A Performance Review Utilising Administratively Collected Hospital Patient Information and Coding Data

OBJECTIVES: Collection of data and self audit can be a difficult undertaking in orthopaedic private practice. The aim of this study is to demonstrate that review of administratively collected patient information can provide useful information for self-audit and clinical outcomes. METHODS: Baseline coding, Financial and Limited Adverse Outcome Screening (LAOS) data relating to a single Orthopaedic Surgeon’s Knee Practice at one private hospital, relating to surgical admissions between the 31(st) January 2013 and the 31(st) March 2015 was analysed. Measures looked at included; absolute numbers of surgical procedures, breakdown of procedures according to coding, readmissions within 30 days, length of stay per procedure, return to theatre, adverse events including thromboembolism, infection and bleeding. RESULTS: Administratively collected data proved to be a useful self- audit and monitoring tool. It is not a substitute for prospectively collected clinical data. The strength of this data is that it is relatively easily accessed and may alert the individual to trends in their practice that may prompt further investigation and practice modification. This information is already being provided to insurers and statutory bodies without clinical interpretation and is becoming increasingly important as insurers look to stop funding certain adverse outcomes that require treatment. The process maybe mutually beneficial to both clinician and hospital. The clinician gets to access the data to assist in outcomes evaluation/ improvement whilst the hospital benefits through more accurate recording of adverse events and potentially better coding of data. CONCLUSION: Procurement and basic analysis of administratively collected data can be performed by a solo practitioner without access to any extra research resources. This data allows performance monitoring and may stimulate further practice evaluation and change.