Peer Audit

The CCMDB Peer Audit is a real-time audit to quantify the variability in our data collection.

Preamble

What the Peer Audit is and is not

The Peer Audit is not meant identify "wrong" data or to single out a specific collector who is doing something bad. We are trying to quantify the precision rather than the accuracy of our individual data elements. A lot of us have hunches about where there are problems, this audit is to give us objective indicators.

Following that, please do not compare notes on the patients you are auditing as this would prevent us from getting an accurate idea how consistent our data is.

Goals and follow-ups to the peer audit

Julie will generate accuracy scores from the audit data, and we will provide these back to you in this article.

Once we know which areas have the least accuracy we will look for reasons for the inaccuracies and try to eliminate them. This will largely happen ad-hoc using the wiki. We may also come back to you personally to find out why there are discrepancies, but this is to find the reasons and fix the underlying problem, not to criticize individuals.

We will also use our findings to correct data, but this is for a very small subset of our database and just coincidental.

Start Date

• programming by Tina - Done
• testing by collection office - in progress
• pilot by collectors - START TEST: Nov 17-27.09.TOstryzniuk 13:00, 17 November 2009 (CST)
  • sites to start testing Nov 17.09:
    • GRACE Medicine (Steph and Sheila)
    • STB ICU - Laura K
    • HSC SICU & MICU - Joyce and Lois
    • H4 and A4 (Gail, Con, Pat, Marie)
    • VIC Med (Tara and Shirley Nov 18. Next week: Tara, Wendy and Shirley)

Processes and Procedures

What is collected

• All data elements for patients.

How it is collected

Every data collector (except community ICU) has an audit ward assigned in Peer Audit Partners.

The first patient admitted to the audit ward on Thursday morning will be an audit patient and will be followed as if he or she were a patient admitted to the regular ward of that collector.

• for pilot testing purpose Nov 17-27.09 -select any day of the week.

The serial numbers to be used for audit patients will be 111 and following. If a patient is not discharged by next Thursday, use the next number, e.g. 112. Re-use earlier numbers once they become available, i.e. once patient 111 is sent and deleted, use the number for the next audit patient.

On the next send day a separate batch is sent for audit patients discharged during the previous week. To do this, make sure you either first delete your regular sent patients, or that you uncheck their "FinalCheck" checkbox. The records are sent as a separate batch with the following parameters

• batch: "a"
• initials: dd-mmm-yy- and use your own initials, e.g. 03-jun-09_TT

This will differentiate this data from our other collection data and facilitate further processing by our statistician.

Data Sending

If the batch is "a" (i.e. for audit patients) then CCMDB.mdb will send and temp information to the following alternative audit locations:

• Tasks: Regional Server\output\tasks_peer_audit.mdb
• Temp: Regional Server\output\TmpV2_peer_audit.mdb
• Don't need to process pending for this.

Data Processing

To do: Find out where Pagasa stores regular files once appended, make a subdirectory for "a" files there...

Discussion

• Waiting for update to Data Appending ProcessTtenbergen 16:05, 10 September 2009 (CDT)

Data Analysis

• retrieve file from <above> location
• match every field one on one, give count of good vs bad and degree of difference
• do a pair-analysis for dxs, Admit 1 specific, and others regardless of diagnosis number

Follow-Up

• Post accuracy scores to this article
• further investigate causes for differences

Discussion

• does the peer audit include doing a TISS which is normally done by bedside nurse?--Laura Kolesar