Putting Practice Guidelines to Work in the Department of by Donna O. Farley

By Donna O. Farley

This consultant describes a method that may support your MTF effectively in achieving evidence-based perform, an immense precedence of the DoD

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Administrative data on service utilization usually contain diagnosis and procedure codes. However, different codes can be used to describe the same event and the accuracy and completeness of coding are not always consistent. Using administrative data also limits you to the information that the computerized systems already collect, unless you can add desired data elements to the systems. , DEERS): Enrollment data have the advantage of providing information about the entire population of patients served by your MTF.

Useful data sources include: patient charts and documentation forms, surveys, and administrative and enrollment information. 1: Advantages and Disadvantages of Data Collection Methods Data Collection Method Advantages Disadvantages Administrative data: Encounter data Low cost; readily available Inconsistent coding, data not available for many measures Enrollment data Provide data on entire patient population Data not available for many measures of interest; data may not be regularly updated Patient management sheet (documentation form) Guideline-specific data; provider reminder Incomplete data if forms not completed for all patients Chart abstraction Detailed clinical data on appropriateness and outcomes of care Costly; time intensive Patient surveys Capture patient perceptions of guideline implementation and health status Costly; time intensive; one point in time; uncertainty about patient perceptions Special study data: • Chart abstraction: Because the patient chart contains detailed diagnostic information, it can be used to determine the appropriateness of care, the quality of care, clinical outcomes, and the access of certain groups to specific types of care.

COLLECT DATA Methods for Monitoring Implementation Once you have chosen your metrics, the next task is to put implementation monitoring systems in place at your MTF. There are two basic methods for collecting data to monitor your chosen metrics. • Routine monitoring of administrative data, which usually come from an MTFs’ automated information systems, include enrollment records, encounter records for outpatient visits, inpatient stays, prescription drugs, and use of ancillary services (such as laboratory, radiology, physical therapy, and other diagnostic or therapeutic services).

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