Ferrocyanide Safety Program: Data requirements for the ferrocyanide safety issue developed through the data quality objectives (DQO) process

Abstract Background The secondary use of electronic health records (EHRs) promises to facilitate medical research. We reviewed general data requirements in observational studies and analyzed the feasibility of conducting observational studies with structured EHR data, in particular diagnosis and procedure codes. Methods After reviewing published observational studies from the University Hospital of Erlangen for general data requirements, we identified three different study populations for the feasibility analysis with eligibility criteria from three exemplary observational studies. For each study population, we evaluated the availability of relevant patient characteristics in our EHR, including outcome and exposure variables. To assess data quality, we computed distributions of relevant patient characteristics from the available structured EHR data and compared them to those of the original studies. We implemented computed phenotypes for patient characteristics where necessary. In random samples, we evaluated how well structured patient characteristics agreed with a gold standard from manually interpreted free texts. We categorized our findings using the four data quality dimensions “completeness”, “correctness”, “currency” and “granularity”. Results Reviewing general data requirements, we found that some investigators supplement routine data with questionnaires, interviews and follow-up examinations. We included 847 subjects in the feasibility analysis (Study 1 n = 411, Study 2 n = 423, Study 3 n = 13). All eligibility criteria from two studies were available in structured data, while one study required computed phenotypes in eligibility criteria. In one study, we found that all necessary patient characteristics were documented at least once in either structured or unstructured data. In another study, all exposure and outcome variables were available in structured data, while in the other one unstructured data had to be consulted. The comparison of patient characteristics distributions, as computed from structured data, with those from the original study yielded similar distributions as well as indications of underreporting. We observed violations in all four data quality dimensions. Conclusions While we found relevant patient characteristics available in structured EHR data, data quality problems may entail that it remains a case-by-case decision whether diagnosis and procedure codes are sufficient to underpin observational studies. Free-text data or subsequently supplementary study data may be important to complement a comprehensive patient history.

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STRATEGIES OF FOOD SAFETY PROGRAM IMPROVEMENT TO PREVENT FOOD POISIONING OUTBREAK AT OIL & GAS INDUSTRIAL CITY

ADI Journal on Recent Innovation (AJRI) ◽

10.34306/ajri.v1i1.99 ◽

2019 ◽

Vol 1 (1) ◽

pp. 46-53

Author(s):

Kholil Kholil ◽

Kohar Sulistyadi ◽

Subagja Arlan

Keyword(s):

Food Safety ◽

Program Implementation ◽

Public Involvement ◽

Safety Issue ◽

Descriptive Analysis ◽

Food Poisoning ◽

Food Service ◽

Program Improvement ◽

Safety Program ◽

Industrial City

Nowadays, The food safety issue is a major problem which is related to the people’s health, livelihood, and the national economy. However, the food safety incidents occur frequently in recent years. These incidents bring the blow for the consumer’s confidence and it leads to the crisis of trust. These incidents not only affect the health and the safety of the consumers, but also affect seriously the health development of the food industry. Consumers require the higher requirement for the safety degree of the food. In order to reduce the occurrence of the food safety issue and ensure the quality of life, it is necessary to evaluate the food safety program implementation. Food safety program is importance barrier to prevent any food poisoning outbreak and issue in oil & gas industrial city. The purpose of this study is to determine the most priority and most important of food safety program in oil & gas industrial .Data analysis method used is descriptive analysis based on expert justification and assessed using SAST (Strategic Assumption Surfacing & Testing) and AHP (Analytic Hierarchy Process). The result of SAST analysis shows that program inspection and monitoring to food service facility (food producer) is most certain and most importance. Based on assessed by AHP analysis, the first priority of food safety program is also inspection & monitoring with a value 0.275, followed by food safety training (0.207), campaign & awareness (0.184), HACCP system (0.136), public involvement (0.108) and the last is law enforcement (0.090). The consistency value ratio (CR) is 0.01 less than 0.1.

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1881. The Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use: Results From a National Antibiotic Stewardship Intervention of 402 United States (US) Hospitals

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz359.111 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S50-S50

Author(s):

Pranita Tamma ◽

Melissa A Miller ◽

Prashila Dullabh ◽

Roy Ahn ◽

...

Keyword(s):

Decision Making ◽

Best Practices ◽

Acute Care ◽

Safety Issue ◽

Antibiotic Use ◽

Healthcare Research ◽

Post Intervention ◽

Frontline Staff ◽

Safety Program ◽

The Impact

Abstract Background The AHRQ Safety Program for Improving Antibiotic Use aims to improve antibiotic (abx) use in acute, long-term, and outpatient care settings by enhancing abx stewardship programs (ASP) and engaging frontline providers to incorporate stewardship into daily abx decision-making, with an emphasis on viewing appropriate prescribing as a patient safety issue. We report on the impact of implementation of the Acute Care Safety Program on abx use and Clostridioides difficile in a cohort of US hospitals. Methods The Acute Care Safety Program was implemented from December 2017 to November 2018. At least one unit from each hospital participated. The Safety Program trained local ASP leaders and assisted ASPs and frontline staff to: (a) address attitudes and culture that pose challenges to judicious abx use and (b) incorporate best practices for the management of common infections into daily practice using the Four Moments of Antibiotic Decision Making framework (Figure 1). Education occurred via 17 live Webinars and an online toolkit that included recorded Webinars, narrated presentations, and other tools to assist with the development and dissemination of syndrome-specific local guidelines (Table 1). Units submitted days of abx therapy (DOT) per 1,000 patient-days (PD), C. difficile LabID events per 10,000 PD, and 10 review forms per month documenting structured discussions between the ASP and frontline staff about patients on abx. Linear and generalized linear mixed-effects models were employed to calculate pre-post intervention changes in abx use and C. difficile LabID events, respectively. Results 402 hospitals completed the Safety Program, including 28 (7%) academic medical centers (AMC), 289 (72%) community hospitals, and 85 (21%) critical access hospitals. 476 participating units consisted of 165 (35%) ICUs, 300 (63%) medical-surgical floors, and 11 (2%) other units. Both abx use and C. difficile LabID events decreased when comparing pre-post data (−41 DOT per 1,000 PD, [from 886.56, Figure 2], P = 0.001 and −1.2 LabID events per 10,000 PD [from 6.3], P = 0.027), respectively. Conclusion By targeting both improving abx prescribing culture and knowledge of best practices, the AHRQ Safety Program led to reductions in abx use across a diverse cohort of hospitals. Disclosures Sara E. Cosgrove, MD, MS, Basilea: Consultant; Theravance: Consultant.

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