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Prospective pilots of routine data capture by paediatricians in clinics and validation of the Disabilities Complexity
Karen A Horridge1, Kenneth Mcgarry2, Jane Williams3
1City Hospitals Sunderland NHS Foundation Trust, Sunderland, UK.
Insights
Prospective data collection by pediatricians is feasible, even for complex cases. Counting patient needs effectively quantifies complexity and informs clinical care and service design.
Area of Science:
- Pediatric healthcare informatics
- Clinical data management
- Health services research
Background:
- Paediatricians require efficient methods for collecting patient data at the point of care.
- Quantifying the complexity of paediatric patient needs is crucial for effective service delivery.
- Existing data collection methods may not adequately capture the nuances of complex paediatric cases.
Purpose of the Study:
- To pilot prospective data collection by paediatricians using a defined terminology set.
- To demonstrate the feasibility and utility of point-of-care data collection and its outputs.
- To validate counting the number of needs per child as a measure of complexity.
Main Methods:
- Paediatricians in 16 settings collected anonymized data during consultations.
- Participants completed a survey on the data collection process.
- Data analysis was performed using R version 3.1.2.
Main Results:
- 8117 needs were recorded from 1224 consultations.
- Clinicians reported positive experiences with the process and data utility.
- The number of needs significantly correlated with gross motor function, epilepsy severity, and intellectual disability severity.
Conclusions:
- Prospective point-of-care data collection is feasible in paediatric clinics without disrupting care.
- Counting patient needs is a valid and simple method for quantifying complexity.
- Electronic data collection is the most time-efficient method.
- Data outputs can inform service design and commissioning for quality improvement.
Aims:
To pilot prospective data collection by paediatricians at the point of care across England using a defined terminology set; demonstrate feasibility of data collection and utility of data outputs; and confirm that counting the number of needs per child is valid for quantifying complexity.
Method:
Paediatricians in 16 hospital and community settings collected and anonymized data. Participants completed a survey regarding the process. Data were analysed using R version 3.1.2.
Results:
Overall, 8117 needs captured from 1224 consultations were recorded. Sixteen clinicians responded positively about the process and utility of data collection. The sum of needs varied significantly (p<0.01) by level of gross motor function ascertained using the Gross Motor Function Classification System for children with cerebral palsy; epilepsy severity as defined by level of expertise required to manage it; and by severity of intellectual disability.
Interpretation:
Prospective data collection at the point of clinical care proved possible without disrupting clinics, even for those with the most complex needs, and took the least time when done electronically. Counting the number of needs was easy to do, and quantified complexity in a way that informed clinical care for individuals and related directly to validated scales of functioning. Data outputs could inform more appropriate design and commissioning of quality services.
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