Abstract
Background
Accurate and efficient data collection is crucial for effective evaluation of quality
of care. The objective of this study is to compare two methods of data collection
used to score quality indicators for musculoskeletal injury management in Emergency
departments: prospective observation, and chart audit.
Methods
An analysis was undertaken of data collected from 633 patients who presented with
a musculoskeletal injury to eight emergency departments in Queensland, Australia in
2016–17. Twenty-two quality indicators were scored using both prospective observation
and chart audit data for each occasion of service. Quality indicators were included
if they were originally published with both collection methods. Analyses were performed
to compare firstly, the quality indicator denominators, and secondly, the quality
indicator trigger rates, scored using each collection method. Chi Square statistics
were used to identify significant differences.
Results
Prospectively collected data scored quality indicator denominators significantly (p
value<0.05) more often than chart audit data for five (22.7 %) of the 22 quality indicators.
The remaining 17 quality indicators (77.3 %) showed no statistical differences. When
comparing quality indicator trigger rates, 16 (72.7 %) had significantly different
results between methods with 12 (54.5 %) scoring higher using prospective data and
four (18.2 %) with chart audit data. The remaining six quality indicators (27.3 %)
in this comparison showed no significant difference between chart and prospective
data.
Conclusion
Quality indicators including aspects of care associated with patient safety, and those
relying on clinician written orders or forms were adequately scored using either prospective
observation or chart audit data. Whereas quality indicators relying on time-sensitive
information, elements of a social history, general physical exams and patient education
and advice scored higher using prospective observation data collection.
Keywords
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Article info
Publication history
Published online: September 22, 2022
Accepted:
September 7,
2022
Received in revised form:
August 29,
2022
Received:
May 23,
2022
Identification
Copyright
© 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.