Quality Quarterly

Ask CHPSO: Null Fields – Improving the Quality of Patient Safety Event Reporting Data

This year, as part of the CHPSO annual report we provided feedback on the quality of the data submitted to CHPSO. This is part of a larger effort to improve our ability to develop our signal detection methods and other advanced analytic capacities in the CHPSO database. In the Data Quality section of the CHPSO annual report we provided definitions of various data fields, the rational for submitting certain fields to the Patient Safety Organization (PSO), along with the breakdown of the frequency of null fields for specific data elements. 

This article will help our facilities to better understand why certain fields may be null in their safety event reports, how to remedy the issue, and further explore why certain fields are high priority for CHPSO’s analysis of member data.  

The first question that a facility should ask if certain fields in their event reports are null is whether it is captured in their internal event reporting system. There are many different approaches to the collection of safety event reports. Some are as simple as the manual creation of a spreadsheet that summarizes paper safety event reports. Others are created in event reporting systems with varied levels of integration with the facility’s electronic health record (EHR). So, if a field is null in the CHPSO database the first question is was it collected at all? 

Once it is determined that an event type is in fact collected by the facility, we can begin an exploration into why the field might be null in the CHPSO database. The simplest reason is that the facility chose not to map that field when setting up their data submission template. This may be a simple fix, or it may be more complex. An easy fix would be adding mapping for variables already in alignment with the Agency for Healthcare Research and Quality (AHRQ) common formats for event reporting, as this requires just a few clicks to adjust what fields are mapped in a facility’s template.  

However, the process can be more complicated and may require facilities to reconsider how they handle certain variables within their own event reporting systems. Harm level is a good example of the levels of complexity involved in safety event report submission. Take, for example, “unable to determine” as a response to the question of the level of harm involved in a safety event. Because CHPSO maps to the AHRQ common formats for event reporting, facilities must decide whether to map these events to a specific harm level or choose the “ignore” option in the mapping template. Selecting “ignore” will result in a null value in the CHPSO database. This will result in those events being excluded from certain analyses that require harm level as a variable for inclusion. 

If you are a CHPSO member, and you are unsure about which fields are null in the CHPSO database, we would encourage you to reach out to the CHPSO team and request a review of your 2019 data. As a starting point we would encourage you to familiarize yourself with the AHRQ common formats webpage and then request a review of the following variables for all safety event reports in which event severity is equal to incident. If, after a review of the frequency with which these variables — age, gender, race and ethnicity, event description, and harm level — are null in the CHPSO database you would like to explore options for improving the quality of the data that you are submitting to your PSO, we would be happy to assist you and your team in such efforts. Doing so will allow CHPSO to provide more robust feedback through the development of our analytic capabilities.