Strategically there is a need to not only take a clinical process view of health care delivery but also identify the appropriate information to support the processes. When considering the clinical process view, the challenge for continuous quality improvement is to eliminate inappropriate process steps, and continuously document performance/outcome. The questions are what performance measures are useful, and does a state level data collection capture relatable measures of a process of care.
Victorian Admitted Episode Dataset (VAED), developed and maintained by the Department of Human Services, Victoria (DHS), is an important data collection of acute hospital admitted patient data. The collection plays a vital part in enabling DHS to meet the health service provider-relevant legislative requirements, and has become an essential tool in the implementation and monitoring of the Casemix funding system. VAED comprises of demographic, clinical and administrative details of every admitted episode of care occurring in Victorian acute hospitals. It forms the core set of collected information that hopes to assist the providers, purchases and consumers of acute health services in their performance measurement analysis and decision-making.
Evidence based medicine often reports events that need to take place, the triggers for the events and the intra- and inter-event times. Organisational excellence is often based upon time lags and event planning. Although time is a coarser matrix, it may provide a useful starting point and augment event-based approach to study of the care process. Time and event measures have certain strengths and weakness, and make certain assumptions.
This study identifies some useful time and event measures form VAED that can pro vide information about a process of care. Using three consecutive years’ data, the interrelationship between the above measures is explored. Studies such as this may help clinicians and health managers to view state level data collections as a tool for better understanding of the current clinical care process, and provide some useful overall measures of quality of care.