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Quality Management in Healthcare

HIM 403

Chapter 3
Issues, Opportunities and Challenges in Data Collection
for Quality Improvement

This Chapter covers CLO 3: Explain the joint commission standards and recent trends of
quality management / improvement and continues quality issues in accreditation of health care
organizations.

Source: https://kic.blackboard.com/ultra/courses/_6380_1/outline
https://kic.blackboard.com/ultra/courses/_5747_1/outline

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 Chapter Outline
• Health Data, Information & Knowledge
• What is Health Data Management?
• What we Need is Quality Data
• The importance of Information in Healthcare
• key Functions for Healthcare Information System
• Types of Healthcare Information Needed
• Informatics Challenges
• The Responsibility of Healthcare Organizations Towards Data Collection
• Opportunities and Challenges in the Context of Current Practices
• Steps Toward Improving Data Collection
• Collecting and Sharing Data Across The Healthcare System
• Poor Data Quality Concerns
• The Causes of Poor Data Quality
• Impacts of Poor Data Quality
• Technology is A critical Tool to Collect Quality Health Information

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 Health Data, Information & Knowledge

• Healthcare information is processed

healthcare data.

• Healthcare knowledge is a processed

healthcare Information.

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 What is Health Data Management?
• Health Data Management (HDM), also known as Health
Information Management (HIM) is the systematic
organization of health data in digital form. This can be
anything from Electronic Medical Records (EMR)
generated by different means and providers, to
Electronic Health Records (EHR), to handwritten medical
notes scanned to a digital origin.

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 What we Need is Quality Data

Actual ? Reported
Results Results

Data Quality:
How well our data “tell the true story.”

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 The importance of Information in Healthcare
• Sound and reliable information is the foundation of
decision-making across all health system building
blocks.
• It is essential for health system policy development
and implementation, governance and regulation,
health research, human resources development,
health education and training, service delivery and
financing.

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key Functions for Healthcare Information System
• Data generation.
• Data assembling.
• Data analysis.
• Data tuning, and communication and use.

• The health information system collects data

from the health sector and other relevant
sectors, analyses the data and ensures their
overall quality, relevance and timeliness, and
converts data into information for health-
related decision-making. 7
 Types of Healthcare Information Needed
Health planners and decision-makers need different kinds
of information including:
• Health determinants (socio-economic, environmental
behavioral, genetic factors)
• Inputs to the health system and related processes
including policy and organization, health infrastructure,
facilities and equipment, costs, human and financial
resources.
• The performance of the health system such as
availability, accessibility, quality and use of health
information and services, responsiveness of the system to
user needs, and financial risk protection
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 Types of Healthcare Information Needed-
Con’d
• Health outcomes (mortality, morbidity,
disease outbreaks, health status, disability,
wellbeing).
• Health inequities, in terms of determinants,
coverage of use of services.

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 Informatics Challenges

• Clinical quality
• World Class Commissioning
• Payment by Results
• Improving efficiency
• Audit, inspection and assurance

For which we need to:

 Measure the right things
 Measure them right
 Use the measures right…

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 The Responsibility of Healthcare Organizations
Towards Data Collection
• Some entities face health information technology (Health
IT) constraints and internal resistance.
• Addressing health and healthcare disparities requires
the full involvement of organizations that have an
existing infrastructure for quality measurement and
improvement.
• Although hospitals, community health centers (CHCs),
physician practices, health plans, and local, state, and
federal agencies can all play key roles by incorporating
race, ethnicity, and language data into existing data
collection and quality reporting efforts.
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 The Responsibility of Healthcare Organizations
Towards Data Collection- Con’d
• While a range of health and healthcare entities collect
data, the data do not flow among these entities in a
cohesive or standardized way
• Entities within the healthcare system face challenges
when collecting race, ethnicity, and language data from
patients, enrollees, members, and respondents.
• Explicitly expressing the rationale for the data collection
and training staff, organizational leadership, and the
public to appreciate the need to use valid collection
mechanisms may improve the situation.

