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P127: Health information technology and the Ontario emergency department return visit quality program - A population level continuous quality improvement program

Published online by Cambridge University Press:  02 May 2019

A. Taher*
Affiliation:
University of Toronto, Toronto, ON
E. Bunker
Affiliation:
University of Toronto, Toronto, ON
L. Chartier
Affiliation:
University of Toronto, Toronto, ON
H. Ovens
Affiliation:
University of Toronto, Toronto, ON
B. Davis
Affiliation:
University of Toronto, Toronto, ON
M. Schull
Affiliation:
University of Toronto, Toronto, ON

Abstract

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Introduction: Emergency department (ED) return visits are used for quality monitoring. Health information technology (HIT) has historically supported return visit programs in the same hospital or hospital system. The Emergency Department Return Visit Quality Program (EDRVQP) is a novel population level continuous quality improvement (QI) program connecting EDs across Ontario that leverages HIT. We sought to describe the EDRVQP HIT architecture, experience of participants, enabling program factors and barriers. Methods: The Informatics Stack conceptual framework was used to describe the HIT architecture. A literature review of peer-reviewed background literature, and stakeholder organization reports was conducted. Purposive sampling identified key informants. Semi-structured interviews were conducted until saturation. Common themes were identified by inductive qualitative thematic analysis. Results: Twenty-three participants from 15 organizations were interviewed. The EDRVQP architecture description is presented across the Informatics Stack. The levels from most comprehensive to most basic are world, organization, perspectives/roles, goals/functions, workflow/behaviour/adoption, information systems, modules, data/information/knowledge/algorithms, and technology. Enabling factors were a high rate of EHR adoption, provincial legislative mandate for data collection and program membership, use of functional and data standards, local variability, phased deployment, and QI and patient safety culture. Two main barriers were increased case turnaround time and privacy legislation. Conclusion: The Informatics Stack framework provides a robust approach to thoroughly describe the HIT architecture of this population health programs. The EDRVQP is a population health program that illustrates the pragmatic use of continuous QI methodology across a population (provincial) level.

Type
Poster Presentations
Copyright
Copyright © Canadian Association of Emergency Physicians 2019