Cox Nicholas, Brennan Angela, Dinh Diem, Brien Rita, Cowie Kath, Stub Dion, Reid Christopher M, Lefkovits Jeffrey
Department of Medicine, Melbourne Medical School - Western Precinct, The University of Melbourne, Melbourne, Vic, Australia; Cardiology Unit, Western Health, Melbourne, Vic, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic, Australia.
Heart Lung Circ. 2018 Apr;27(4):464-468. doi: 10.1016/j.hlc.2017.01.023. Epub 2017 Mar 12.
Clinical outcome registries are an increasingly vital component of ensuring quality and safety of patient care. However, Australian hospitals rarely have additional resources or the capacity to fund the additional staff time to complete the task of data collection and entry. At the same time, registry funding models do not support staff for the collection of data at the site but are directed towards the central registry tasks of data reporting, managing and quality monitoring. The sustainability of a registry is contingent on building efficiencies into data management and collection.
We describe the methods used in a large Victorian public hospital to develop a sustainable data collection system for the Victorian Cardiac Outcomes Registry (VCOR), using existing staff and resources common to many public hospitals. We describe the features of the registry and the hospital specific strategies that allowed us to do this as part of our routine business of providing good quality cardiac care.
All clinical staff involved in patient care were given some data collection task with the entry of these data embedded into the staff's daily workflow. A senior cardiology registrar was empowered to allocate data entry tasks to colleagues when data were found to be incomplete. The task of 30-day follow-up proved the most onerous part of data collection. Cath-lab nursing staff were allocated this role.
With hospital accreditation and funding models moving towards performance based quality indicators, collection of accurate and reliable information is crucial. Our experience demonstrates the successful implementation of clinical outcome registry data collection in a financially constrained public hospital environment utilising existing resources.
临床结果登记系统对于确保患者护理质量和安全而言,正日益成为至关重要的组成部分。然而,澳大利亚的医院很少有额外资源或能力来为额外的员工时间提供资金,以完成数据收集和录入任务。与此同时,登记系统的资金模式并不支持现场工作人员收集数据,而是用于数据报告、管理和质量监测等中央登记任务。登记系统的可持续性取决于在数据管理和收集方面提高效率。
我们描述了一家大型维多利亚州公立医院所采用的方法,即利用许多公立医院共有的现有员工和资源,为维多利亚州心脏结果登记系统(VCOR)开发一个可持续的数据收集系统。我们描述了该登记系统的特点以及医院特定策略,这些策略使我们能够将此作为提供优质心脏护理日常工作的一部分来完成。
所有参与患者护理的临床工作人员都被分配了一些数据收集任务,并且这些数据的录入被嵌入到工作人员的日常工作流程中。当发现数据不完整时,一名高级心脏病学住院医师有权将数据录入任务分配给同事。30天随访任务被证明是数据收集最繁重的部分。心导管室护理人员被分配了这一职责。
随着医院认证和资金模式朝着基于绩效的质量指标发展,收集准确可靠的信息至关重要。我们的经验表明,在资金紧张的公立医院环境中,利用现有资源成功实施了临床结果登记系统的数据收集工作。