Monthly in-house reports using the AKTIN Emergency Department Data Registry: advantages of standardised key figures: Development and implementation of a reporting system based on emergency department medical record data

Background: With increasing utilisation and current changes in German emergency care, standardised recording of relevant key figures in emergency departments (EDs) is crucial. Objectives: Consensus of key figures and technical implementation of an automated reporting for EDs that participate in the AKTIN Emergency Department Data Registry are described. The aim was a balanced monthly report for medical controlling and quality management of an ED. Materials and methods: The basis is the Emergency Department Medical Record V2015.1 of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI). Consensus on key figures was reached based on external references and professional expertise. The technical development was based on a test dataset. The final report is created in PDF format automatically using R and Apache Formatting Objects Processor (FOP). Results: The report contains, for example, information on case numbers, patient demographics, presenting complaints, acuity assessment, disposition and selected process indicators, presented as tables and graphs. It is generated automatically from the routine data on a monthly basis or on request. Missing values and outliers are shown separately in order to assess data quality. Conclusions: The monthly AKTIN report is an instrument that summarises and visualises the work load and care provided in an ED. The key figures are a suitable and pragmatic approach and also reflect the requirements of the Federal Joint Committee for initial acuity assessment. The use of interoperability standards allows for the use of routine medical data, ensures independence from individual information technology (IT) systems and may serve as a basis for cross-institutional benchmarking.