Take a walk through an emergency department (ED) these days and you cannot go more than a few feet without seeing a nurse, tech, and physician interacting with some kind of an electronic device. Computer, telemetry, and tracking screens are everywhere. As hospitals are encouraged by incentive dollars to continue to invest heavily in technology, data entry of clinical and administrative information has become a normal part of ED culture. This cultural evolution has resulted in an exponential increase in the volume, depth, and breadth of data captured, all of which is potentially available for analyses. This chapter describes the critical role of data collection, analysis, and reporting in the management of a 21st century ED.
Hospital administrators, especially those in the C-suite, are being told by their chief information officer (CIO) and IT/IS departments that all data required to validate staffing, evaluate quality, monitor productivity, or prove return on investment (ROI) on all service requests made by ED managers can be obtained from currently installed computer systems. Electronic health record (EHR) vendors purport that all of the required information is available at a “push of the button,” either through standard reporting or ad hoc reporting tools.
With the above statement in mind, this chapter attempts to answer the following questions:
- In what computer system(s) is clinical, operational, financial, satisfaction, and productivity data captured and how can it be accessed?
- What actions must be performed and processes put in place to make sure information being used by ED management and hospital administration is the “right” data, is “clean,” and is accurate?
- What can be done when the EHR's standard reports and ad hoc reporting tools are not satisfying the analytics' needs?
Rather than focusing on the most relevant, impactful information or key performance indicators (KPIs) an ED manager must produce,1 this chapter will focus exclusively on the mechanics of how, why, and from where data makes its journey onto a report.
However, the prospect of learning where metrics (items of data that can be calculated) may be collected and reported, along with how data moves from its source onto a report can be very tedious and not very exciting. Therefore, this chapter brings to life these topics and present concepts in a way that hopefully clarifies them and suggests best practices to stay involved in all data acquisitions and analyses efforts. The chapter will guide the ED clinical team in its partnership with the IT/IS team to not default to the IT/IS team, but rather to become involved by:
- Obtaining data and providing direction for the types and location of actionable information
- Defining the key performance indicators (metrics—KPIs as defined by the reader) that can easily be produced and from which operational computer system these KPIs can be obtained
- Collecting, cleaning, and organizing this data, as well as the benefits of consolidating this information into a centralized repository...