DATA QUALITY OF NATIONAL QUALITY INDICATORS AND THEIR ACCEPTANCE IN SWISS NURSING HOMES

ABSTRACTBackground: Medication reconciliation at transitions of care increases patient safety. Collection of an accurate best possible medication history (BPMH) on admission is a key step. National quality indicators are used as surrogate markers for BPMH quality, but no literature on their accuracy exists. Obtaining a high-quality BPMH is often labour- and resource intensive. Pharmacy students are now being assigned to obtain BPMHs, as a cost-effective means to increase BPMH completion, despite limited information to support the quality of BPMHs obtained by students relative to other health care professionals.Objectives: To determine whether the national quality indicator of using more than one source to complete a BPMH is a true marker of quality and to assess whether BPMHs obtained by pharmacy students were of quality equal to those obtained by nurses.Methods: This prospective trial compared BPMHs for the same group of patients collected by nurses and by trained pharmacy students in the emergency departments of 2 sites within a large health network over a 2-month period (July and August 2016). Discrepancies between the 2 versions were identified by a pharmacist, who determined which party (nurse, pharmacy student, or both) had made an error. A panel of experts reviewed the errors and ranked their severity.Results: BPMHs were prepared for a total of 40 patients. Those prepared by nurses were more likely to contain an error than those prepared by pharmacy students (171 versus 43 errors, p = 0.006). There was a nonsignificant trend toward less severe errors in BPMHs completed by pharmacy students. There was no significant difference in the mean number of errors in relation to the specified quality indicator (mean of 2.7 errors for BPMHs prepared from 1 source versus 4.8 errors for BPMHs prepared from ≥ 2 sources, p = 0.08).Conclusions: The surrogate marker (number of BPMH sources) may not reflect BPMH quality. However, it appears that BPMHs prepared by pharmacy students had fewer errors and were of similar quality (in terms of clinically significant errors) relative to those prepared by nurses.RÉSUMÉContexte : L’établissement du bilan comparatif des médicaments au moment du transfert des soins accroît la sécurité des patients. L’obtention d’un meilleur schéma thérapeutique possible (MSTP) exact à l’admission en est une étape clé. Des indicateurs nationaux de la qualité sont utilizes comme critères de substitution pour évaluer la qualité des MSTP, mais il n’y a pas de documentation se penchant sur leur exactitude. Obtenir un MSTP de grande qualité est souvent exigeant sur le plan du personnel et des ressources. Des étudiants en pharmacie se voient maintenant confier l’élaboration de MSTP, une façon peu coûteuse d’accroître les taux de réalisation de MSTP; or, il n’y a que peu d’information pour valider le degré de qualité des MSTP obtenus par des étudiants en comparaison avec ceux produits par d’autres professionnels de la santé.Objectifs : Déterminer si l’indicateur national de qualité basé sur le recours à plus d’une source de renseignements pour réaliser un MSTP est un vrai marqueur de qualité et évaluer la qualité relative des MSTP de la part des étudiants en pharmacie et du personnel infirmier.Méthodes : Dans la présente étude prospective réalisée sur une période de deux mois (en juillet et en août 2016), les chercheurs ont comparé les MSTP recueillis auprès du même groupe de patients par du personnel infirmier et par des étudiants en pharmacie qualifiés dans les services des urgences de deux établissements faisant partie d’un important réseau de santé. Un pharmacien relevait les divergences entre les deux versions du MSTP et imputait l’erreur soit au personnel infirmier, soit à l’étudiant en pharmacie ou soit aux deux parties. Un groupe d’experts a étudié les erreurs et leur a accordé une cote selon leur degré de gravité.Résultats : Des MSTP ont été réalisés auprès de 40 patients. Ceux préparés par le personnel infirmier étaient plus susceptibles de contenir une erreur que ceux établis par les étudiants en pharmacie (171 contre 43 erreurs, p = 0,006). On a noté une tendance non significative selon laquelle les erreurs commises par les étudiants en pharmacie étaient moins graves. Aucune différence significative n’a été relevée quant au nombre moyen d’erreurs par rapport à l’indicateur de qualité (2,7 pour les MSTP provenant d’une source contre 4,8 pour les MSTP provenant de deux sources ou plus, p = 0,08).Conclusions : Le critère de substitution (nombre de sources pour le MSTP) pourrait ne pas être représentatif de la qualité du MSTP. Cependant, il semble que les MSTP préparés par les étudiants en pharmacie comportaient moins d’erreurs et étaient de qualité comparable (quant aux erreurs cliniquement significatives) à ceux établis par le personnel infirmier.

