dhis2-kenya team mailing list archive

[samuel cheburet <samuelcheburet@xxxxxxxxx>]

Thanks Ola for comprehensive report. The areas highlighted require a lot
of discussion and have standards been used. example there is hospital
having ward 1,2, 3 4 or other have peadiatric together with Adult
female,etc what will happen with them?? The creation of separate databases
for hospital to me is not a solution but more problem. The only solution is
to have either EMR,openMRS etc. Another option is to use standards ward
need based on acceptable names like medical wards,
surgical, orthopedics ward, eye ward, labour ward, etc this will be a easy
way of standards of wards.

Issue of beds agreed, but this should be imputed on monthly because bed
give on changing and it affect statistic

A lot of exploration required and discussion required.


Regards


On Mon, Nov 7, 2011 at 9:40 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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-- 
Samuel Cheburet
Ministry Of Health
P.O. Box 20781
Nairobi, Kenya
Mobile- 0721624338

*Don't Compromise The Quality! Don't Risk It! apply Available Standards to
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