Needham Dale M, Sinopoli David J, Dinglas Victor D, Berenholtz Sean M, Korupolu Radha, Watson Sam R, Lubomski Lisa, Goeschel Christine, Pronovost Peter J
Pulmonary and Critical Care, Johns Hopkins University, Baltimore, MD, USA.
Int J Qual Health Care. 2009 Apr;21(2):145-50. doi: 10.1093/intqhc/mzp005. Epub 2009 Feb 13.
The results of many quality improvement (QI) projects are gaining wide-spread attention. Policy-makers, hospital leaders and clinicians make important decisions based on the assumption that QI project results are accurate. However, compared with clinical research, QI projects are typically conducted with substantially fewer resources, potentially impacting data quality. Our objective was to provide a primer on basic data quality control methods appropriate for QI efforts.
Data quality control methods should be applied throughout all phases of a QI project. In the design phase, project aims should guide data collection decisions, emphasizing quality (rather than quantity) of data and considering resource limitations. In the data collection phase, standardized data collection forms, comprehensive staff training and a well-designed database can help maximize the quality of the data. Clearly defined data elements, quality assurance reviews of both collection and entry and system-based controls reduce the likelihood of error. In the data management phase, missing data should be quickly identified and corrected with system-based controls to minimize the missing data. Finally, in the data analysis phase, appropriate statistical methods and sensitivity analysis aid in managing and understanding the effects of missing data and outliers, in addressing potential confounders and in conveying the precision of results.
Data quality control is essential to ensure the integrity of results from QI projects. Feasible methods are available and important to help ensure that stakeholder's decisions are based on accurate data.
许多质量改进(QI)项目的结果正受到广泛关注。政策制定者、医院领导和临床医生基于QI项目结果准确这一假设做出重要决策。然而,与临床研究相比,QI项目通常在资源大幅减少的情况下开展,这可能会影响数据质量。我们的目标是提供一份适用于QI工作的基本数据质量控制方法入门指南。
数据质量控制方法应应用于QI项目的所有阶段。在设计阶段,项目目标应指导数据收集决策,强调数据的质量(而非数量)并考虑资源限制。在数据收集阶段,标准化的数据收集表格、全面的员工培训和精心设计的数据库有助于最大限度地提高数据质量。明确界定的数据元素、对收集和录入的质量保证审查以及基于系统的控制可降低出错的可能性。在数据管理阶段,应通过基于系统的控制迅速识别并纠正缺失数据,以尽量减少缺失数据。最后,在数据分析阶段,适当的统计方法和敏感性分析有助于管理和理解缺失数据及异常值的影响,处理潜在的混杂因素并传达结果的精确性。
数据质量控制对于确保QI项目结果的完整性至关重要。可行的方法是存在的,并且对于帮助确保利益相关者的决策基于准确数据很重要。