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Quality Improvement Questionnaires – Nursing Homes (QIQ-NH): validation of questionnaires for measuring quality of care in nursing homes from various perspectives

10.21203/rs.3.rs-70866/v1 ◽

2020 ◽

Author(s):

Mattanja Triemstra ◽

Juliane Menting ◽

Bellis van den Berg

Keyword(s):

Quality Improvement ◽

Nursing Home ◽

Quality Of Care ◽

Nursing Homes ◽

Family Caregivers ◽

Content Validity ◽

Nursing Home Care ◽

Cognitive Interviews ◽

National Quality

Abstract Background This study aims to describe the validation and optimization of a new instrument specifically designed to measure and improve the quality of care in nursing homes; the Quality Improvement Questionnaires for Nursing Homes (QIQ-NH). This instrument comprises several questionnaires on the perceived quality of care for various perspectives (e.g. clients, family and professional caregivers) and covers eight themes of the national quality framework for nursing home care in the Netherlands. Methods Data was collected in six nursing homes between September 2017 and June 2018, among 359 residents, 48 family caregivers and 648 professional caregivers who completed a subgroup-specific questionnaire of the QIQ-NH. The construct and criterion validity of the three questionnaires were tested with item- and scale analyses. The content validity of the questionnaires was tested in cognitive interviews with 20 participants (7 residents, 5 family caregivers, 8 professional caregivers). Results Psychometric analyses confirmed the multidimensionality and reliability of the three questionnaires, and the cognitive interviews showed various possibilities for further optimization of the instruments. The construct, criterion and content validity of the three questionnaires ranged from acceptable to good. Cronbach’s alphas were > .70 for almost all scales. More than half of the items were candidate for optimization according to the cognitive interviews, mainly due to clarity or knowledge problems, and the questionnaires of the QIQ-NH were optimized accordingly. Conclusions The Quality Improvement Questionnaires for Nursing Homes (QIQ-NH) provides a solid basis to continuously measure and improve the quality of nursing home care, by covering the national quality themes and by integrating the various perspectives of all parties involved. With real-time feedback, the instrument enables the management and care teams to select possibilities or areas for improvement and to implement and continuously monitor the effects of quality improvement strategies in nursing homes.

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Literature Consistency of Bioinformatics Sequence Databases is Effective for Assessing Record Quality

10.1101/101873 ◽

2017 ◽

Author(s):

Mohamed Reda Bouadjenek ◽

Karin Verspoor ◽

Justin Zobel

Keyword(s):

Data Quality ◽

Quality Indicators ◽

Large Scale ◽

Genomic Data ◽

Principal Component ◽

Mutual Relationship ◽

Query Quality ◽

Automatic Methods ◽

Sequence Databases

AbstractBioinformatics sequence databases such as Genbank or UniProt contain hundreds of millions of records of genomic data. These records are derived from direct submissions from individual laboratories, as well as from bulk submissions from large-scale sequencing centres; their diversity and scale means that they suffer from a range of data quality issues including errors, discrepancies, redundancies, ambiguities, incompleteness, and inconsistencies with the published literature. In this work, we seek to investigate and analyze the data quality of sequence databases from the perspective of a curator, who must detect anomalous and suspicious records.Specifically, we emphasize the detection of inconsistent records with respect to the literature. Focusing on GenBank, we propose a set of 24 quality indicators, which are based on treating a record as a query into the published literature, and then use query quality predictors. We then carry out an analysis that shows that the proposed quality indicators and the quality of the records have a mutual relationship, in which one depends on the other. We propose to represent record-literature consistency as a vector of these quality indicators. By reducing the dimensionality of this representation for visualization purposes using Principal Component Analysis, we show that records which have been reported as inconsistent with the literature fall roughly in the same area, and therefore share similar characteristics. By manually analyzing records not previously known to be erroneous that fall in the same area than records know to be inconsistent, we show that 1 record out of 4 is inconsistent with respect to the literature. This high density of inconsistent record opens the way towards the development of automatic methods for the detection of faulty records. We conclude that literature inconsistency is a meaningful strategy for identifying suspicious records.

