PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “data auditing”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 811 records · Page 45Linked to original sources
PubMed1991

Cost rounds: presentations by residents on the cost of care.

Cost rounds are conferences on ambulatory medical care presented by third-year residents at the University of Washington in Seattle. The content includes data from a chart audit, charges for services in the clinic and laboratory, and suggested management guidelines. The chart audits stimulate interest in the conferences, and they are feasible when residents are provided with ways to identify patients by diagnosis, specific medication, or laboratory test. This program is a sustainable method of involving residents in discussions about the quality and cost of the care they deliver.

Congresses as Topic↗
PubMed1991

Topical corticosteroids usage in dermatology.

Prescribing of topical corticosteroids was studied in 200 patients attending the dermatology outpatients, randomly auditing the written prescriptions. Data with regard to potency, quantity, frequency, duration and site of application was collected and analyzed. Potent topical steroids were commonly used in 86 (43%) patients. The quantity of topical steroid was mentioned in only 4% patients whereas the frequency was specified in 77%, the site in 69% and the duration in 55% patients, respectively. The importance of these parameters is discussed, guidelines regarding use of topical steroids suggested.

Administration, Topical↗
PubMed2002

Issues of consent and privacy affecting the functioning of ASERNIP-S.

The Australian Safety and Efficacy Register for New Interventional Procedures - Surgical (ASERNIP-S) undertakes horizon scanning, systematic reviews and audits. By disseminating information derived from these processes, ASERNIP-S aims to improve the quality of health care. In the present article, we discuss some of the legal and ethical issues surrounding the collection of identified data for the purposes of audit. The individual's right to privacy is considered as well as the benefits of improving the quality of surgical health care.

Australia↗
PubMedDate not supplied

Exploring the links between quality assurance and laboratory resources. An audit-based study.

OBJECTIVE: To investigate and rectify the problems related to Ziehl-Neelsen (Z-N) staining in a cytology laboratory in the context of quality assurance. STUDY DESIGN: An audit based quality assurance study of 1,421 patients with clinical diagnoses of tubercular lymphadenopathy who underwent fine needle aspiration cytology. Data from 8 months were audited (group 1). Laboratory practices related to selection of smears for Z-N staining were studied. A 2-step corrective measure based on results of the audit was introduced for 2 months (group 2). Results were subjected to statistical analysis using the chi 2 test. RESULTS: Of 1,172 patients in group 1,368 had diagnoses other than tuberculosis. Overall acid-fast bacillus (AFB) positivity was 42%. AFB positivity in 249 patients in group 2 was 89% (P < .0001). CONCLUSION: Several issues in the laboratory are linked to quality assurance. Solving everyday problems can have far-reaching benefits for the performance of laboratory personnel, resources and work flow.

Biopsy, Fine-Needle↗
PubMed2006

Data-driven quality improvement in the Emergency Department at a level one trauma and tertiary care hospital.

To demonstrate how a comprehensive and internally driven Continuous Quality Improvement (CQI) program was designed and implemented in our Emergency Department (ED) in 1999. This program involved monthly data collection and analysis, data-driven process change, staff education in the core concepts of quality, and data reanalysis. Data components collected during the program included census data, physician profiling, and focused clinical audits. CQI measures collected at the beginning of the program and quarterly included: (1) CQI metric data (turnaround times [TAT] and rates of left against medical advice [AMA] or left without being seen [LWOBS]), (2) rates and nature of patient complaints, and (3) results of patient satisfaction surveys performed by an outside consulting firm contracted by hospital administration. During the 4 years since its implementation the program demonstrated improvement in all measured areas. Despite an increase in patient volume of 32% to nearly 37,000 visits/year, and only minimal staffing adjustments, the mean quarterly TAT decreased from 183 min to 165 min (9.8% decrease), the rate of complaints dropped by 56.1% (2.1 per 1000 patients to 0.92), and patients leaving AMA or LWOBS decreased 66.7% from 2.7% to 0.9%. Overall, 44.8% of ED patients rated their care as "excellent." In summary, we demonstrate how a comprehensive quality improvement program was structured and implemented at a tertiary care center and how such a program demonstrated improvement in specific CQI parameters.

