A management information system (MIS) is an information system used for decision-making, and for the coordination, control, analysis, and visualization of information in an organization. The study of management information systems examines people, processes and technology in an organizational context. This system gathers data from internal and external sources of an organization and processes it to assist managers and heads in the process of decision making [1,2].
Evolution of clinical MIS
Even after the standardization of entire clinical system across Kauvery, a common platform was missing for the clinical service departments to share their knowledge and best practices followed in their respective units.
Even though the clinical incidents, clinical service related complaints and most of the challenges faced in each unit were similar, individual units handled them differently as there was no common forum to discuss about them and find an appropriate solution.
The idea of this MIS emerged after seeing the successful evolution of group operational MIS. This forum was initiated at the beginning as nursing MIS & monitoring of nursing key performance indicators (KPI) but slowly evolved to include more clinical parameters. Medical administrator and nursing heads were the key participants, and unit heads participated at times. So, this forum was later named as group clinical MIS. It was started with around 15 parameters. The 80% data was captured manually and the rest were IT supported. This forum has now been utilized for the past five years. The number of parameters has now reached around 46 which are analysed every month. Now most of the data are harvested through the IT enabled hospital management system.
Streamline the treatment flow of patients in the hospital, while allowing doctors and other staff to perform to their peak ability, in an optimized and efficient manner.
Challenges faced and resolved
Components of clinical MIS
Clinical MIS parameters
|S.No||Reference Code||Clinical MIS Parameters|
|1||CMIS/001||Adverse surgery & anaesthesia events|
|2||CMIS/002||AMA audit report |
|7||CMIS/007||Clinical incident analysis|
|8||CMIS/008||CNE program report|
|9||CMIS/009||Code blue and MEAT analysis|
|11||CMIS/011||CP MIS – Drug allergy entry, Higher antibiotic report, Medication error, Albumin usage, Pharmacy return|
|12||CMIS/012||Critical care transfer report|
|14||CMIS/014||Diabetic nurse's report|
|15||CMIS/015||Diagnostic service errors|
|18||CMIS/018||Employee vaccination report|
|21||CMIS/021||Needle stick injury|
|28||CMIS/028||Opinion trend analysis|
|29||CMIS/029||Over time man hour of nurses|
|31||CMIS/031||Post discharge call analysis|
|32||CMIS/032||Pressure injury report|
|33||CMIS/033||Procedure photo uploading|
|34||CMIS/034||Quality MIS - active medical record, drill & committee|
|36||CMIS/036||Service request cancel report|
|40||CMIS/040||Video consent uploading|
CMIS – Clinical management information system, AMA – Against medical advice, CNE – Continuing nursing education, MEAT – Medical emergency aid team, CPR – Cardio pulmonary resuscitation, CVC – Central venous catheter, DVT – Deep vein thrombosis, PAAT – Pain assessment and aid team, CP – Clinical pharmacist, MRD – Medical records department.
1. Schedule of Clinical MIS
2. Chairperson of monthly review
3. Clinical MIS meeting
Benefits of clinical MIS
Sharing of knowledge in this forum, and the discussions, enable us to make more data driven decisions with goal setting. This enable the hospital to focus on their goals and improve performance.
Comparing the KPIs between the hospitals not only help them to improve their goal setting but enable them work towards their goal and to achieve it in a way better than the other hospitals comparatively.
Sharing best practices and insights
This forum helps the hospitals to share the best practices followed in each unit and to compare each other and to determine whether their management methods are effective.
Better decision making
The biggest benefit of the Clinical MIS is better decision-making. It allows the unit heads to look at summaries of aggregated data to make informed clinical decisions as per their concern
Prevention of incidents
Focusing on the goals set and sharing of insights among each unit will prevent recurrence of the same. Ex: Preventable deaths
Easy retrieval of data
As this forum is having monthly reviews and half-yearly & yearly trend analysis, any data can be retrieved at the group level anytime.
Builds a transparent and open culture
Open discussions and non-threatening approaches in the Clinical MIS help in bringing in transparency and open culture.
Targets, deadlines and defined time duration increases accountability among team members. Ex: raising of clinical incidents within 24 hours and RCA and CAPA within 48 hours.
Apart from all this, there are many more benefits from having this central forum of discussion that happens every month. It improves communication, quality of services provided across Kauvery, reduces health care costs through sharing of best practices, make care more efficient and improves patient safety. Besides this, it creates an environment to connect with people of other units.
Thus this forum plays a major role in focusing on improved goal setting and to achieve the goals and targets. It functions as a platform to discuss about patients, treatment measures, incidents & it’s prevention. It helps in quality improvement and thereby brings patient delight, employee satisfaction and clinical excellence.