Improving Quality and Safety Through Use of Secondary Data: Methods Case Study

Abstract

Researchers need to evaluate the strengths and weaknesses of data sets to choose a secondary data set to use for a health care study. This research method review informs the reader of the major issues necessary for investigators to consider while incorporating secondary data into their repertoire of potential research designs and shows the range of approaches the investigators may take to answer nursing research questions in a variety of context areas. The researcher requires expertise in locating and judging data sets and in the development of complex data management skills for managing large numbers of records. There are important considerations such as firm knowledge of the research question supported by the conceptual framework and the selection of appropriate databases, which guide the researcher in delineating the unit of analysis. Other more complex issues for researchers to consider when conducting secondary data research methods include data access, management and security, and complex variable construction.

Keywords

patient safety health services research quality improvement electronic health records database management

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References

Agency for Healthcare Research and Quality. (2005). Overview of the nationwide inpatient sample (NIS). Retrieved from http://www.hcup-us.ahrq.gov/nisoverview.jsp

Agency for Healthcare Research and Quality. (2007). Patient safety indicators. AHRQ quality indicators. Retrieved from http://www.qualityindicators.ahrq.gov/Modules/psi_resources.aspx

Agency for Healthcare Research and Quality. (2012). Fact sheet on patient safety indicators. Retrieved from http://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a1b_combo_psifactsheet.pdf

Agency for Healthcare Research and Quality. (2014). HCUP comorbidity software. Healthcare cost and utilization project (HCUP). Rockville, MD: Author. Retrieved from www.hcup-us.ahrq.gov/toolssoftware/comorbidity/comorbidity.jsp

Andersen

R. M.

(2008). National health surveys and the behavioral model of health services use. Medical Care, 46, 647-653. doi:10.1097/MLR.0b013e31817a835

Averill

R. F.

Mullin

R. L.

Steinbeck

B. A.

Goldfield

N. I.

Grant

T. M.

(2001). Development of the ICD-10 procedure coding system (ICD-10-PCS). Topics in Health Information Management, 21(3), 54-88.

Carayon

Schoofs Hundt

Karsh

B. T.

Gurses

A. P.

Alvarado

C. J.

Smith

Flatley Brennan

(2006). Work system design for patient safety: The SEIPS model. Quality and Safety in Health Care, 15(Suppl. 1), i50-i58. doi:10.1136/qshc.2005.015842

Cary

M. P.

Jr. Merwin

E. I.

Oliver

M. N.

Williams

I. C.

(2016). Inpatient rehabilitation outcomes in a national sample of Medicare beneficiaries with hip fracture. Journal of Applied Gerontology, 35, 62-83. doi:10.1177/0733464814541325

Centers for Medicare & Medicaid Services. (2012). The Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) training manual. Baltimore, MD: Author.

10.

Centers for Medicare & Medicaid Services. (2013, May 2). IRF Patient Assessment Instrument. Retrieved from http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/InpatientRehabFacPPS/IRFPAI.html

11.

Couloures

K. G.

Beach

Cravero

J. P.

Monroe

K. K.

Hertzog

J. H.

(2011). Impact of provider specialty on pediatric procedural sedation complication rates. Pediatrics, 127, e1154-e1160. doi:10.1542/peds.2010-2960

12.

Coyle

Y. M.

Battles

J. B.

(1999). Using antecedents of medical care to develop valid quality of care measures. International Journal Quality Health Care, 11(1), 5-12.

13.

Cravero

J. P.

Blike

G. T.

Beach

Gallagher

S. M.

Hertzog

J. H.

Havidich

J. E.

Gelman

(2006). Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: Report from the Pediatric Sedation Research Consortium. Pediatrics, 118, 1087-1096. doi:10.1542/peds.2006-0313

14.

Crego

(2014). Pediatric sedation: Using secondary data to describe registered nurse practice in radiology. Journal of Radiology Nursing, 33, 166-180. doi:10.1016/j.radnu.2014.08.004

15.

Crego

Baernholdt

Merwin

(2017). Differences in pediatric non-interventional radiology procedural sedation practices and adverse events by registered nurse and physicians. Journal of Pediatric Nursing, 35, 129–133.

16.

Donabedian

(1980). The definition of quality and approaches to its management. Ann Arbor, MI: Health Administration Press.

17.

Goode

Phillips

DeGuzman

Hinton

Rovnyak

Scully

Merwin

E. A.

(2016). Patient safety dilemma: Obesity in the surgical patient. American Association of Nurse Anesthetist Journal, 84, 404–412.

18.

Hamilton

B. B.

Laughlin

J. A.

Fiedler

R. C.

Granger

C. V.

(1994). Interrater reliability of the 7-level functional independence measure (FIM). Scandinavian Journal of Rehabilitation Medicine, 26, 115-119.

19.

Krishnankutty

Bellary

Kumar

N. B.

Moodahadu

L. S.

(2012). Data management in clinical research: An overview. Indian Journal of Pharmacology, 44, 168-172. doi:10.4103/0253-7613.93842

20.

Langkamp

D. L.

Lehman

Lemeshow

(2010). Techniques for handling missing data in secondary analyses of large surveys. Academic Pediatrics, 10, 205-210. doi:10.1016/j.acap.2010.01.005

21.

Magee

Lee

Giuliano

Munro

(2006). Generating new knowledge from existing data: The use of large data sets for nursing research. Nursing Research, 55(Suppl. 2), S50-S56.

22.

Merwin

(2007-2012). Course Faculty: Database Management: Secondary Data analysis, Department of Public Sciences, University of Virginia.

23.

Merwin

Thornlow

(2006). Methodologies used in nursing research designed to improve patient safety. Annual Review of Nursing Research. 24:273-292. PMID: 17078418.

24.

Mitchell

Ferketich

Jennings

(1998). Quality health outcomes model: American Academy of Nursing Expert Panel on Quality Health Care. Journal of Nursing Scholarship, 30, 43-46.

25.

Multicenter Perioperative Outcomes Group. (2011). Retrieved from https://www.mpogresearch.org/mpog-and-aqi

26.

Multicenter Perioperative Outcomes Group. (2014). Retrieved from https://www.mpogresearch.org/contributing-mpog

27.

Office of the National Coordinator of Health Information. (2014). Policy researchers & implementers. Retrieved from https://www.healthit.gov/policy-researchers-implementers

28.

SAS Institute Inc. (2004). SAS/STAT9.1 users guide. Cary, NC: Author.

29.

Sorenson

H. T.

Sabroe

Olsen

(1996). A framework for evaluation of secondary data sources for epidemiological research. International Journal of Epidemiology, 25, 435-442.

30.

Thornlow

Merwin

(2009). Managing for quality: The relationship between accreditation standards, safety practices, and patient outcomes. Health Care Management Review, 34, 262-272. doi:10.1097/HMR.0b013e3181a16bce

31.

University of Virginia. (2012). Clinical data repository. Retrieved from https://med.virginia.edu/phs/office-of-the-chair/administrative-divisions/division-of-biomedical-informatics/uva-clinical-data-repository/

32.

Windle

P. E.

(2010). Secondary data analysis: Is it useful and valid? Journal of PeriAnesthesia Nursing, 25, 322-324. doi:10.1016/j.jopan.2010.07.005

33.

World Health Organization. (2000). Obesity: Preventing and managing the global epidemic. Geneva, Switzerland: Author.

34.

World Health Organization. (2008). World health statistics. Retrieved from http://www.who.int/gho/publications/world_health_statistics/EN_WHS08_Full.pdf