The clear starting point in using the MIS for quality improvement is to review the system to understand what it collects, how it works, and how teams can cull (or contribute) information using it. Here are some basic questions to consider:
Remember to consider all of the ways the organization regularly collects information or data. One improvement team developed a bereavement questionnaire, only to have the first respondent point out that she had answered similar questions from the hospital chaplain's office just a few days earlier! In nursing homes required to use the extensive Minimum Data Set (MDS) tool, a great deal of information will already have been gathered. Sometimes marketing, nursing, or billing departments have data that would be useful - and that would not require additional patient surveys.
A quick review enables an improvement team to find what its members know - or don't know - about the organization's record-keeping and information management processes. What can the MIS do? Can it track the outcomes relevant to the team's improvement projects? What kinds of information can be used to enrich quality improvement efforts? Are there ways to use information from the financial system - for example, tallying diagnostic tests or procedures used on patients with certain diagnoses - to track quality improvement measures? The process itself can generate quality improvement endeavors.
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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.
For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].