Questioning data validity
Questioning data validity occurred during the discussion of many areas of data feedback although were particularly relevant in questions centering around patient satisfaction and teaching evaluations by learners. Many of the physicians’ interviews mentioned that, despite seeing the need for measuring patient experience and satisfaction, the importance placed on this metric by the system and patient were likely to be more significant than their own assessment of importance and could, in some instances, be driven by social factors.
“We have a very high proportion of patients who are under housed, with mental health and addictions and so, there might be a signal there that the reliability of patient data on the quality of care may be influenced by the patient population […].” [P15]
Several clinicians commented on the uniqueness of data reporting in a community setting, reducing in many cases its validity. Some stated that the nature of community EDs rendered data reporting less useful as outcomes may already be known for patients returning to the ED. Patients may be returning for planned visits or to see their primary care physician in the ED.
“So, they might think that numbers might get skewed. So, in the community there might be a lot more bring back patients for things like imaging tests, [intravenous] antibiotics etc., so those numbers may get skewed more in the community because there are more bring back tasks.” [P6]
Some female respondents questioned the validity of the data by stating that the metrics currently being measured often do not resonate with female practitioners. They also stated that those measures in which female MDs excel are not often part of the datasets measured by departments or that the data metrics measured were not part of their personal values.
“But if the simple metric is patients per hour then there might be gender affect there that could get interpreted in the wrong way which would say that women should work faster.” [P15] “I think that they would place little value in that. I think that they may see it as incongruent with their own philosophy of how they practice.” [P7]