Academic Medical Centers↗
PubMed1991

A complementary approach to outcome analysis in the parturient.

As part of routine Quality Assurance (QA) activity in our Department, a quarterly audit of patient outcome after obstetric anaesthetic care is completed. Previously this consisted of a technical (criteria-based) audit and some assessment of patient satisfaction. The most recent audit was carried out by a volunteer providing a cost-effective and flexible means of data collection. In addition, the focus of this audit has shifted to emphasize the importance of 'Patient Described Outcome' (PDO). These data are gathered by means of an interview by the volunteer and a patient questionnaire (PDO factors) and a chart audit (technical details). Simple analysis of data is done to assess both technical and PDO information. Technical details allow comparison to internal and published standards. PDO data provide a complementary means of assessing Structure, Process and Outcome. Thus, the audit permits internal and external evaluation of departmental activities and feedback of QA information necessary to a comprehensive QA program.

Adolescent↗
PubMed2003

The organisation of head and neck oncology services in the UK: The Royal College of Surgeons of England and British Association of Head and Neck Oncologists' preliminary multidisciplinary head and neck oncology audit.

This study was a collaboration between The Royal College of Surgeons of England Clinical Effectiveness Unit and the British Association of Head and Neck Oncologists (BAHNO). We created a multidisciplinary database through an enquiry to all 49 UK radiotherapy centres. A questionnaire audit identified teams and individuals in the UK involved with treatment of head and neck cancer. A questionnaire on their organisation, and intentions for change was sent to the 108 teams (90% response) and 11 sole practitioners (45% response) identified. Overall, 335 surgical consultants were involved in the treatment of 7500 cases per annum, with large variations in size of catchment populations served by teams. Mean length of time spent with each out-patient was 11 min. Of respondents, 58% were already using the BAHNO basic dataset and more indicated intention to use it, but only 32% could actually deliver information on their work-load. More computerisation of data collection is essential, and national audit may bridge the data gap.

Databases, Factual↗
PubMed2002

Completeness of data entry in three cancer surgery databases.

AIMS: Clinical databases are regularly used for audit and research purposes. The accuracy of data input is critical to the value of these tools, but little is known about the factors which influence the completeness of data recording. The aim of this study was to evaluate the influences affecting completeness of data recording in computerized clinical databases of cancer treatment. METHODS: Data omission rates in three databases dealing with management of breast, colorectal and gastro-oesophageal cancers were calculated. The effects of (a) type of record; (b) nature of data and (c) training required to interpret data were evaluated by univariate and multivariate analyses. RESULTS: The overall data omission rate was 21.9% (upper GI 27.6%, breast 19.6%, colorectal 32.7%, P=0.13). For different categories of data, omission rates varied from 0% to 55%. Fields requiring a 'text field' or 'numerical' entry, or containing demographic data, data required for the process of care or data which required no interpretation were associated with low omission rates. Clinical data, and fields requiring a 'yes/no' response were associated with high omission rates (45 and 48% respectively). Clinical data and data relating to patient demographic details were independently associated with high and low omission rates respectively (odds ratios for significant missing data 86.9 and 1 respectively). CONCLUSION: Clinical data are poorly captured by current cancer surgery databases. Reasons for the poor completion of fields requiring input by clinical staff, particularly availability of time and training, and prioritization of work, should be addressed. Re-design of databases to ensure that data entry is simple and unambiguous may improve accuracy.

Breast Neoplasms↗
PubMed1993

Quality assurance and internal organizational communications.

Reviews the relationship between internal communication in organizations and the effective delivery of service. Illustrates how quality internal communications can reduce the levels of uncertainty experienced by staff, especially at times of change, and describes a methodology--the communication audit--whereby organizations can monitor and evaluate quality in this sphere. Explains the core steps involved in implementing this type of audit and itemizes the main data collection tools.

