Enhancing data quality through the NJR audit process

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NJR data completeness and quality audits

Understanding data as a tool for quality improvement is an important part of the ongoing data-driven implementation that is happening right across the orthopaedic sector. Data quality and validation are essential components of any audit or scientific research so the NJR’s programme of work to improve the quality of our data has been a key focus in recent years, driven through the NJR’s ‘Supporting Data Quality Strategy’. 

Key to this strategy has been our national programme aimed at assessing data completeness and quality within the registry and we conduct our audit programme to retrospectively check the quality of data and the commitment to patient safety from all hospitals reporting to the registry on an annual basis. The Data Quality Audit programme, which completed its sixth year during Summer 2021, has enabled us to compare patient record for record procedures recorded in local hospitals’ databases to the registry, with the aim of investigating the accurate number of joint replacement procedures submitted compared to the number carried out. 

We recently conducted an audit of elbow data, to ensure our data was the best it could be.
You can find more about this audit here.

We will be conducting an audit of shoulder replacement surgery in 2023/24.
You can find more about this audit here.

Background to NJR Data Quality Audits

In 2014, the National Joint Registry (NJR) started a review of data quality in the registry and looked at how to enhance data completeness, timely submission and data accuracy further. This is to ensure that the information held in the registry can be used effectively at all levels of analysis; nationally, regionally and at hospital and individual surgeon level, for the benefit of patients, surgeons, hospitals and implant suppliers and research programmes.

The audit enables a direct comparison of a hospitals activity against NJR activity that it has reported, enabling identification of any discrepancies. The NJR Data Quality Audit is an annual activity that comprises a local hospital providing an extract of data from the local hospital administration system to the NJR.  This data is then compared (or matched) against the NJR registry data submitted by the hospital, and any missing records and any discrepancies in data are reported to the hospital in an audit tool (excel workbook) for these to be corrected.

During the last few years of running the audit process, the NJR has been gathering feedback from hospitals and has been working on improving and enhancing the process to make it more user-friendly and efficient.  We are now about to commence working on the financial year 20/21 data quality audit, covering operation dates within the period 1st April 2020 – 31st March 2021. 

We have published a paper on how we have developed the NJR data quality audit programme. Please see https://online.boneandjoint.org.uk/doi/full/10.1302/2633-1462.39.BJO-2022-0051.R1

NJR Data Entry – Automated Data Quality Audit Functionality

In 2019 we implemented a new automated process on the live data entry system providing functionality that enables users to upload the PAS data file directly to the NJR via the system and to then view the results of the audit on screen. This makes the process more straightforward for hospitals, giving them greater usability and control of locally submitted data.

Moving to an automated process for audit enables the accessibility to submit and check data at any time during the year and therefore maintain quality compliance figures throughout the year and also serves as an early alarm for any potential missing records, enabling timely action to address this.

Any questions regarding data quality audits can be addressed to Maggie Tate, our Data Quality Officer. 

 Email: Maggie.Tate@necsws.com

The NJR Quality Data Provider Scheme

NJR data creates the ability to drive forward change, influence best practice, undertake important research and ultimately maximise patient safety and outcomes. High quality data are the foundation of any joint replacement registry and now with around 3.7 million records, the NJR’s valuable data is a fundamental driver to help inform improved quality of care for patients, so it is imperative that the data provides an accurate picture. 

The ‘NJR Quality Data Provider’ (DQP) scheme has been devised to offer hospitals public recognition for achieving excellence in supporting patient safety standards through their compliance with the mandatory NJR data submission quality audit process.

To gain DQP status hospitals are required to meet targets for best practice, increase engagement and awareness of the importance of quality data collection and embed the ethos that thorough and accurate data ultimately enables the NJR to develop improved patient outcomes. By awarding the NJR Quality Data Provider certificates annually at the end of the audit process, the scheme rewards only those hospitals who have achieved our stringent targets.

qdpa bishops wood hospital
Theatre staff at Bishops Wood Hospital, holding their Certificate upon achieving Quality Data Provider status.

If awarded, the emblem seen on the left-hand side of this page is also placed on their hospital dashboard page on the NJR’s Surgeon and Hospital Profile website, here.

The website displays orthopaedic data, which is published on an annual basis, for hospitals where any joint replacement operations are carried out, in the geographical areas where the NJR is operational. We also provide the emblem for the hospital’s own website and support for promotion through both their own and NJR media channels.

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