Background: In Australia, aged care and disability service providers are legally required to maintain comprehensive and accurate clinical documentation to meet regulatory and funding requirements and support safe and high-quality care provision. However, evidence suggests that poor-quality clinical data and documentation are widespread across the sector and can substantially affect clinical decision-making and care delivery and increase business costs.
Objective: In the Optimizing the Quality of Clinical Data in an Australian Aged Care and Disability Service to Improve Care Delivery and Clinical Outcomes (OPTIMISE) study, we aim to use an Agile Lean Six Sigma framework to identify opportunities for the optimization of clinical documentation processes and clinical information systems, implement and test optimization solutions, and evaluate postoptimization outcomes in a large postacute community-based health service providing aged care and disability services in Western Australia.
Methods: A 3-stage prospective optimization study will be conducted. Stage 1 (baseline [T0]) will measure existing clinical data quality, identify root causes of data quality issues across services, and generate optimization solutions. Stage 2 (optimization) will implement and test changes to clinical documentation processes and information systems using incremental Agile sprints. Stage 3 (evaluation) will evaluate changes in primary and secondary outcomes from T0 to 12 months after optimization. The primary outcome is the data quality measured in terms of defects per unit, defects per million opportunities, and Sigma level. The secondary outcomes are care delivery (direct care time), clinical incidents, business outcomes (cost of quality and workforce productivity), and user satisfaction. Case studies will be analyzed to understand the impact of optimization on clinical outcomes and business processes.
Results: As of June 1, 2022, stage 1 commenced with T0 data quality audits conducted to measure current data quality. T0 data quality audits will be followed by user consultations to identify root causes of data quality issues. Optimization solutions will be developed by May 2023 to inform optimization (stage 2) and evaluation (stage 3). Results are expected to be published in June 2023.
Conclusions: The study findings will be of interest to individuals and organizations in the health care sector seeking novel solutions to improve the quality of clinical data, support high-quality care delivery, and reduce business costs.
International registered report identifier (irrid): DERR1-10.2196/39967.
Keywords: aged care; data; disability; health services; information technology; quality.
©Lakkhina Troeung, Gap Tshering, Rebecca Walton, Angelita Martini, Martin Roberts. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 27.03.2023.