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The Importance of Data Quality and Context Information in Indicator Production: Proof of Concept in a Metropolitan Paediatric Emergency Department

In the Paediatric emergency department scenario there were considerable efforts developing indicators over the past decade, specially referring to process, e.g. timeliness. Nevertheless, to fully characterize quality in Paediatric emergency department, indicators are developed but require further assessment and a more complete validation. This paper's aim is to emphasise the importance of data quality, data cleaning and the indicator choice in indicator production. The dataset provided for this analysis is from the São João Hospital Centre's information system and is composed by records of all the visits to the paediatrics emergency department from the 1st of January of 2014 to the 31st of December 2016. Only the variables time from admission to triage, admission to physician and length of stay were selected from the dataset to be analysed. Summary statistics and plots of each variable through the hours of the day were produced. Considering waiting time from admission till being seen by a physician, the variability of the arithmetic mean and median through the hours of the day range from 18 to 73 and 14 to 49 minutes of waiting time respectively. The maximum difference between indicators at a specific time happens at 0 a.m. and is 24 minutes. When considering waiting time from admission to triage the arithmetic mean is 15.2 however 75% of the children i.e. 3rd quartile waited 12 minutes or less. The choice of indicator is essential, it should accurately reflect what is being measured, taking into account the action that might be taken with the information.