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Some critics say the Joint Commission on Accreditation of Healthcare Organizations is trying to implement the ORYX data collection project too fast. But the machinery is in motion now, and there appears to be no stopping it, so what can you do?
Start by trying to pinpoint the costs of this whole endeavor, says Karen Reeves, vice president of professional services with the South Carolina Hospital Association in West Columbia. Take that into consideration when you select the two data sets that your facility will gather next year, and remember that they are not all equally difficult to collect. At the Regional Medical Center of Orangeburg (SC) and Calhoun County, Indun Whetsell, RN, BSN, quality management coordinator, says she started working with the congestive heart failure and myocardial infarction data sets because clinicians there already had an interest in those subjects and wanted to make use of the information. They are getting good, usable data, but she suspects some other data sets might have been easier to tackle.
Remember that the data sets are not created equal — far from it, actually. Acute myocardial infarction (AMI) has nine measures, heart failure (HF) has six, community acquired pneumonia (CAP) has nine, pregnancy and related conditions (PRC) has three, and surgical procedures and complications (SPC) has two measures. Health care providers will want to consider the value of the data for their own use, but you also should consider the amount of work involved, Whetsell says. If you know you’re really going to tax your resources, it might be wiser to choose PRC or SPC instead of a data set that requires more work. "What you choose will determine how labor intensive the work will be," she says. "Go into it with your eyes open."
Scott Williams, PsyD, the Joint Commission’s associate project director in the division of research, is managing the pilot project. Williams says feedback from the pilot project participants indicates that the level of support from upper administration makes a huge difference. "What seems to be pretty consistent is that for those hospitals with a tremendous amount of CEO buy-in, performance measurement is important, a lot of resources are available to them, and it’s not that much of a burden," he says. "For those without a lot of buy-in, they have to make do with resources they already have and that were set aside for other activities. They have more difficulty with the project."
Logue and Williams offer this advice for how to prepare for the July 2002 deadline and make the data collection less burdensome:
• Study the data collection sets and get familiar with the specific requirements of each one. Deter-mine how your particular organization would respond to each.
• Look for opportunities to streamline your medical records and make finding the data elements more efficient.
• Make sure you are documenting all the required data effectively.
"We’ve found that with some measures, hospitals do them very well but don’t document them very well," Williams says. "Smoking cessation programs are a good example. If hospitals improve their documentation, they not only get the benefit of being credited with that work but also they reduce the time required to find that information and pull it together."
Automation will lessen the workload with some data collection, but the work certainly can be done by hand, Logue says. By the time the ORYX program is finalized for the July 2002 deadline, the Joint Commission will be able to offer more specific advice gleaned from the pilot project, he says. "There are things you can do now to prepare so you’re not blindsided and wake up in July 2002 and suddenly have this incredible job in front of you," Logue says. "And by that time, we will have streamlined the process in some ways and heard some helpful advice that we can pass on."