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Partnering to improve data quality and birth outcomes

Partnering to improve data quality and birth outcomes. Extending our reach through partnerships June 2-6, 2013, Phoenix AZ. From Good to Great – Collaborating to Advance Data Quality. The Birth Data Quality Workgroup. Extending our reach through partnerships June 2-6, 2013, Phoenix AZ.

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Partnering to improve data quality and birth outcomes

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  1. Partnering to improve data quality and birth outcomes Extending our reach through partnerships June 2-6, 2013, Phoenix AZ

  2. From Good to Great – Collaborating to Advance Data Quality The Birth Data Quality Workgroup Extending our reach through partnerships June 2-6, 2013, Phoenix AZ

  3. MembersBirth Data Quality Workgroup Co-chairs Isabelle Horon (MD), David Justice (NCHS), Joyce Martin (NCHS) Members Sukhjeet Ahuja (NAPHSIS), Sally Almond (MN), Marie Aschliman(UT), KarynBackus (CT), Karin Barrett (MA), Krista Bauer (MN), Mary Chase (CO), Bruce Cohen (MA), Cindy Coleman (MN), Greg Crawford (KS), Cheri Denardo (MN), Judy Edwards (MN), Claudia Fabian (IL), Mark Flotow (IL), Coleen Fontana (RI), Kelly Friar (OH), Melissa Gambatese (NYC), Gloria Haluptzok(MN), Cindy Hooley (VT), Renata Howland, (NYC)Priya Kakkar (KS), Larry Nielsen (NAPHSIS), Lloyd Mueller (CT), Ann Madsen (NYC), Carol Moyer (KS), Laura Ninneman (WI), Michelle Osterman (NCHS), Sharon Pagnano(MA), Mariah Pokorny (SD), Phyllis Reed (WA), Matthew Rowe (WY), George Rudis (IL), Margarita Segundo (CO), NeetiSethi(MN), Shae Sutton (SC), Marie Thoma (NCHS), Elaine Tretter (MD), Regina Zimmerman (NYC)

  4. Origins Birth Data Quality Workgroup NAPHSIS/NCHS Good to Great collaboration VSCP Directors’ conference calls Workgroup established one year ago at 2012 Joint Meeting

  5. Mission Birth Data Quality Workgroup Assess and improve the quality of vital statistics birth and fetal death data Focus on improving data at the source i.e., at the hospital

  6. PrioritiesBirth Data Quality Workgroup Subgroups • Hospital reports • Karyn Backus (CT) • Engaging hospitals • Kelly Friar (OH), Colleen Fontana (RI) • Prenatal care items • Isabelle Horon (MD) Newsubgroups • E-learning training for hospital staff • Identify items to drop from the national birth data file • Working with the Good to Great to develop process for dropping items

  7. Birth Data Quality Workgroup Meeting Wednesday @ 7:15 am Please join us!

  8. Data Quality Workgroup Subgroup 1 • Members: • KarynBackus (CT) • Ann Madsen Straight (NYC) • Phyllis Reed (WA) • Elaine Tretter (MD) • Greg Crawford (KS) • Carol Moyer (KS) • Mary Chase (CO) • Sharon Pagnano (MA) • David Justice (NCHS) • Marie Thoma (NCHS) • Sukhjeet Ahuja (NAPHSIS)

  9. Background • Charge: Recommend a process (metrics, means of communication, actions) for vital records offices to improve hospital reporting of birth certificate data • Aim 1: Survey jurisdictions on their current activities to • Measurehospital-level data quality • Communicatefindings to hospitals • Acton information

  10. NAPHSIS survey participants

  11. Current Practices: Standardized Worksheets Jurisdictions using the 2003 birth certificate (n=33)

  12. Current Practices: Evaluating Data Quality U.S. jurisdictions (n=41)

  13. Current Practices: Evaluating Data Quality • Does your jurisdiction maintain a desire to perform a more extensive quality review? • 90% indicated “Yes” • 95% indicating limited resources as main impediment

  14. Current Practices: Evaluating Data Quality Evaluated Impact Detected Improvement No Yes! Completeness Reports, 63% (n=19) Medical Record Audits, 67% (n=9) Other Detailed Analyses, 71% (n=17) 29-37% 63-71% 100%

  15. Current Practices: Raising Awareness U.S. jurisdictions (n=40)* * No response for 1 jurisdiction

  16. Future Directions • Produce Final Summary Report • Subgroup 1 - Goals: • Develop metrics to evaluate birth facility data quality that are feasible for jurisdictions to implement • Develop means of communications to promote birth data quality • Prepare best practice recommendations for data quality management • Support overall data quality workgroup and ongoing national initiatives

