Introduction
- (RQ1) Is it feasible to use routinely collected data within the ECC to calculate QIs that identify improvements areas orad-hocimprovements for an ED and.
- (RQ2) do QIs based on routinely collected data add value to the assessment of emergency care quality?
Methods
Setting
Type of IS | Field of application |
---|---|
Hospital IS | All patient charts with diagnoses and therapies |
Emergency Department IS | Triage, diagnosis, and therapy within the ED |
Treatment Report IS | Report on ED closures to the regional emergency control center overseeing multiple hospitals/EDs |
Emergency Medical Service IS | Triage and treatment by paramedics and emergency physicians, connected to the emergency department IS |
Research process
Selection of quality indicators
Preparation
Analysis of existing IS
Extraction and preprocessing of data
Information system | Data relation | Description | Data fields |
---|---|---|---|
Hospital IS | Transfers | Transfers within the hospital (departed from ED) | 29 |
Discharges | Discharged patient contacts from hospital | 38 | |
Diagnoses | Hospital admission diagnoses (equals ED discharge diagnoses) and hospital discharge diagnoses | 12 | |
Emergency Department IS | Dossiers | Patient contacts that have been admitted through paramedics (NIDA) or ED | 203 |
Medications | Administered medication within the ED | 50 | |
Tasks | Treatments carried out within the ED | 30 | |
Treatment Report IS | Closures | Closures of the ED that have been reported to an emergency call center (incl. Partial closures) | 23 |
Characteristic | Description |
---|---|
Age | Overall, the average age was 49.06, with a standard deviation of 26.50 years. The minimum age was 0, whereas the maximum age was 104. |
Sex | 50.55% of the patient contacts were labeled as “male”, 48.00% as “female”, and 1.45% of the patient contacts were unspecified. |
Type of Treatment | In total, 54.31% of the analyzed patient contacts were labeled as “inpatient”, 45.50% as “outpatient” and 0.19% are not labeled. |
Triage Level | 0.83% of all patient contacts were labeled with triage level “red”, 21.13% with “orange”, 29.71% with “yellow”, 35.60% with “green”, 6.21% with “blue” and 6.52% were labeled as “grey” meaning there has been no triage (used e.g., for planned patient contact). |
Calculation
Left without been seen
Unplanned reattendance
Diagnostic efficiency
ICD-10-GM code | Diagnostic agreement | Length of stay (minutes, avg.) | Diagnostic efficiency |
---|---|---|---|
G45 + I63 (n = 2900) | 0.442 | 96.149 | 0.459 |
I21 (n = 1406) | 0.536 | 102.127 | 0.524 |
I71 (n = 57) | 0.561 | 1018.193 | 0.006 |
J12 – J18 (n = 2670) | 0.467 | 103.051 | 0.453 |
S06 (n = 1896) | 0.943 | 106.117 | 0.889 |