Facilitators for using data from a quality registry in local quality improvement work: a cross-sectional survey of the Danish Cardiac Rehabilitation Database

Abstract

ObjectivesTo investigate use of data from a clinical quality registry for cardiac rehabilitation in Denmark, considering the extent to which data are used for local quality improvement and what facilitates the use of these data, with a particular focus on whether there are differences between frontline staff and managers.DesignCross-sectional nationwide survey study.Setting, methods and participantsA previously validated, Swedish questionnaire regarding use of data from clinical quality registries was translated and emailed to frontline staff, mid-level managers and heads of departments (n=175) in all 30 hospital departments participating in the Danish Cardiac Rehabilitation Database. Data were analysed descriptively and through multiple linear regression.ResultsSurvey response rate was 58% (101/175). Reports of registry use at department level (measured through an index comprising seven items; score min 0, max 7, where a low score indicates less use of data) varied significantly between groups of respondents: frontline staff mean score 1.3 (SD=2.0), mid-level management mean 2.4 (SD=2.3) and heads of departments mean 3.0 (SD=2.5), p=0.006. Overall, department level use of data was positively associated with higher perceived data quality and usefulness (regression coefficient=0.22, p=0.019), management request for data (regression coefficient=0.40, p=0.008) and personal motivation of the respondent (regression coefficient=1.63, p<0.001). Among managers, use of registry data was associated with data quality and usefulness (regression coefficient=0.43, p=0.027), and among frontline staff, reported data use was associated with management involvement in quality improvement work (regression coefficient=0.90, p=0.017) and personal motivation (regression coefficient=1.66, p<0.001).ConclusionsThe findings suggest relatively sparse use of data in local quality improvement work. A complex interplay of factors seem to be associated with data use with varying aspects being of importance for frontline staff and managers.

Mobilizing registry data for quality improvement: A convergent mixed-methods analysis and application to spinal cord injury

“…Findings from the scoping review highlighted the diversity of QI approaches used to support change management and evaluation. QI interventions using registry data have been previously described in both the primary care ( 84 , 85 ) and inpatient rehabilitation setting ( 27 , 30 ) for persons with complex chronic conditions. Presently, there is unclear evidence to support the design of an effective QI intervention that spans across professional disciplines ( 86 , 87 ).…”

“…Information from registry databases can be used to develop and inform QI strategies that improve clinical outcomes and reduce variation in care. Despite the existence of several registries on complex, chronic conditions, there is limited literature explicitly describing their direct application for QI initiatives (26)(27)(28). The use of patient registries for health system decision making is complex, and a growing barrier is widespread awareness and application of this data to inform health system QI of care (26).…”

How registry data are used to inform activities for stroke care quality improvement across 55 countries: A cross‐sectional survey of Registry of Stroke Care Quality (RES‐Q) hospitals

“…Denmark and England [24,25]. While uptake of RES-Q for stroke care monitoring has increased over time, more effort is needed to translate hospitals' quality monitoring into quality improvement.…”

“…Despite involvement in RES‐Q seen as being worthwhile for enhancing stroke care improvement, only 60% of respondents used RES‐Q data to drive local quality improvement activities. Limited use of registry data from multiple specialties for local quality improvement has also been noted in research from Australia [ 17 , 23 ], Denmark and England [ 24 , 25 ]. While uptake of RES‐Q for stroke care monitoring has increased over time, more effort is needed to translate hospitals' quality monitoring into quality improvement.…”

Outcome Measurement at a Ugandan Referral Hospital: Validation of the Mbarara Surgical Services Quality Assurance Database

“…Possible quality improvement efforts include triangulation, improved operative record‐keeping, and clarification of definitions. In the end, quality improvement requires active efforts to translate database registries to clinical practice [44, 45].…”