Forms and Records Control↗
PubMed2003

Fetus at risk: prevalence of alcohol consumption during pregnancy estimated with a simple screening method in Swedish antenatal clinics.

AIMS: Maternal alcohol consumption is a major health hazard for the fetus. Sweden has an extensive system of public antenatal care clinics, whose mission is to detect and prevent this type of health hazards. However, very few cases of alcohol consumption during pregnancy are detected. The aim of this study was to examine the prevalence of hazardous or harmful alcohol consumption during pregnancy in a consecutive series of Swedish pregnant females. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: The Alcohol Use Disorders Identification Test (AUDIT) was used to collect anonymous data from consecutive pregnant subjects admitted during 1 year to an antenatal clinic in Stockholm, and signing up for parental education offered routinely (n = 1327). Data were obtained from 1101 subjects, typically in pregnancy week 30. A complete AUDIT form was filled out referring to alcohol use during the year prior to pregnancy. A separate form with the consumption items from AUDIT was filled out to report behaviour during pregnancy. FINDINGS: For the year preceding pregnancy, 17% of subjects reported AUDIT scores of 6 or higher, indicating hazardous or harmful alcohol use in women. Few individuals reported scores of 13 or higher (indicating abuse or dependence), but almost half the subjects (46%) reported binge drinking (six standard drinks on a single occasion) once/month or more often, and 6% reported binge drinking on every occasion of alcohol consumption. One-third of the subjects (30%) continued regular alcohol use during pregnancy, and 6% reported consumption two to four times/month. In a logistic regression model, AUDIT scores for the year prior to pregnancy and subject age, but not education level were significant predictors of continued alcohol use during pregnancy. CONCLUSIONS: Alcohol use during pregnancy is more extensive than has been presumed in Sweden. Simple, clinically useful screening methodology detects hazardous consumption during pregnancy in a manner which regular antenatal care does not. If this methodology can be shown to have similar sensitivity when administered under non-anonymous conditions, it should be made part of routine antenatal care.

Adult↗
PubMed2001

The Medicare Cost Report and the limits of hospital accountability: improving financial accounting data.

Health policy makers, legislators, providers, payers, and a broad range of other players in the health care market routinely seek information on hospital financial performance. Yet the data at their disposal are limited, especially since hospitals' audited financial statements--the "gold standard" in hospital financial reporting--are not publicly available in many states. As a result, the Medicare Cost Report (MCR), filed annually by most U.S. hospitals in order to receive payment for treating Medicare patients, has become the primary public source of hospital financial information. However, financial accounting elements in the MCR are unreliable, poorly defined, and lacking in critical detail. Comparative analyses of MCRs and matched, audited financial statements reveal long-standing problems with the MCR's data, including major differences in reported profits; variations in the reporting of both revenues and expenses; an absence of relevant details, such as charity care, bad debt, operating versus nonoperating income, and affiliate transactions; an inconsistent classification of changes in net assets; and a failure to provide cash flow statements. Because of these problems, MCR financial data give only a limited and often inaccurate picture of the financial position of hospitals. Audited financial statements provide a more complete perspective, enabling analysts to address important questions left unanswered by the MCR data. Regulatory action is needed to create a national database of financial information based upon audited statements.

Accounting↗
PubMedDate not supplied

The clinical application of the nursing process in selected acute care settings: a professional mirage.

The nursing process is the problem solving framework purported to be used in a multiplicity of health care settings. Although its use is widespread in educational and clinical settings, some nurse clinicians display negative attitudes towards its use and state that it is incongruent with nursing practice. To date, there has been no study cited that has examined it use within clinical settings to determine the substance of these claims. Using grounded theory methodology, this study examined the clinical application of the nursing process in acute care hospital settings. Data were obtained from semi-structured interviews with predominantly nurse clinicians (n = 27), participant field observations of nurse clinicians, and in-depth audits of patient records. Textual data were managed using NUD-IST and analysed using constant comparative method. Data generation and analysis proceeded simultaneously using open coding, theoretical coding, and selective coding techniques until saturation was achieved. Nurses in this study experienced the basic social problem of being in a state of "Unknowing" that was linked to a number of factors, such as, the existence of a fragmented and inconsistent method of determining and communicating patient care and work conditions of immense change and uncertainty. The findings revealed several problems with the clinical application of the nursing process and illustrated that the espoused theory was unable to be clinically applied.

