The provision of care, policy development, implementation and monitoring, and the performance of the NHS are all improved if based on better quality information. High quality information requires high quality data.
The Information Quality Improvement (IQI) initiative is a mechanism to improve the quality of information being used to support patient care and address issues of compliance with national data standards, as well as to review and develop the standards themselves. In turn, the Initiative aims to address deficiencies in the data and information being used to plan, inform and monitor NHS Wales healthcare activity and services.
The initiative is responsible for driving forward these improvements by identifying national priorities, as well as developing policies and action plans designed to focus attention on the related information quality issues and finding solutions to the underlying causes of these problems. These groups comprise representation from a wide range of bodies which can effect change in this area.
IQI is therefore a coordinated national initiative which proactively seeks to tackle quality issues affecting strategically important information by promoting a collaborative approach which makes best use of scarce resources to drive effectual and worthwhile improvements.
All resources relating to this initiative are published on this website.
Information is an increasingly valuable commodity within the healthcare sector. As well as the obvious primary use of healthcare information in treating patients, there are a range of secondary uses, including public health surveillance, performance monitoring, service planning/improvement and financial costing.
Clearly, high quality data are necessary in order to maximise the value of this information. The increasing appetite for health information means that its quality is integral in forming sound foundations for decision-making. In times of austerity, data collection, processing and reporting needs to be able to demonstrate efficiency in delivering value in return for substantial investment.
Arguably a more important consideration is the risk that substandard data poses and the potential impact both on strategic outcomes and monetary cost, as well as more directly on the treatment of patients. Significant clinical risks can arise from seemingly inconsequential data entry and processing practices.
Poor information quality negatively impacts the work of the NHS and the Health & Social Services Group (Welsh Government) and represents a reputational risk to the Welsh Government more generally. The provision of care, policy development, implementation and monitoring and the performance of the NHS are all improved if based on better quality information. High quality information requires high quality data.
Quality assurance processes aim to intercept data of substandard quality before it is used for published reports and national statistics, but occasionally these processes fail. Recent instances of this have highlighted the need to revisit mechanisms for assuring the quality of healthcare information and for a fundamental change in the approach to tackling the information quality issues themselves.
A Welsh Health Circular (WHC 2015027) was issued on 11th June 2015 introducing the Information Quality Improvement (IQI) initiative and notifying the Service of the intention to establish IQI groups to oversee the work of the programme.
In broader terms, the purpose of the IQI initiative is to improve information quality.
It is acknowledged that terms such as ‘information quality’ and ‘data quality’, as well as ‘information standards’ and ‘data standards’, can often be used interchangeably to describe the same things. In the context of this initiative, information quality is defined as a qualitative measure of what can be understood from that information in a given context, as opposed the more quantitative measures that data quality indicators provide. It also differs from the term information standards in that it considers compliance with definitions as well as the robustness of the definitions themselves.
The IQI initiative is therefore a mechanism to address issues of compliance with standards as well as to review and develop the standards themselves where necessary. Thus, the IQI initiative aims to address deficiencies in the data and information being used to plan, inform and monitor NHS Wales’ healthcare activity and services.
A clear aim of the initiative is to implement changes that can realise the benefits that high quality information can provide. Improved business processes enable efficient use of this valuable data through potentially considerable cost savings. It is recognised that appropriate presentation of information is also vital in ensuring that information is delivered in a way which is meaningful to its users.
All organisations with a role in the collection, processing or reporting of healthcare information have a range of good practices in place to tackle problems with data quality. However these are not routinely captured in nationally-submitted and published data quality policies and improvement programmes. The first challenge is therefore to develop and publish such policies and programmes to help raise the profile of data quality and better inform all staff who have a role in its improvement.
Although previous and ongoing efforts to improve data quality have had a positive effect on particular areas of focus, these have ultimately been unable to deliver sustained improvements. Causes of poor data quality are varied and wide ranging, and are often ingrained in systems, processes and practices. The reasons why previous attempts at addressing these have not been able to affect change are similarly complex. Whilst there is still immense appetite for improved data quality, there is also a lack of ownership and responsibility which has nurtured a culture of apathy and resignation.
It was clear that a more inventive approach was essential to the success of any future initiative.
Key to the success of this initiative is engagement with those who can implement change and this must be at the heart of the IQI initiative. Board-level support will add some authority but the effectiveness of the work of the initiative is ultimately dependent on commitment from those involved at all levels.
All too often, improvements to data quality are attempted at the data warehousing or reporting stages of the process. Organisations both locally and nationally already have the necessary tools at their disposal to measure and monitor the quality of their data. In order to make real inroads, there must be a focus on improvements at the point of data entry, and this can only be achieved through close collaborative working both within and between organisations and a focus on data and information quality within the operational IT systems being used across NHS Wales.
Ideally, all occurrences of errors should be corrected immediately but, in practical terms, limited resources both locally and nationally mean that a degree of prioritisation is necessary. Efforts should therefore be focussed on areas of high importance, either in terms of strategic policy (e.g. issues preventing organisations from reporting accurately against national performance measures), or for patient safety (e.g. accurate recording/retrieval of patient demographics).
Detailed work programmes linked to national priorities are therefore vital to the success of the initiative, and the IQI groups are responsible for implementing these programmes and monitoring progress against them.