Data and Measurement
Increase Department of Health and Hospitals data capacity and performance measurement of maternity care
Another critical component of a comprehensive strategy to improve patient safety is to create an environment that encourages organizations to identify errors, evaluate causes and take appropriate actions to improve performance in the future. The collection of complete, comprehensive and timely quantitative and qualitative data is critical to operating effective quality improvement initiatives. External reporting systems represent one mechanism to enhance our understanding of errors and the underlying factors that contribute to them. They can be designed as part of a public system for holding health care organizations accountable for performance. In this instance, reporting is often mandatory, usually focuses on specific cases that involve serious harm or death, may result in fines or penalties relative to the specific case, and information about the event may become known to the public.
Louisiana data systems relevant to birth outcomes, including Vital Records, hospital discharge and Medicaid data can be better utilized in order to achieve this goal. For example, Louisiana has relied on vital records for documentation of premature birth rates, which, until very recently, had a typical delay of one to two years. The Office of Public Health has recently updated the LEERS system and now expects much faster birth certificate data turnaround. Transition of death and fetal death data to the LEERS system is planned. Additional analytic and evaluation capacity, and data sharing across programs and agencies must be accomplished to achieve success.
Improving Louisiana's Birth Outcomes requires understanding the available data that measure specific outcomes. Firstly, a baseline must be established to know just how many babies are born low or very low birth weight, born too early, and born to mothers who smoke cigarettes, drink alcohol or experience mental illness. The Louisiana Department of Health and Hospitals will witness the improvement of the overall health of our moms and babies by documenting the reduction of negative birth outcomes and the increase of positive outcomes. The degree of change from these baseline figures will reflect how policy changes have worked well and have been most affective.
Creation of the birthing hospital report card first requires a comprehensive survey of existing quality metrics for maternity and neonatal care. In addition, a statewide network of data experts should participate in a survey of existing quality metrics. A data portal must be created for the report card and this should be created with the idea that reporting could reach beyond birth outcomes into other metrics. Consensus must be created around best practices for measuring non-medically indicated elective deliveries prior to 39 weeks gestation and a plan developed for measurement so that hospitals and physicians can be held accountable for practices. Finally, data will be shared with appropriate entities tasked with generating the statewide annual report card. Collection of data as well as voluntary reporting of data from hospitals must be achieved.