Questioning data validity
Questioning data validity occurred during the discussion of many areas
of data feedback although were particularly relevant in questions
centering around patient satisfaction and teaching evaluations by
learners. Many of the physicians’ interviews mentioned that, despite
seeing the need for measuring patient experience and satisfaction, the
importance placed on this metric by the system and patient were likely
to be more significant than their own assessment of importance and
could, in some instances, be driven by social factors.
“We have a very high proportion of patients who are under housed, with
mental health and addictions and so, there might be a signal there that
the reliability of patient data on the quality of care may be influenced
by the patient population […].” [P15]
Several clinicians commented on the uniqueness of data reporting in a
community setting, reducing in many cases its validity. Some stated that
the nature of community EDs rendered data reporting less useful as
outcomes may already be known for patients returning to the ED. Patients
may be returning for planned visits or to see their primary care
physician in the ED.
“So, they might think that numbers might get skewed. So, in the
community there might be a lot more bring back patients for things like
imaging tests, [intravenous] antibiotics etc., so those numbers may
get skewed more in the community because there are more bring back
tasks.” [P6]
Some female respondents questioned the validity of the data by stating
that the metrics currently being measured often do not resonate with
female practitioners. They also stated that those measures in which
female MDs excel are not often part of the datasets measured by
departments or that the data metrics measured were not part of their
personal values.
“But if the simple metric is patients per hour then there might be
gender affect there that could get interpreted in the wrong way which
would say that women should work faster.” [P15]
“I think that they would place little value in that. I think that they
may see it as incongruent with their own philosophy of how they
practice.” [P7]