Clinical‐quality registries: their role in quality improvement

McNeil, John J; Evans, Susan; Johnson, Niall; Cameron, Peter

doi:10.5694/j.1326-5377.2010.tb03499.x

Cited by 109 publications

(107 citation statements)

References 10 publications

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“…[15] In Australia, jurisdictional data from RHD Control Programs are provided to the centralised Data Collection System and also to the Australian Institute of Health and Welfare for periodic reporting. [16] Internationally, the absence of systematically collected recent data on RHD treatment and outcomes has been identified as a key gap in our understanding of ARF and RHD management, and as a result the REMEDY registry ( R h e u m atic H e art D isease Registr y ) has been initiated.…”

Section: Discussionmentioning

confidence: 99%

Adherence to secondary prophylaxis for rheumatic heart disease is underestimated by register data

et al. 2017

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ObjectiveIn high-burden Australian states and territories, registers of patients with acute rheumatic fever and rheumatic heart disease are maintained for patient management, monitoring of system performance and research. Data validation was undertaken for the Australian Northern Territory Rheumatic Heart Disease Register to determine quality and impact of data cleaning on reporting against key performance indicators: overall adherence, and proportion of patients receiving ≥80% of scheduled penicillin doses for secondary prophylaxis.MethodsRegister data were compared with data from health centres. Inconsistencies were identified and corrected; adherence was calculated before and after cleaning.Results2780 penicillin doses were validated; 426 inconsistencies were identified, including 102 incorrect dose dates. After cleaning, mean adherence increased (63.5% to 67.3%, p<0.001) and proportion of patients receiving ≥80% of doses increased (34.2% to 42.1%, p = 0.06).ConclusionsThe Northern Territory Rheumatic Heart Disease Register underestimates adherence, although the key performance indicator of ≥80% adherence was not significantly affected. Program performance is better than hitherto appreciated. However some errors could affect patient management, as well as accuracy of longitudinal or inter-jurisdictional comparisons. Adequate resources are needed for maintenance of data quality in acute rheumatic fever/rheumatic heart disease registers to ensure provision of evidence-based care and accurate assessment of program impact.

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Section: Discussionmentioning

confidence: 99%

Adherence to secondary prophylaxis for rheumatic heart disease is underestimated by register data

et al. 2017

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“…Herein lies a challenge, as these agencies and disciplines often work in isolation. While a study such as this offers an insight into performance across agencies and disciplines, real-time monitoring and feedback through a dynamic clinical-quality cardiac arrest registry19 would offer sustained quality assurance and incentivise quality-improvement measures. The establishment of Ireland's OHCAR will address many of these issues.…”

Section: Discussionmentioning

confidence: 99%

Out-of-hospital cardiac arrest in Cork, Ireland

Henry¹,

Murphy

Willis³

et al. 2012

Emerg Med J

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BackgroundOut-of-hospital cardiac arrest (OHCA) in Ireland accounts for approximately 5000 deaths annually. Little published evidence exists on survival from OHCA in this country to date. We aimed to characterise and describe ‘presumed cardiac’ OHCA in Cork City and County attended by the Ambulance Service.MethodsDispatch records, ambulance patient records and hospital records for a 1-year period were examined for patient demographics, OHCA characteristics, interventions and patient outcomes.ResultsThere were 231 ‘presumed cardiac’ OHCAs attended over the study period; 130 (56%) were in urban locations and 101 (44%) in rural. OHCAs were lay-witnessed in 20% (n=46), and 22% (n=50) received bystander CPR. Shockable rhythm was present in 36 cases (16%) on initial assessment, and there was no difference in presence of shockable rhythm between urban and rural OHCAs (18% vs 13%, p=0.31). Resuscitation was attempted in 176 cases (77.5%), of whom 27 (15%) achieved return of spontaneous circulation and 13 (7.4%) survived to leave hospital. Survival when the initial rhythm was shockable was 16.7% (6 of 36 patients). Despite longer response times for rural compared with urban OHCAs (median (IQR) 16.5 (11.0–23.5) vs 9 (7–12) min, p<0.001), survival to leave hospital alive where resuscitation was attempted was similar (7.4% vs 7.4%, p=0.99, respectively).ConclusionA survival rate of 16.7% in shockable rhythms indicates scope for improvement which would influence the overall survival rate which was found to be 7.4%. Real-time feedback of performance and quality of the continuum of patient care through a clinical-quality cardiac arrest registry would monitor and incentivise such initiatives.

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“…Patient and implant registries are appropriate for monitoring and benchmarking processes and outcomes where known variation exists and where inferior performance results in high additional cost or poor quality of life (McNeil et al 2010). In addition to providing information on safety and efficacy of treatment, data from registries can also be used to evaluate whether patients have timely access to care, and whether care is delivered that is consistent with best practice and evidence-based guidelines.…”

mentioning

confidence: 99%

Intraoperative findings and procedures in culturally and geographically different patient and surgeon populations

Granan¹,

Inacio²,

Maletis³

et al. 2012

Acta Orthopaedica

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Background and purpose Patient and implant registries are important clinical tools in monitoring and benchmarking quality of care. For comparisons amongst registries to be valid, a common data set with comparable definitions is necessary. In this study we compared the patients in the Norwegian Knee Ligament Registry (NKLR) and the Kaiser Permanente Anterior Cruciate Ligament Reconstruction Registry (KP ACLRR) with regard to intraarticular findings, procedures, and graft fixation characteristics reported by the operating surgeon for both primary and revision anterior cruciate ligament reconstructions (ACLRs).Methods We performed a cross-sectional comparison of the NKLR and KP ACLRR cohorts registered between 2005 and 2010. Aggregate-level data including patient characteristics (age, sex, and laterality), meniscal and cartilage injury patterns and corresponding treatment procedures, choice of graft, and fixation characteristics (type and component material) were shared between registries. Descriptive analyses were then conducted.Results During the study period, 11,217 ACLRs were registered in the NKLR and 11,050 were registered in the KP ACLRR. In the NKLR, hamstring autograft was used more (68% vs. 30%) for primary ACLRs and allograft was used less (0.2% vs. 41%) than in the KP ACLRR. The KP ACLRR reports more meniscal tears among both primary and revision ACLRs (63% and 50% vs. 49% and 36%). The NKLR reports less use of biodegradable fixation devices.Conclusions Baseline findings between the NKLR and the KP ACLRR were congruent regarding patient characteristics and most injury patterns, adding to the evidence that comparisons and collaborations between these registries will provide generalizable information to the international orthopedic community. The variation in the treatment, including graft and implant selection and meniscus procedures, between the 2 registries provides opportunities to explore the impact of treatment choices on the outcomes of ACLRs.

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Clinical‐quality registries: their role in quality improvement

Cited by 109 publications

References 10 publications

Adherence to secondary prophylaxis for rheumatic heart disease is underestimated by register data

Adherence to secondary prophylaxis for rheumatic heart disease is underestimated by register data

Out-of-hospital cardiac arrest in Cork, Ireland

Intraoperative findings and procedures in culturally and geographically different patient and surgeon populations

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