Feasibility of a harmonised data collection system from hospitals and clinics in Malta.

Abstract

A Harmonized Data Collection system would lead to the implementation of the National Hospital/Clinic Minimum Data Set (NHCMDS). This would include a set of indicators that are required from all health care providers in the country. The rationale of such a system would be to obtain good quality comprehensive data for the purposes of local services management. A National Hospital/Clinic Minimum Data Set is a minimum set of data elements agreed for mandatory collection and reporting at national level. NHCMDS is compiled from raw data from establishments within national health systems. The demand for this data has increased substantially over recent years; at the same time, there is also a growing concern about the lack of comparability in the data collection. This has led to a joint effort by the Organization for Economic Co-operation and Development (OECD), European Commission (BC), and World Health Organization (WHO), together with the member states including Malta, to improve the comparability of data by agreeing on common boundaries and breakdown categories. Implementation of a policy such as the introduction of NHCMDS is in the hands of many different groups of people, all of whom maybe involved in policy formulation. It is necessary to mobilize sufficient power to execute a policy such as this, and this depends a great deal on the policy environment and the country's beliefs, culture and legal structures.

All the public and private health establishments were invited to participate in this study with a response rate of 100% from public institutions and 73% from private entities. A self-administered questionnaire was formulated by the researcher and used to collect the data, Quantitative data were analysed using statistical tests whilst qualitative data was analysed by context and thematic analysis. Findings from the research showed that some of the institutions that participated already knew about NHCMDS whereas others did not. Differences in the data availability and in the format - whether paper based or electronic or both were noted between the institutions participating. Other findings specificied the establishments' views on the current situation, together with the participants' attitudes towards the change processes needed to introduce such a data collection. Some resistance to change can be expected but implementation will be facilitated if reasonable explanation as to why the data collection is needed and the gain perceived from this implementation is offered to the staff at the health institutions. These local experiences together with other countries efforts in the implementation of this data system shows that it is possible to implement NHCMDS and have a detailed ongoing and working updata data system. Many difficulties are likely to be encountered and only hard work and goodwill from everyone involved will obtain the much desired results which is that of a national, good quality data collection system.

Creating ownership for this data collection system and demonstrating acceptance towards the implementation of all changes in this system brings about leaders or administrators of the participating institutions to act by giving examples to their respective staff and to develop an environment where a compelling 'case' for change is truly needed, so that all stakeholders support it.