2023-10-22-世界卫生组织-WHO_Clinical_Registry_2页_426kb

WHO Clinical Registry Summary

Background

The WHO Clinical Registry was developed to address the global challenge of improving clinical outcomes for patients with acute illnesses and injuries. The lack of standardized data on emergency care services hampers the ability to compare, aggregate, and monitor performance across facilities and health systems. World Health Assembly Resolution 72.16 emphasizes the need for standardized data collection mechanisms to better characterize acute disease burden and enhance emergency care coordination, safety, and quality.

Utility of Registries to Improve Quality of Care

Registries serve as data repositories that support quality improvement through case-level analysis. They enable the collection of integrated data from prehospital settings to emergency unit visits and inpatient stays. This data includes patient presentation, care provided, and outcomes. By analyzing these data, the registry identifies potentially preventable deaths and supports iterative quality improvement cycles, allowing clinical teams to review and implement targeted education and corrective actions.

About the WHO Clinical Registry

The WHO Clinical Registry is a platform designed to systematically collect, aggregate, and analyze case-based emergency care data. It currently focuses on facility-based data and plans to expand to include prehospital data in the future. The platform is free to use and built on the open-source DHIS2 software, making it accessible and scalable for various health systems.

Key Features

• Multi-lingual and multi-platform: The interface supports 28 languages and can be translated through user settings. It offers both online and offline operation, with a mobile app for low connectivity environments.
• Validated Minimum Dataset: The registry uses the WHO Minimum Dataset for Injury (DSI), which is a standardized set of data elements for monitoring and improving injury care. It is also developing the WHO Minimum Dataset for Emergency Care (DSEC) to cover all emergency care presentations beyond injury. These datasets are embedded in the WHO Standardized Clinical Form, enabling a systematic approach to data collection.
• Built-in Analytics and Reporting: The platform provides dashboards and standard reports to monitor injury epidemiology trends and key indicators over time. Pre-programmed audit filters can flag cases for in-depth review, such as patients with hypoxia who did not receive oxygen. Users can also configure custom reports and visualizations based on their needs.

Implementation Considerations

• Data Entry Staff: Each facility must appoint dedicated staff to enter data into the registry. These could be existing medical records staff or quality officers, depending on the facility's needs.
• Staff Time Requirements: The time required for data entry depends on the trauma volume at the facility. The WHO team can assist in making initial projections.
• Infrastructure Needs: A minimum of one desktop, laptop, or tablet with internet access is required at the facility. In areas with limited internet connectivity, a tablet can be used for offline data entry, with periodic synchronization when stable Wi-Fi is available.
• User Management: Login credentials are provided after confirming the list of users and their roles. Facility geo-location within country administrative zones must also be verified. The WHO Standard User Agreement must be signed by the facility administrator or MOH staff and returned to WHO before access is granted.
• Training: A recommended 3-4 hour online training session is provided before launch, covering clinical providers, data entry staff, and data analytics and visualization training. This ensures that all users are adequately prepared to utilize the platform effectively.