The Pediatrix BabySteps® Data Warehouse and the Pediatrix QualitySteps Improvement Project System—Tools for “Meaningful Use” in Continuous Quality Improvement

BabySteps development and data extraction

In 1996, Pediatrix Medical Group initiated development of a proprietary EHR throughout its practices. Several goals were associated with this project. First, the EHR was intended to create a clear, easily-readable admission, discharge, and daily medical record note that was consistent throughout the expanding number of neonatal practices within the organization (now numbering approximately 200 in 33 states plus Puerto Rico). Beginning in 2004, a series of concepts was defined as being critical

Goals for data extraction from BabySteps, the BabySteps data warehouse

The ultimate goals for the data were also discussed in great detail and several key objectives were identified. Most importantly, outcome data needed to be extracted from the electronic record automatically. This approach would have several benefits. Physicians would not be burdened by designing a way to get chart information into a database, which would require additional time commitment on their part or the cost of a data extractor. In addition, automated data extraction would eliminate the

BabySteps data warehouse reports

The CDW is constantly evolving to provide practicing physicians with the most current data possible, and as many report types as is practical for managing patients in their NICU. By responding to clinician feedback, the CDW has become an increasingly useful tool for meaningful assessment of outcomes and quality improvement initiatives. Data within the CDW is refreshed on a weekly basis to retain currency.

Box 3 lists currently available CDW reports. Reports are categorized into several types:

The data warehouse in quality improvement

The Pediatrix CDW is a valuable technology for examining many common neonatal outcomes and some basic population data. Although the provision of outcome data can have a strongly influential effect in improving the quality of care, the effect can be magnified through the use of directed methodology in quality improvement. The application of these evidence-based strategies can further enhance improvement, truly illustrating how an EHR can provide “meaningful use.”

The CDW has been the basis for

The quality improvement project system (QualitySteps)

In recognizing the value of data-driven applications in health care, Pediatrix Medical Group has also noted a growing need exists for other applications for measuring patient outcomes. Ideally, these applications should allow simplified data entry, extraction of summarized information, and generation of annotated run charts that would enable users to follow targeted outcomes over time. Furthermore, this system should enable comparisons with other databases, yet be flexible enough to allow

Summary

The Pediatrix BabySteps CDW is a rich and novel tool allowing unbiased extraction of information from an entire neonatal population care by physicians and advanced practice nurses in Pediatrix Medical Group. Because it represents the practice of newborn medicine ranging from small community intensive care units to some of the largest NICUs in the United States, it is highly representative of scope of practice in this country. Its value in defining outcome measures, quality improvement projects,