dhis2-kenya team mailing list archive

[Knut Staring <knutst@xxxxxxxxx>]

Relevant to the discussion we had last week in Oslo

Regards, Knut (via mobile phone)
On Nov 7, 2011 6:40 AM, "Ola Hodne Titlestad" <olati@xxxxxxxxxx> wrote:

> Hi all,
>
> *Some background*
> Manya, Gikunda and I visited Kisumu District Hospital on Friday and had an
> interesting discussion on the information needs for district hospitals.
> What they need is to be able to monitor activities in each ward, e.g. look
> at bed occupancy, turnover intervals, average length of stay etc.
> The current data sets to not support this since they are designed to be
> collected by the district hospital orgunit and not its children (the wards).
>
> The 717 - Service workload has some very general data elements that are
> based on the three groups of wards:  General Adults, General Paediatrics,
> Maternity Mothers only, Amenity.
> Here the data elements represent the activity (Admission, Discharge etc.)
> and the category options are the types of ward (listed above).
> This makes it possible for higher level people to see roughly which types
> of wards that has the highest workload etc. but it is useless for district
> hospital managers that want to manage individual wards.
>
> The dataset Hospital Administrative Statistics is better, but still
> difficult to use for hospital management, Here the data elements represent
> the different types of wards and the category options the activities
> (Admissions, Discharges, Available beds etc.). This has some design
> drawbacks. First of all the hospitals call they wards differently and do
> not have exactly the same type of wards. So the various hospitals will ask
> for more data elements to be added, we have already seen requests in the
> message board. This will be difficult to standardise across all hospitals.
> Another issue here is the idea of putting Beds/Cots and
> admissions/discharges/etc as options for the same data element ("Male
> Medical"). This doesn't work well when we aggregate over time since beds
> are not supposed to be summed together, but admissions are. A quarterly
> report will show three times as many beds that are actually there..... We
> need to discuss what to do with this dataset. If we want to keep it we at
> least need to split it so that beds and cots are separate data elements.
>
> *The proposed solution*
> So we ended up with the following solution, which is a third way of doing
> inpatient data for hospitals:
> (I don't like that we have three different approaches, but think we at
> least need this one. Let's talk about cleaning up this later.)
>
> *- new orgunits under the district hospital to represent the individual
> wards at the hospital, e.g. "Kisumu DH 1-Maternity", "Kisumu DH
> 2-Peadiatrics", "Kisumu DH 3-Female Medical" etc.*
> *- some new orgunit groups to represent the different standard types of
> wards at the district hospitals ("Medical", "Surgical" etc.)*
>
> Representing the wards as orgunits and not as data elements or categories
> gives more flexibility to the various hospitals to define their own wards
> (give them the names that they call them), and to do analysis on ward
> level. Kisumu DH has 10 wards. I suspect that the number of wards will vary
> between 5-10 for most district hospitals.
> This will add some more orgunits to the database of course, but I think it
> is worth it considering the value it adds to local hospital management. And
> these orgunits will only have 11 data values each month. While I think the
> bigger hospitals like the national and provincial with many more wards
> should use a separate hospital database, I don't think that is a good idea
> for these small district hospitals. Better for the district hospitals to
> have all their data in one place. Anyway, let's see how this scales.
>
> *- a new data set called "Inpatient activities" with all the typical data
> elements like "IP - Admissions", "IP - Discharges", "IP - Available Beds"
> etc.*
>
> *- a set of indicators for IP management based on the new data elements
> described above*
>
> *- for now, 1 chart and 1 standard report using the new indicators - more
> needed here*
>
> Kisumu District Hospital (in Kisumu East district) will start data entry
> for this data set this week, so we can soon test the indicators and reports.
>
> Ola
> ----------
>
>
> ----------------------------------
> Ola Hodne Titlestad (Mr)
> HISP
> Department of Informatics
> University of Oslo
>
> Mobile: +47 48069736
> Home address: Vetlandsvn. 95B, 0685 Oslo, Norway. Googlemaps link<http://maps.google.com/maps?f=q&source=s_q&hl=en&geocode=&q=Vetlandsvn.+95B,+0685+Oslo,+Norway>
>
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