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Change in Quality of Tuberculosis (TB) Care since National Quality Assessment Program of TB Healthcare Service

Quality Improvement in Health Care ◽

10.14371/qih.2021.27.2.73 ◽

2021 ◽

Vol 27 (2) ◽

pp. 73-82

Author(s):

Seong-Ja Jang ◽

Mi-Jin Hwang ◽

Chung-Hun Lee ◽

Hyeon-Ju Lee ◽

Tae-Sun Shim ◽

...

Keyword(s):

Quality Assessment ◽

Quality Indicators ◽

Healthcare Service ◽

Care Management ◽

Drug Susceptibility ◽

Susceptibility Test ◽

Drug Susceptibility Test ◽

National Quality ◽

Medical Facilities

Purpose: This study aims to examine the quality of tuberculosis (TB) care after the 1st to 3rd national quality assessment (QA) program for TB healthcare service in Korea was conducted.Methods: We analyzed Health Insurance Review & Assessment Service (HIRA) claims data of new TB patients during the period of January to June from 2018-2020. The new TB patients were defined as TB patients reported to Korea Centers for Disease Control and Prevention Agency (KCDA). The unit of analysis was the patient. Chi-square tests were used to analyze the differences in indicator value according to the types of medical facilities. The QA indicators of TB care were divided into 3 areas consisting of the following 7 quality indicators: 4 indicators of diagnosis test (the rate of acid-fast bacilli smear, the rate of acid-fast bacilli culture, the rate of Mycobacterium tuberculosis-polymerase chain reaction, drug susceptibility test), 1 compliance of treatment guideline, and 2 indicators of care management of TB patients (encounter rate, day of therapy).Results: The QA program for TB care was conducted among 8,246 patients from 534 facilities in 2020. The value of the 7 quality indicators was shown to increase as a result of the QA program. The indicators of the diagnostic test were all higher than 95%, with the exception of the drug susceptibility test which was 84.8%. Both indicators for care management of TB patients were 88.5%.Conclusion: The quality of TB care has been improving with the implementation of the QA program. In order to continue to improve the quality of TB care, it will be necessary to disclose the results of the QA program in medical facilities in the future.

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Analysis of discrepancies in mirror data relating to the weight of goods in intra-EU trade statistics

Wiadomości Statystyczne. The Polish Statistician ◽

10.5604/01.3001.0014.3525 ◽

2020 ◽

Vol 65 (8) ◽

pp. 27-38

Author(s):

Iwona Markowicz ◽

Paweł Baran

Keyword(s):

European Union ◽

Data Quality ◽

Research Methods ◽

Quality Indicators ◽

Research Methodology ◽

Quality Of Data ◽

Eu Countries ◽

The Eu ◽

Data Quality Indicators

In the research carried out to date by the authors of the article, the assessment of the quality of mirror data in the exchange of goods between European Union (EU) countries was based on the value of goods. A similar approach is applied by many researchers. The aim of the research discussed in the article is to assess the quality of data relating to intra-EU trade based on not only the value, but also on the quantity of goods. The analysis of discrepancies in data relating to trade between EU countries, with a particular emphasis on Poland, was based on selected research methods known from literature. Both the value-based and the quantitative approach constitute the authors' contribution to the development of research methodology. Data quality indicators were proposed and data pertaining to the weight of goods were used. Information on trade in goods between EU countries in 2017 obtained from Eurostat's Comext database was analysed. The research relating to the dynamics also covered the years 2005, 2008, 2011, and 2014. The results of the analysis demonstrated that the total share of export of goods from Poland to a given country within the EU is different for data expressed in value (value of goods) and in quantity (weight of goods). Therefore, both approaches should be applied in the study of the quality of mirror data.

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Physical Restraint Use in Swiss Nursing Homes: Two New National Quality Indicators

Innovation in Aging ◽

10.1093/geroni/igaa057.2300 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 665-665

Author(s):

Lauriane Favez ◽

Franziska Zúñiga ◽

Catherine Blatter ◽

Narayan Sharma ◽

Michael Simon

Keyword(s):

