Using Research Electronic Data Capture (REDCap) to Conduct National Healthcare Safety Network Dialysis Event Validation

BACKGROUND:  The Tennessee Department of Health (TDH) conducted validation of dialysis event data reported to the National Healthcare Safety Network (NHSN) by 30 Tennessee outpatient hemodialysis facilities. TDH utilized REDCap (Research Electronic Data Capture), a web application developed at Vanderbilt University, to manage all aspects of the project.

METHODS:  The database created in REDCap had two main components: facility information and patient information. Each record in the facility information component corresponded to an individual facility and captured communications between TDH and the facility. The application also allowed facilities to securely upload patient lists. During on-site visits, results from the NHSN dialysis event surveillance practices survey and information about the type of medical records available for review were captured. The patient information component was adapted from the medical record abstract tools developed by CDC for the purposes of NHSN dialysis event validation. Each record in this component was associated with a single patient, who was associated with a facility from the facility information component. Reviewers accessed REDCap via iPad tablets during onsite medical record review to complete data entry. Data were downloaded from REDCap as a SAS dataset for convenient analysis.

RESULTS: This database streamlined the management of the project for all staff involved by providing one central location to store and access information related to the project. Most facilities were able to upload patient information into REDCap, which greatly decreased the number of paper records managed. The project also captured the time spent on each record and individual form via date- and timestamp fields, taking that burden off of the medical record reviewers. The electronic forms used during record review eliminated the need for paper forms and subsequent data entry, reducing staff time and data entry errors. The built-in reporting feature also allowed for the quick generation of reports to identify missing or incomplete records, and for monitoring the overall status of the project.

CONCLUSIONS:  The database created in REDCap greatly improved the efficiency of the validation project and significantly reduced staff time. In addition, the structure of this project can easily be shared with other states or organizations using REDCap for similar projects.