qip - ebr
TRANSCRIPT
Enhancing Communication Quality Project 2013 Page: 1
Quality Improvement Project
At
The Aga Khan Hospital for Women & Children, Kharadar
Establishing
Electronic Database
for Conservation of
Birth Records
Spreading Over 7
Decades
Enhancing Communication Quality Project 2013 Page: 2
Contents Quality Project Plan Summary ...................................................................................................................... 3
1.0 Introduction ...................................................................................................................................... 4
2.0 Rationale for selection of Quality Project ......................................................................................... 4
2.1 The Problem ........................................................................................................................................ 5
3.0 Relevance to Quality & Safety Policy/ Vision/ Core Values .............................................................. 5
4.0 Quality Project Goal ................................................................................................................................ 5
5.0 Project Methodology .............................................................................................................................. 5
6.0 Project Plan ............................................................................................................................................. 6
6.1.1 Data Collection ................................................................................................................................. 6
6.1.2 Brainstorming................................................................................................................................... 7
6.1.3 Action Plan ....................................................................................................................................... 7
7.0 Project Implementation .......................................................................................................................... 8
7.1 Establishment of an Electronic Database: .......................................................................................... 8
7.2 Pilot Phase: Entry of data for the first decade .................................................................................. 12
8.0 Project Outcome ................................................................................................................................... 13
8.1 Data Summary ................................................................................................................................... 13
9.0 Project Sustainability ............................................................................................................................ 14
10.0 Acknowledgement .............................................................................................................................. 14
Enhancing Communication Quality Project 2013 Page: 3
Quality Project Plan Summary
Project Title: Establishing Electronic Database for Conservation of Birth Records
Spreading Over 7 Decades
Project Duration: November, 2012 – June, 2013
Project Class: Departmental - Non-Clinical
Project Category: Service Improvement for Customers Project
Department: The Aga Khan Hospital for Women & Children, Kharadar
Project’s Identification: The project was identified through analyzing Client’s
feedback.
Project Team:
Members Designation Role
Mr Irfan Valliani Manager,
Administration
Team Leader
Mr Muhammad Bilal Hardware Technician Member
Mr Alidino Khowaja Admin Officer Member
Mr. Asghar Dinar MR Incharge Member
Ms Saba Akber QIPS Officer Member
Project Methodology:
Organizational Continuous Quality Improvement Model of Plan-Do-Study-Act
(PDSA), as defined and described in the AKUH Quality Improvement and Patient
Safety Program.
Enhancing Communication Quality Project 2013 Page: 4
1.0 Introduction
The Aga khan Hospital for Women & Children, Kharadar is one of the oldest
hospitals of the country. Its establishment dates back to the year 1924, long
before the formation of Pakistan. Initially known as the Janbai hospital, the entity
functioned as a maternity home. With the introduction of an advanced general
surgery unit for women, the maternity home now functions as a full-fledged
hospital for women and children. Even till today, the hospital is known for its long
history of services in maternal health.
2.0 Rationale for selection of Quality Project
With the passage of time, the need for proper documentation has increased. As
the national policies and procedures strengthen, citizens are required to abide by
the requirement of legal documents. Among all of the kind, birth certificate is the
one that has now become an essential document for every person.
Recently, it was identified that the clients, who were born decades ago, would
approach the Medical Records department with a request for their birth
certificate. In response to such requests, the old records were reviewed and it
was identified that the hospital holds a manual record of birth, starting from the
year 1942.
Enhancing Communication Quality Project 2013 Page: 5
2.1 The Problem
At the Aga Khan Hospital for Women & Children, Kharadar, the birth records are
maintained from 1942 were in registers, and their retrieval, preservation and
storage was a tedious task.
3.0 Relevance to Quality & Safety Policy/ Vision/ Core Values
* Provision of access to the essential information
* Application of Technology
4.0 Quality Project Goal The project aimed at:
*Establishing an electronic database for conservation of the birth records, which
are in hundred thousands.
*Converting the manual records into the established electronic database (A
decade per year), from 1942 to 2010
5.0 Project Methodology Deming’s PDSA Cycle had been selected as project methodology.
Enhancing Communication Quality Project 2013 Page: 6
6.0 Project Plan
Nov-Dec, 2012 Jan – Mar, 2013 Apr- Jun, 2013
Problem Identification
Planning
Establishment of the
electronic database
Pilot: Birth record
entries (2001-2010)
System Audits
6.1.1 Data Collection
Data collection based on the clients’ feedback which included:
1) Written/verbal feedback
2) Requests for birth certificates
On an average, the medical record department gets 15 requests per month for
the issuance of birth certificate from people who were born in the past years.