Acute Disease↗
PubMed1983

Analytic procedures for evaluating health care. Statistical control charts.

The concern for quality of health care motivates evaluation programs designed to monitor the health care system, patient outcome, and provider expertise. An array of audit methods and instruments for evaluating professional and institutional performance has been developed. Although evaluation is viewed by many as the basis for accountability and improvement of health care, few are aware that most existing evaluation programs are really data-collecting systems. Very little if any, analysis of the data is done with the objective of optimizing the system. The "sampling with intervention" procedures often used to monitor the health care delivery system are primarily directed toward the individual patient while the system and provider continue to operate in the established mode. This article outlines analytic procedures for interpreting evaluation data generated by quality control and audit systems. Five common univariate statistical quality control charts are described.

Data Collection↗
PubMed1989

A microcomputer-based clinical trial database incorporated with an 'audit trail' for correction process.

Multicenter clinical trials usually involve several hundred research variables with tens of thousands of records and require mainframe computers for processing. Because of recent advances in hardware and software, it has become possible to support data management and statistical analysis for a complex research project totally on a microcomputer. The Veterans Administration Cooperative Studies Program Coordinating Center (CSPCC) in Hines, IL, U.S.A. has successfully implemented three studies employing the SIR/PC Database Management System (DBMS) on an IBM PC AT. The CSPCC DBMS was designed with a method of verifying data and of updating the database, that leaves a more detailed 'audit trial' of the original data and subsequent modifications than provided by the SIR audit trail facility. Data validation can be done at any time throughout the study to facilitate error identification as early as possible in the data handling process. DBMS operation and maintenance are automated by a system of menus. The utility programs are prestored in a procedure file to optimize performance. The simple design speeds implementation and also reduces the cost of development.

Clinical Trials as Topic↗
PubMed2004

National clinical sentinel audit of evidence-based prescribing for older people.

OBJECTIVES: To audit the performance of hospitals in evidence-based prescribing. SETTING: All hospitals in England were invited to participate. The audit was completed in 62 hospitals. SUBJECTS: Prescribing and clinical data were collected on 100 consecutive medical inpatients aged >/= 65 years at each site, enabling evaluation of eight prescribing indicators before and after intervention. The data were collected using a specifically designed database. INTERVENTIONS: The results of the first audit were available immediately from the software and a national report with locally identifiable information was returned to hospitals. Hospitals were encouraged to design and deliver their own intervention strategy. A questionnaire was sent to all hospitals to document prioritization of indicators. RESULTS: Generic names were used for 36 061 (82.6%) in 1999 and 39 188 (86.4)% in 2000. In 1999, 50% (3074) of patients had documentation of allergy status. This increased to 60% (3684) in 2000. For 21.2% of patients prescribed paracetamol in 1999 and 18.1% in 2000, the prescription was written such that it was possible to exceed the maximum recommended dose of 4 g in 24 hours. Long-acting hypoglycaemic drugs were prescribed to 29 patients in 1999 and 20 patients in 2000. Anti-thrombotics were used appropriately for 54% (520/966) of patients in atrial fibrillation in the first audit and 57% (579/1019) in the second audit. The appropriate use of aspirin increased from 91% (595/651) to 94% (725/772) and the appropriate use of benzodiazepines dropped from 49% (537/1088) to 47% (460/966) between the audits. For three indicators, the allocating of a high priority translated into a bigger improvement between the audits. CONCLUSIONS: Local ownership of data and the quality improvement process, and provision of national benchmarking data did not result in a significant improvement in prescribing in the second audit.

Aged↗