Discussion: Organization discharge data
Discussion: Organization discharge data
A local hospital publicly reported organization discharge data. The
data were risk adjusted to control for pre-existing comorbidities to
level the playing field with data reported from other hospitals. The
report notes little risk adjustment for stroke mortality. Recently,
the hospital received stroke center designation for following best
practice protocols for stroke management. The DNP scholar and
data analyst track stroke mortality data and note a spike in
mortality for a given quarter, which explains why the state public
report is unsatisfactory. Drilling into the data to examine the
numerator deaths due to stroke, denominator and total patient
population. The data analysts determines that the risk mortality
has a score of one to four, with one being a minor risk of mortality.
This explains why the hospital did not risk adjust well, because
these patients did not appear to have risks associated with severe
illness that would reasonably explain the associated mortalities.
Next, the data analyst drills further into the detailed subject
oriented data of actual patient records and then completes a full
chart review to obtain the sweet spot to inform quality
improvement.
Consider the scenario above to address the following.
· Do you recommend that the data analyst examine aggregate
data, detailed data, or both, to investigate this quality issue?
Please explain your rationale