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 Opportunities and Challenges in the Context
of Current Practices

•To identify the next steps toward improving data

collection, it is helpful to understand these opportunities
and challenges in the context of current practices. In
some instances, the opportunities and challenges are
unique to each type of organization; in others, they are
common to all organizations

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 Steps Toward Improving Data Collection
These steps begin by examining current practices and
issues related to collecting and sharing data across the
health care system.
These steps include:
•How to ask patients and enrollees questions about race,
ethnicity, and language and communication needs.
•How to train staff to produce this information in a
respectful and efficient manner.
•How to address the discomfort of registration/admission
staff (hospitals and clinics) or call center staff (health
plans) about requesting this information.
•How to address system-level issues, such as changes in
patient registration screens and data flow. 14
 Collecting and Sharing Data Across The
Healthcare System
• Healthcare involves a diverse set of public and private
data collection systems, including health surveys,
administrative enrollment and billing records, and
medical records, used by various entities, including
hospitals, CHCs, physicians, and health plans.
• Data on race, ethnicity, and language are collected, to
some extent, by all these entities, suggesting the
potential of each to contribute information on patients
or enrollees.

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 Collecting and Sharing Data Across The
Healthcare System- Con’d
• The flow of data does not even fully reflect the
complexity of the relationships involved or the
disparate data requests within the healthcare system.
Currently, fragmentation of data flow occurs because of
silos of data collection:
1. Individual data.
2. Provider level collection.
3. State level collection.
4. Multi –state collection.
5. National level collection.
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 Collecting and Sharing Data Across The
Healthcare System- Con’d
• No one of healthcare entities has the capability by itself
to gather data on race, ethnicity, and language for the
entire population of patients, nor does any single entity
currently collect all health data on individual patients.

• One way to increase the usefulness of data is to

integrate them with data from other sources. Thus,
there is a need for better integration and sharing of
race, ethnicity, and language data within and across
health care entities and even (in the absence of suitable
information technology [IT] processes) within a single
entity. 17
 Collecting and Sharing Data Across The
Healthcare System- Con’d
• Health information technology (Health IT) may have
the potential to improve the collection and
exchange of self-reported race, ethnicity, and
language data, as these data could be included, for
example, in an individual's personal health record
(PHR) and then utilized in electronic health record
(EHR) and other data systems.

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 Poor Data Quality Concerns
• Simple errors such as inaccurate/incorrect names,
addresses, and insurance or benefit information
can have a negative impact on the satisfaction of
patients and staff alike.
• Patients have a right to expect that the details of
their care are documented completely and
correctly and that the quality and safety of their
care is not compromised by inaccurate or
ambiguous data.

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 The Causes of Poor Data Quality
• Poor documentation.
• Expired information.
• Duplicated information.
• Irrelevant information.
• Untrusted data.
• Unauthoritative Data.
• Inaccurate data.
• Insufficient data.
• Unusable data,
• Vague data.
• Un comparative data.
• Insufficient communication between providers.20
 Impacts of Poor Data Quality
• Can lead to errors & adverse events.
• Threats to quality and safety.
• Patient and staff dissatisfaction.
• Increased operational cost.
• leads to low satisfaction and increased cost.
• Less effective decision-making.
• Reduced ability to make and execute strategy.
• Operational costs can be increased because of
unnecessary duplication of tests or procedures,
inefficient care processes, or additional time
and resources that must be directed toward
detecting and correcting data problems. 21
 Impacts of Poor Data Quality- Con’d
• Gaps in the data due to missing or incomplete
detail or suspicious accuracy complicate the
process of effective decision making.
• Mistrust of data can spill over into mistrust of
other team members and their motives. This
can lead to duplicate-data collection resulting
in further delays in analyses and ineffective
decision-making.
• Data-quality problems have always continued,
sometimes to a larger degree in some data
elements or processes than in others.

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 Technology is A critical Tool to Collect
Quality Health Information
• Technology is a critical tool in achieving high-
quality data in an electronic health record and
realizing the benefits of health information
exchange.
• Technology alone is not sufficient. It is vital for
organizations to maintain patient safety and
quality of care measures into their electronic
processes and systems.
• Technology can translate the data into a form
that can be used for the assigned purpose is part
of the analysis phase. You may hear this referred
to as “transforming data into information”.
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