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List of Factor affecting data quality: Difference between revisions

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m Much of this is 9 years old; removing the things that are no longer relevant.
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Please feel free to add other thoughts and ideas
Please feel free to add other thoughts and ideas


# One example identified at a meeting today by [[User: CMarks| CMarks]] was if there is no MOST, because a patient was in palliative care, and only vital signs available is from 1 week prior to acceptance to medicine service then what do you put in as a BP, HR, WBC?  The guidelines state if there are no values assume normal.  But what are the normal values that should be recorded?
== Arrive Date / Times ==
#*Solution: Tina suggested putting '''not available''' and when data sent to Server, values will be output as a preset standard normals.
# Another example ID'd by [[p:Lois Bilesky-retire Jan 10, 2019 | Lois Bilesky]] was for APACHE - the exact physiological item is not recorded because APACHE score is based on selecting a value within a RANGE for points. If the points are the same why fuss about which value to select?  There were never any guidelines instructing a collector which value to choose within a range.
#*Solution: Update guidelines for APACHE II collection rules.
# [[p:PStein | PStein]] - ID'd that she sometimes find 2 or more sources of DATE and TIME first accepted to the Medicine Service.  She uses the first date and time she finds on the chart?
# [[p:PStein | PStein]] - ID'd that she sometimes find 2 or more sources of DATE and TIME first accepted to the Medicine Service.  She uses the first date and time she finds on the chart?
#*Solution: Update guidelines so that FIRST date and time found on a chart or [[EPR]] at STB is recorded.
#*Solution: Update guidelines so that FIRST date and time found on a chart or [[EPR]] at STB is recorded.
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**[[p:Gail Hall-resign, Nov 29, 2018| Gail Hall]] adds 10-15 minutes to the last set of vital signs done by ER.[[p:CMarks|CMarks]] 08:15, 11 January 2011 (CST)
**[[p:Gail Hall-resign, Nov 29, 2018| Gail Hall]] adds 10-15 minutes to the last set of vital signs done by ER.[[p:CMarks|CMarks]] 08:15, 11 January 2011 (CST)


=Discussion=
== APACHE improvements ==
*Some collectors take the time of acceptance by Medicine from the doctors orders in the chart and compare it to the Admission/Separation sheet admit time,then compare to take the earliest time.For arrival time on the ward they look at the nurses notes to see if it is''' clearly documented''' and in that case they will take that time. If the arrival time is not clearly charted they look at the log book for a time.They also look at notes of the sending location to see if there is a departure time and compare it to the arrival time to see if it makes sense.
# One example identified at a meeting today by [[User: CMarks| CMarks]] was if there is no MOST, because a patient was in palliative care, and only vital signs available is from 1 week prior to acceptance to medicine service then what do you put in as a BP, HR, WBC?  The guidelines state if there are no values assume normal. But what are the normal values that should be recorded?
 
#*Solution: Tina suggested putting '''not available''' and when data sent to Server, values will be output as a preset standard normals.
 
# Another example ID'd by [[p:Lois Bilesky-retire Jan 10, 2019 | Lois Bilesky]] was for APACHE - the exact physiological item is not recorded because APACHE score is based on selecting a value within a RANGE for points. If the points are the same why fuss about which value to select?  There were never any guidelines instructing a collector which value to choose within a range.
**I have been thinking about ways in which apache scores could be done more consistently.  If a mean BP calculator was put into access so that entering the systolic and diastolic numbers will result in a mean BP every time, this would be very helpful.  Another thought that I had was that every value have a permanent display of the median (normal) number.  For example the median for Potassium is 4.4, for WBC it is 9, etc.    If the median number is permanently displayed on the screen then it is easier to ascertain the number furthest from that number either higher or lower.    I think this is easier than having the range display.    It would also be more accurate I think.  --[[User:LKolesar|LKolesar]] 07:44, 10 January 2011 (CST)   
#*Solution: Update guidelines for APACHE II collection rules.
***This display of median number of the normal scale would also apply to vital signs.  --[[User:LKolesar|LKolesar]] 07:25, 11 January 2011 (CST)
*I have been thinking about ways in which apache scores could be done more consistently.  If a mean BP calculator was put into access so that entering the systolic and diastolic numbers will result in a mean BP every time, this would be very helpful.  Another thought that I had was that every value have a permanent display of the median (normal) number.  For example the median for Potassium is 4.4, for WBC it is 9, etc.    If the median number is permanently displayed on the screen then it is easier to ascertain the number furthest from that number either higher or lower.    I think this is easier than having the range display.    It would also be more accurate I think.  --[[User:LKolesar|LKolesar]] 07:44, 10 January 2011 (CST)   
 
**This display of median number of the normal scale would also apply to vital signs.  --[[User:LKolesar|LKolesar]] 07:25, 11 January 2011 (CST)
 
 
 
 
 




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