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Systematic use of quality registers in psychiatry

Background

There are 11 national quality registers in the field of psychiatry, but compared to registers in many other diagnostic areas, development has been slow and coverage is low. There is thus great potential for a more systematic use, for example for knowledge management at the strategic level, monitoring at activity level and as a communication tool in the interaction between patient and therapist.

The challenge

Along with the quality registers in psychiatry in two counties, Sirona conducted development work to improve data quality and increase usability in order to develop the activities.

Implementation

Sirona combined both quantitative and qualitative methods in this assignment. As a first step, a quantitative analysis was carried out based on the cross-referencing of quality register data with county council healthcare data. The analysis contained a calculation of coverage levels per register and unit, together with a medical review of registration through comparison between different units and county councils with a view to investigating differences in coverage levels.

In parallel, semi-structured interviews were carried out with representatives of the affected psychiatric units, the county council's psychiatric management and a number of quality registers. To anchor the results and insights in the units, a basis for inter-unit dialogue was established. The work to develop this consisted of producing example analyses based on the quality registers and carrying out business intelligence analyses of quality registers outside psychiatry to identify good examples. This was combined with qualitative conclusions regarding the implications for the units and which questions should be analysed further. Workshops were carried out with representatives from the county council and the units to create a joint image of the current position and to create participation in and motivation for change. This generated many new insights and stimulated the units to develop their own ideas for improvements. Registration in quality registers has traditionally been low and this assignment involved producing cultural change in order to increase registration.

Results

The project resulted in a complete situational analysis and a set of analysis material for the participating county council. This produced 1) new insights regarding psychiatric quality registers and their use, 2) the identification of good examples for extended and expanded discussion of the orientation of psychiatric quality registers, 3) insights into the areas of use of registers in activity development. Knowledge was shared and the results were disseminated, including through SKL's National Quality Register Conference. The effects of the project were a continued focus on quality development work.