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Doctors must improve approach to hospital data

Clinicians must improve the quality and value of their hospital data, a report says.

The report, by the NHS Information Centre, urges consultants to take responsibility for their clinical data, both in the way that notes are recorded and the accuracy with which patient data is coded.

A lack of clinical engagement over the accuracy of hospital data is a major concern for royal medical colleges and directors of trusts, it says.

Hospital Episode Statistics: improving the quality and value of hospital data accuses doctors of having little knowledge of the large Secondary Uses Service database into which trusts submit data from their Patient Administration Systems, or of the Hospital Episode Statistics database which stores data for monitoring the quality of healthcare and shows health trends.

It says: “Since the first national set of data was collected in 1989 there has been considerable evidence that the majority of clinicians have not engaged in the process.

“They have not been concerned about the accuracy of the data, the many ways that it is used, nor have they used the data to support their own clinical practice or service developments.”

The report, which is endorsed by the Academy of Medical Royal Colleges, claims that improvements in the collection and use of hospital data by clinicians would improve patient outcomes and inform patient choice.

It must be “urgently addressed” because national data is increasingly being used to assess the quality of clinical services and will be available in a patient-anonymised format on pubic websites such as NHS Choices.

“Metrics and indicators of clinical quality will increasingly be published for individual, named consultants, in line with government policies on patient choice of consultant-led teams and ‘transparency’ of detailed data on public services,” it says.

Appraisal and revalidation will also require statistical evidence of good clinical practice, it adds.

The report calls on trusts and colleges to discuss how data input and use can be improved.

“The weaknesses in the current processes for collection of HES data cannot be fully rectified without radical change,” it says.

“These weaknesses include the limitations of the data collected from a clinical perspective, the use of statistical classifications for coding rather than a clinical terminology, and the very fact that a parallel process is used to extract data from non-standardised, largely unstructured paper records.”

The AMRC is calling for a review of this process and a migration towards the collection of data directly from standardised, patient-focused electronic records in which the data items are recorded at the point of care.

Consultants are being urged to teach juniors good note keeping and the importance of clinical coding.

Read the full report.

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5 Responses to “Doctors must improve approach to hospital data”

  1. joshek says:

    Wrong. Very, very wrong indeed! The only thing clinicians “have to” do is to kick all these jumped up auxiliaries (and yes, the IT clowns are part of them) in the butt and remind them that they all, the whole bloody lot, solely exist to ASSIST the clinicians!

  2. Dr Zorro says:

    Agree totally with joshek. Proud to say I have never heard of this system, and am not going out of my way to find out.

  3. tom says:

    joshek and Dr Zorro, something to hide have we? The sooner we retire this ancient system of paper records and their supporters the better.

  4. joshek says:

    those with the reflex of “whoever refuses to comply with IT has smthg to hide” do not deserve acknowledgement … but they do show how urgently clinicians with any remnants of a spine need to ram pedis into several glutaei!

  5. pete says:

    The factor behind all this is the progressive disengagement of clinicians from so many areas of NHS activity, moreover a disengagement engineered by government and local management. When clinicians have so much responsibility removed from them….exclusion from local contracting, interventions by CQC, GMC, MTAS, PMETB,NICE, EWTD, ‘guidelines’& protocols substuting for personal decision-making, Health & Safety, Child Protection issues and much much more, then they begin to shrug their shoulders and say “to hell with your data, we know its inaccurate, it always is and it suits you managers to be able to produce quick false stats for meetings, contracting etc”. Poor data is a threat to the NHS, not to individual clinicians because the one thing we have on our side is this……the sick will always be with us, and in one way or another we’ll always be needed. When managers start to understand that the consultant body in any given hospital is a huge resource of wisdom and experience with intelligence far above any other segment of the workforce, managers or otherwise (who else needs all A*’s or A’s to get into university) then maybe things will change. But at the moment all one sees is a progressive withdrawal by doctors from anything except direct clinical work, and they make that difficult enough! Once upon a time consultants stayed until the job was done, at cost even to their families. No more. They head, perfectly understandably, to the door at 5pm. And why shouldn’t they when juniors are told to get out on time? If “Royal Colleges and Directors of Trusts” stopped bleating about the “lack of clinical engagement and accuracy of hospital data” and started to understand why we’ve got where we are, then things might improve. They always said that understanding the causes of disease is more important than the treatment, didn’t they? And how dare they criticise after themselves letting doctors down so badly over education, EWTD and much more.

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