Depending on the year of birth, the time taken to prepare the certificate varies
from 3 to 10 days.
Often, the staff gets verbal feedback from the clients about faster service in terms
of tracking back their data.
In the month of March, a written feedback was also received which said that:
Enhancing Communication Quality Project 2013 Page: 7
6.1.2 Brainstorming
The project team conducted brainstorming session in which the problem was
analyzed and the plan for establishing an electronic database was formalized.
6.1.3 Action Plan
As per the plan, the project is divided into three phases:
Phase Strategy Timeline Responsible
01 Establishment of the
Electronic Database
March, 2013 IT department
02 Pilot : Entry of data for
the first decade
June, 2013 MR department,
Manager,
Administration
03 All remaining data
entries (from 2000-1942)
June, 2015 MR department,
Manager,
Administration
Also, it was decided that the entries would be made starting from 2010 and going
back to the 1942. During the pilot phase, the data for the first decade (2010-2001)
would be entered.
“I was born in 1985. Today when I came … and asked for the birth
certificate, it took a lot of time. I would suggest that you maintain a
database of all the past records.”
Enhancing Communication Quality Project 2013 Page: 8
7.0 Project Implementation
7.1 Establishment of an Electronic Database:
For the conservation of the entire data, an electronic database was established,
specifically for the birth records. The technical summary of the database is as
follows:
Server side language: ASP.Net C#
Database: Microsoft SQL server
The administrative login rights were issued to only those responsible for entering,
viewing or approving data. Entry of data was divided into three task management
levels:
Enhancing Communication Quality Project 2013 Page: 9
Level 1: MR Assistants enter the data from the manual
registers.
Using the “Add New” option in the “Bolt On” menu, MR assistant can fill in the
Birth record entry form containing essential information about the baby.
Enhancing Communication Quality Project 2013 Page: 10
Once the form is filled and saved, the data goes into the “Work list” and can be
accessed for the task management level 2.
Level 2: The MR In Charge reviews the entered data.
At this level, the MR In charge uses the “Review” option from the Work list menu,
selects the batch (Month and year) and rechecks all the data entered in level 01.
Enhancing Communication Quality Project 2013 Page: 11
Here, the MR in Charge has three options:
Delete: In case of Wrong or duplicate entry
Edit: In case of Wrong or incomplete entry
View: The birth record entry details
The correct reviewed entries are selected. Using the “Approve Selected” option,
the data is transferred to the Level 3.
Level 3: The Manager, Administration approves randomly
selected data
All the data reviewed in level 2 is now approved by the manager, administration.
Using the “Approve” option, the manager gets an access to the batch wise;
computer generated random selection of entries.
This is the final level of the process. At the end of this, the data is saved.
Enhancing Communication Quality Project 2013 Page: 12
The application also provides an option for the printing of birth certificate, in case
if the client requests for one. The certificate has been designed on the standard
AKUH birth certificate format.
7.2 Pilot Phase: Entry of data for the first decade
The pilot phase started from March, 2013. During this phase, the data for the first
decade (2001-2010) was entered in the established application.
Over 18,000 entries were recorded, reviewed and approved.
Enhancing Communication Quality Project 2013 Page: 13
8.0 Project Outcome
The project has yielded the following outcomes:
1. Accessibility: An easy access to the birth records from the past.
2. Increased External customer satisfaction: So far 17 birth certificates have
been issued through this system, resulting in no complaints from the clients
requesting.
3. Increased Internal customer satisfaction: Since, the MR staff will no longer
need to refer back to the manual registers, the satisfaction level has
increased.
4. Decreased chances of errors: The three task management levels ensure
error free record
5. Improved Efficiency: Access to the data and printing of birth certificates
requires a few clicks only.
6. Sustainability of the Birth Record: Electronic database has ensured that the
data will be preserved and sustained.
8.1 Data Summary
Enhancing Communication Quality Project 2013 Page: 14
9.0 Project Sustainability
At the end of the third phase of this project, every birth record from 1942 will be
available to the user. Also, it is recommended that this application be integrated
with the current application so that all the birth records could be accessed from a
single source.
10.0 Acknowledgement The project team acknowledges the efforts, coordination and cooperation of the
following individuals/ departments:
Dr Huma Naz (Administrator, AKHW&C, Kharadar)
Mr Ali Dino Khowaja (Administrative Officer, AKHW&C, Kharadar)
Medical Records Department (AKHW&C, Kharadar)