Essential Steps in Healthcare Evaluation Methods
Basic Steps in Healthcare Evaluation Methods
1. Defining the Problem
a) What is being evaluated? Quality of clinical documentation and its use in the clinic.
b) Who is being evaluated? Doctors and hospitals, including nurses from hospitals.
In inferential statistics, the term population describes a set of subjects or units with one or more features in common. A sample is a subset selected to be representative of the population for evaluation.
Usually, medical studies use samples instead of entire populations, as studying entire populations is more expensive and often unnecessary for quality assessment. Currently, two main sampling techniques are used:
- Probability sampling
- Non-probability sampling
- Probability Sampling: Methods of evaluation in clinical documentation to ensure a valid and representative sample use probability sampling techniques. The four following probability sampling techniques are most frequently used:
- Simple random sampling
- Stratified sampling
- Systematic sampling
- Multi-stage sampling
In our particular case, we used stratified sampling (the population is divided into subgroups or strata, such as physicians, nurses, and technicians) and then performed simple random sampling from each of the previously obtained samples. This ensures that each unit of the population has an equal chance of being selected.
- Non-Probability Sampling: In this case, the probability of selecting an individual is unknown (e.g., individuals attending a consultation and volunteers).
2. Equipment Evaluation
Active quality control, now known as quality management, is starting in our area hospitals. It is transitioning from an individualistic approach within hospital services to higher authorities such as the Ministry of Health (draft framework Quality Assurance, project COMAC), Concierge Health, INSALUD, CCAA, etc.
3. Sources of Information
The main sources of information that can be used to perform the evaluation are:
- Primary Sources: Information obtained from consultations with healthcare professionals (doctors, nurses, and staff of the SADC) or patients. The most popular method is the questionnaire survey, which provides first-hand information compiled by the evaluation team.
- Secondary Sources: Information obtained from consulting documents included in the health records, statistical admissions, files, and hospital databases (highlighting the MDS).
4. Data Analysis
Certain criteria must be met 100%, such as the correct completion of clinical documentation, especially the clinical discharge report, anesthesia records, and surgical intervention records. Other criteria may admit lower compliance levels and still be considered good quality care.
5. Execution of Proposed Actions
The proposal and execution of corrective actions clearly distinguish the current quality of care from what would only be an evaluation program.
6. Re-evaluation
Within a certain period (6 to 9 months, for example), and using a design similar to that of the previous stage, new data is collected and analyzed to assess the degree to which the initially defined criteria are now met. Depending on the outcome of this re-evaluation, the evaluation cycle would either start again or not.