Reengineering of the Data Collection Process for Discharge Abstract Database

Hong, Joon Hyun; Choi, Kwisook; Lee, Eun Mee

Journal of Korean Society Quality Assurance Health Care 2000;7(1): 106.
Published online May 30, 2000.

퇴원환자 진료정보 DB의 데이터 수집 과정 재설계

홍준현¹, 최귀숙², 이은미¹

¹세브란스병원 의무기록과
²연세대학교 보건대학원

Reengineering of the Data Collection Process for Discharge Abstract Database

Joon Hyun Hong¹, Kwisook Choi², Eun Mee Lee¹

¹Department of Medical Record, Severance Hospital
²Graduate School of Health Sciences and Management, Yonsei University

Abstract

Background
Severance Hospital is an university hospital which has 1,580 beds. A LAN system was installed in the Medical Record Department in 1992 and discharge abstract data have been added to the discharge abstract database(DB) The previous work flow in the Medical Record Department had 5 levels: 1) chart collection from wards, 2) assembling, 3) abstracting data from medical record on worksheet by 2 RRAs, 4) checking deficiencies and coding diagnosis and procedures by 4 RRAs, 5) inputting the data into the discharge abstract data base by 1 RRA. The average processing time took 19.3 days from the patient discharge date. It had the production of monthly statistical report delayed. Besides, it caused the users in the hospital to complain.
Methods
A CQI team was organized to find a way to shorten the processing time less than 10 days. The team identified the factors making the processing time long and integrated three levels from the 3rd level into one. Each of 7 RRAs performed the integrated level on her workstation instead of taking one of three separate levels. The comparison of processing time before and after the changes was made with 3'846 discharges of April, 1999 and 4,189 discharges of August, 1999.
Results
The average processing time was shortened from 19.3 days to 8.7 days. Especially the integrated level took only 3.6 days, compared with 12.3 days before the change. The percentage of finishing up the whole processing within 10 days from discharge was increased up to 77.6%, which was 2.4% before the integration. The prevalence of error in data input was not increased in the new method. Conclusions : The integrated processing method has the following advantages: 1) the expedition of production of monthly statistical report, 2) the increase of utilizing rate of dischare abstract data by Billing Dept, Emergency Room, QI Dept., etc., 3) the improvement of intradepartmental work follow, 4) the enhancement of medical record quality by checking the deficiencies earlier than before.

Key words Reengineering;Data collection;Discharge abstract database;