Dear IHI —
I work on a team that has just kicked off a new quality improvement project, but the IT people are telling me it takes six months to set up a database to collect the data we need to measure. Should I wait for the technology, or is there a way to move this along faster? – DATA HUNGRY
Dear DATA HUNGRY —
You are pinpointing one of the greatest frustrations I’ve had over my career — how can I get the data I need when I need it?
It’s like asking for my favorite flavor of ice cream (these days, burnt caramel) on a warm summer day and having the person behind the counter tell me that she will have to call the factory to change the production process. By the time the wind howls and the snow blows, maybe I will have my burnt caramel. Well, glass half full — at least she didn’t say she would have to get chickens to lay their eggs faster!
As you know, in quality improvement and patient safety, we often look for the root causes of a problem such as this. The simple fact of the matter is that few organizations are providing us with the data we need to guide our improvement. They don’t prominently display real-time data showing trends on key improvement initiatives over time. Rarely are the data you need just a click away. So a root cause may be misalignment between the data an organization generates routinely for administrative and business purposes and the data the front line needs to drive improvement.
So, it’s not surprising that your organization cannot provide you with the data you need without a time-consuming submission and approval process, followed by intensive (and expensive) programming.
I have a simple rule. When I am confronted with a situation like this, I ask myself: What data do I really need to get started? Can it be collected as part of routine work?
If the answer is that your way of working won’t support data collection, maybe you need to revise your workflow so that you can glean the data you need to improve. After all, isn’t improvement supposed to be part and parcel of providing the best possible care every day? It may be tempting to hire someone (for example, a grad student) to collect data for your team, but I would resist that siren call and save some money by streamlining your workflow so that you can incorporate data collection with little additional time and effort.
Now, you may be thinking that’s easy for me to say. But my colleagues and I have tried to practice what we preach, and here’s a paper showing how it can work. I’m proud of this paper for two reasons. First, it’s a product of interprofessional work, and second, it dramatically improved patient safety with minimal disturbance of daily team rounds.
I’d give it a try. Maybe the IT gurus will get jealous and rush to your aid next time you ask for help!
Don Goldmann, MD
Chief Medical and Scientific Officer, IHI
Editor's Note: "Dear IHI" is an advice column in which IHI experts answer questions from health care change agents in the field. Leave your tips in the comments, and look for a new installment every other Thursday. Have a question for "Dear IHI"? Send it to firstname.lastname@example.org or on Twitter using the #DearIHI and @theihi.