strong in providing highly defined and precise information and data, which makes them appropriate for initial measurement activities. However, tables can make it challenging to develop conclusions, especially when data is ambiguous.
Comparing the Tools
Tables have primacy over charts and graphs, especially considering that they are required for the development of charts and graphs. It is also important to note that charts and graphs do not give more refined information like tables as they are most important for the identification of trends. The primary difference between the tools is that while tables communicate using exact values and information, graphs and charts are more visual. Nevertheless, the format of the two tools is not much different considering that they both identify the metric followed by its value (Adams, 2005). It implies that both tools can be used to compare relationships and patterns in data although the audience can only focus on a few numbers or patterns simultaneously when using tables. It is also important to note that there broad categories and classifications of graphs and charts that can be used and, as a result, deeper knowledge will be required for their effective use.
Importance of Measurement, Display, and Reporting Tools
Organizational management and process improvement are heavily dependent on tools of measurement, display, and reporting as they give information on the state of affairs. In healthcare organizations, the tools can be used to present information that is critical to the provision of better services, which can range from patient mortality rates, cash inflows, expenditure, patient safety, employee safety, and number of successful interventions. In many cases, the tools are used to make informed decisions as they give the decision-maker(s) with the information relevant to the context and environment.
- Adams, C. (2005). The everglades: Analyzing graphs, tables, and charts. New York: PowerKids Press.
- AHRQ. (2017). AHRQ – Quality Indicators. Qualityindicators.ahrq.gov. Retrieved 25 January 2017, from http://qualityindicators.ahrq.gov/Modules/psi_resources.aspx
- Hall, J. (2010). Grant management. Sudbury, Mass.: Jones and Bartlett Publishers.
- Spath, P. (2012). Error reduction in health care: A systems approach to improving patient safety. Journal of Nursing Regulation, 2(4), 60. http://dx.doi.org/10.1016/s2155-8256(15)30255-6