Nursing Homes ◽

Quality Indicators ◽

Intraclass Correlation ◽

Physical Restraint ◽

Term Care ◽

Convenience Sample ◽

Systems Research ◽

Restraint Use ◽

National Quality ◽

Standing Up

Abstract Quality indicators are used in nursing homes to assess physical restraint use. Switzerland introduced two publicly reported indicators measuring the use of 1) bedrails and 2) trunk fixation or seating that prevent standing up. Whether these indicators show good between-provider variability is unknown. The study aimed to measure the prevalence of physical restraint use and assess their between-provider variability using a cross-sectional, multicentre study of a convenience sample of nursing homes. The between-provider variability of the indicators was assessed with intraclass correlation 1 and with caterpillar plots based on Empirical Bayes estimates. We included 11,412 residents from 152 nursing homes. Prevalence rates were 13.5% (n=1’433) for bedrails and 3.6% (n=411) for trunk fixation / seating that prevent standing up. For the first indicator, intraclass correlation 1 was 0.245 (95%-CI 0.197-0.286), for the second 0.343 (95%-CI 0.235-0.405). The two indicators showed good between-provider variability and can be recommended for public reporting. Part of a symposium sponsored by Systems Research in Long-Term Care Interest Group.

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Assessment of the Nursing Quality Indicators for Reporting and Evaluation (NQuIRE) database using a data quality index

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocaa031 ◽

2020 ◽

Vol 27 (5) ◽

pp. 776-782 ◽

Cited By ~ 1

Author(s):

Shanoja Naik ◽

Stephanie Voong ◽

Megan Bamford ◽

Kyle Smith ◽

Angela Joyce ◽

...

Keyword(s):

Case Report ◽

Data Quality ◽

Quality Indicators ◽

Quality Index ◽

Best Practice ◽

Quality Framework ◽

The Impact ◽

Nursing Quality Indicators ◽

Nursing Quality

Abstract A comprehensive data quality assessment is necessary to expand a nursing database that is designed for evaluating the impact of implementing Best Practice Guidelines (BPG) developed by the Registered Nurses’ Association of Ontario (RNAO). This case report presents a method to standardize data quality assessments of the Nursing Quality Indicators for Reporting and Evaluation (NQuIRE) database by developing a data quality framework (DQF) and assessing key dimensions of the framework using a data quality index (DQI). The data quality index is a single key performance metric for assessing the quality of the database. The aims of sharing this case report are 2-fold: (1) to promote best practices for assessing data quality by developing and implementing a data quality framework and (2) to demonstrate an unprecedented method of assessing the data quality of a nursing database.

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Assessing Nursing Homes Quality Indicators’ between-Provider Variability and Reliability: A Cross-Sectional Study Using ICCs and Rankability

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249249 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9249

Author(s):

Lauriane Favez ◽

Franziska Zúñiga ◽

Narayan Sharma ◽

Catherine Blatter ◽

Michael Simon

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Quality Indicators ◽

Quality Indicator ◽

Intraclass Correlation ◽

Physical Restraints ◽

Cross Sectional ◽

Nursing Home Quality ◽

Intraclass Correlations

Nursing home quality indicators are often used to publicly report the quality of nursing home care. In Switzerland, six national nursing home quality indicators covering four clinical domains (polypharmacy, pain, use of physical restraints and weight loss) were recently developed. To allow for meaningful comparisons, these indicators must reliably show differences in quality of care levels between nursing homes. This study’s objectives were to assess nursing home quality indicators’ between-provider variability and reliability using intraclass correlations and rankability. This approach has not yet been used in long-term care contexts but presents methodological advantages. This cross-sectional multicenter study uses data of 11,412 residents from a convenience sample of 152 Swiss nursing homes. After calculating intraclass correlation 1 (ICC1) and rankability, we describe between-provider variability for each quality indicator using empirical Bayes estimate-based caterpillar plots. To assess reliability, we used intraclass correlation 2 (ICC2). Overall, ICC1 values were high, ranging from 0.068 (95% confidence interval (CI) 0.047–0.086) for polypharmacy to 0.396 (95% CI 0.297–0.474) for physical restraints, with quality indicator caterpillar plots showing sufficient between-provider variability. However, testing for rankability produced mixed results, with low figures for two indicators (0.144 for polypharmacy; 0.471 for self-reported pain) and moderate to high figures for the four others (from 0.692 for observed pain to 0.976 for physical restraints). High ICC2 figures, ranging from 0.896 (95% CI 0.852–0.917) (self-reported pain) to 0.990 (95% CI 0.985–0.993) (physical restraints), indicated good reliability for all six quality indicators. Intraclass correlations and rankability can be used to assess nursing home quality indicators’ between-provider variability and reliability. The six selected quality indicators reliably distinguish care differences between nursing homes and can be recommended for use, although the variability of two—polypharmacy and self-reported pain—is substantially chance-driven, limiting their utility.

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