The interviewers also asked questions about the leaders' knowledge of the KPCO VDW. The qualitative input gathered during these interviews was incorporated into Team deliberations around potential gaps for intervention.
The MDW at KPCO, the VDW, is a comprehensive data repository that contains the timely, electronically linked data needed to characterize preanalytic and postanalytic laboratory medicine quality gaps.
Completion of the decision aid for each potential gap was assisted by data and information gleaned from published literature, Team members' knowledge, leader input, and VDW data.
The Team examined and deliberated on data extracted from the VDW and other evidence related to these potential quality gaps during 4 to 5 months.
The VDW data tables accessed and linked to characterize the high-risk medication monitoring QI opportunity included enrollment, diagnoses (all individuals had at least 2 diagnoses of one of the following: rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, or plaque psoriasis), laboratory results (dates of completion, result values, and reference ranges), pharmacy (dispensing dates and DMARD generic names), procedures (for DMARDs administered by infusion or injection), and death (an exclusion).
For example, data from the VDW illustrated that an ongoing initiative to decrease low-risk PSA testing was effective: in 2012 (preintervention), 36 168 PSA results were documented in the VDW laboratory results table, whereas in 2015 (postintervention), 19 498 PSA results were documented.