Information for community hospitals

To design and test a revised data collection system for routine patient based data in the Community Hospital setting in Scotland.

A two part qualitative study was designed to identify the requirements for Community Hospital information, develop a data set to meet these requirements and pilot a proposed Community Hospital Information System.

Identification of the information deficit (Stage 1) involved administering face to face questionnaires in all relevant Health Board areas in Scotland; piloting of the proposed information system (Stage 2) was carried out in four Community Hospitals in Scotland.

Stage 1 of the study highlighted the information requirements as including: who is being treated; why they are there; how complex their needs are; what is being done and by whom; and what is happening next. The additionally required data included: admission reason--medical/social; type of care--intended and provided; all relevant diagnoses and social factors; medication--on admission and discharge; interventions--nursing/GP/consultant; dependency throughout stay; delayed discharge information; and discharge plan. The summary of recommendations that flowed from this part of the study includes: incremental electronic record; link with GP and acute systems; interface with other community systems; duplication of recording; accessibility at local level with variable levels of access (to protect patient confidentiality). Stage 2 of the study piloted the collection of the proposed dataset and permitted development of suitable feedback information, in particular the patient summary screens. Economic evaluation of the proposed dataset compared to the existing data was carried out in parallel with the study and is reported elsewhere.

It is feasible and highly desirable to collect clinically useful information at little additional cost and to provide relevant feedback, including useful patient summary screens, representing the patient stay in hospital.