  17. Please visit our poster for more details: Tuesday, 1:30-5pm Presented by Mary Chase (Colorado)

  18. Data Quality Workgroup Subgroup 2 • Members: • Kelly Friar, Ohio • Colleen Fontana, Rhode Island • Melissa Gambatese, New York City • Matthew Rowe, Wyoming • Sharon Pagano, Massachusetts • Elaine Tretter, Maryland • Shae Sutton, South Carolina • Joyce Martin, NCHS

  19. Engaging Hospitals • Overall Charge • Develop approaches in engaging hospitals to improve the quality of the birth certificate data provided to the jurisdictions’ Vital Records office • Goal • Develop a set of standard guidelines for jurisdictions to follow to engage hospital staff to improve the quality of the birth data. • Can be tailored to any jurisdiction • Can be self-sustaining

  20. Deliverables Short List of Deliverables Recommendations to Engage Hospitals Introduce intent of project/campaign to high level hospital key players Ways to identify key data elements that could/should be of concern to hospital Key points to consider when addressing hospital staff Such as…

  21. A Few Key Points of Consideration • Purpose of birth health data • Contributing factors of birth outcomes • How does quality data help the hospital with the community it serves • What could be the “burning platform” for the hospital (QI – PDSA model) • Develop ways for the hospital to access the data • Standardization of definitions • Training • Metrics for vital records offices to improve hospital reporting – Subgroup 1

  22. Action Items Collaborate with national partners Steal shamelessly from other jurisdictions that may have done this! Determine why a hospital should care and how to convince them they should care Determine who in the hospital needs to be convinced Develop methods of communication – what and how

  23. 1) Collaborating with National Partners American Congress of Obstetricians and Gynecologists (ACOG) March of Dimes Association of Women’s Health, Obstetric and Neonatal Nurses (AWHNN)

  24. 2) Steal shamelessly from other jurisdictions – we did! Ohio – Kelly Friar Ohio statewide initiative Improve birth outcomes and reduce infant mortality Key data elements of focus Letter of introduction to hospital executives Dr. Jay D. Iams, Ohio State University Wexner Medical Center Joined our subgroup conference call to gain doctor’s perspective – very enlightening and encouraging California Maternal Quality Care Collaborative - Dr. Elliott Main

  25. We would love to hear from other jurisdictions – just contact any member of the workgroup Thank You !

  26. Prenatal Care Data Items Subgroup 3 • Members: • SukhjeetAhuja (NAPHSIS) • Karyn Backus (CT) • Bruce Cohen (MA) • Isabelle Horon (MD) • Renata Howland (NYC) • Michelle Osterman (NCHS) • Elaine Tretter (MD)

  27. Charge • To assess the quality of prenatal care data items collected on the U.S. Standard Certificate of Live Birth; and • Recommend changes for improvement

  28. Workgroup plan Determine which prenatal care data items should be studied Prepare summary of why these data items were selected for inclusion on the certificate, and how they are used for public health purposes Compile information available on data quality and barriers to collection of accurate data Compile information on state efforts to improve data quality Prepare best practices document If warranted, recommend changes to data items on certificate

  29. Data items selected for study • Date of first prenatal care visit • Date of last prenatal care visit • Number of prenatal care visits

  30. History of collection of PNC data • 1968 • Month PNC began to be collected • 1972 • Number of PNC visits added • 2000—Panel recommendations • Month PNC began Date of 1st PNC visit • Slight revision to number of PNC visits question • 2001—Addendum to Panel Report • Date of last PNC visit added

  31. Barriers to collecting accurate data • Missing data • PNC records not sent to hospital • Mothers may change PNC providers • Inaccurate data • PNC records sent well before delivery and don’t contain current data • Birth clerks may estimate date of last PNC visit and total number of visits • Some states have placed PNC items on mother’s worksheet • Difficult to evaluate what constitutes: • A first PNC visit • A PNC visit • Very time-consuming for birth clerks to collect data items • Providers may provide inaccurate data

  32. Data AccuracyRange of level of agreement in hospitals in 3 states **Accuracy rates probably even poorer, since data in medical records often incorrect**

  33. Jurisdictions with efforts aimed at improving PNC data quality 2013 NAPHSIS Survey 79% believe efforts are making a difference

  34. Does poor data quality prevent PNC data items frombeing useful for public health purposes? 2013 NAPHSIS Survey % of respondents indicating “yes”

  35. Summary • Problems with data accuracy • Limited efforts underway to improve data accuracy • Data quality limits usefulness for public health purposes • Collection/correction requires considerable effort • Medical staff • Birth clerks • Vital Records staff • Next steps • Can the data be improved? • Should changes be made to certificate?

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