Underlying Key Principles of Data Collection and Reporting

A. General considerations

• Prioritize what you collect. Don’t be data rich, info poor (a DRIP).
• To guide the performance improvement process, it is essential that the ACS team track performance longitudinally using a standard set of metrics.
• At a minimum, CMS core measures data should be collected on ACS, including: fibrinolytic agent received within 30 minutes of hospital arrival or percutaneous coronary intervention (PCI) received within 90 minutes of hospital arrival.
• Smoking cessation advice/counseling.
• 30-Day risk-adjusted heart attack mortality.
• Aspirin at arrival.
• Aspirin at discharge.
• ACE inhibitor or ARB for left ventricular systolic dysfunction.
• Beta-blocker at arrival.
• Beta-blocker at discharge.
• Measuring outcomes is important, but focusing on performance indicators is essential for obtaining quick feedback and will allow you to focus on the steps that lead to improved outcomes.
• Sampling/paper collection is quite acceptable if automated data collection is not yet possible. Collect just enough data to inform your team of baseline processes and clinical performance indicators and whether you are making a difference.
• Carefully define what you want to see. Imagine the end product of data collection and reporting, and make sure it’s what you want.
• Define how data will be collected and reported and assign responsibility for carrying this out.
• Try different methods and measures — they will evolve over time.

B. ACS Data

• Automated data collection (and reporting) is preferable whenever possible.
• Use of the core measures data set reduces duplication of work that your institution is already doing.
• Ideally, data should be downloaded to a central database that interfaces with the hospital/system’s main data repositories so that the data can be analyzed in conjunction with patient, service, and unit data. Even if data cannot analyzed using an automated data integration strategy, the more refined your data is, the easier it will be to review trends and look for outliers.
• This rapidly generates LARGE amounts of data, so the way you interpret and report results requires thought, which is optimally done early in the process.
• Service floor– and health care provider–specific data are helpful.
• Data collection and analysis should be separated for each point of care applicable to your improvement plan, including the emergency department and critical care and non–critical care units because the processes and goals of care of each of these care settings are distinct.