Evaluating the Effectiveness of a Clinical Practice Intervention in Increasing Obesity Data Recording at a Western Australian Country Health Service Hospital: A Quasi-Experimental Controlled Trial

Abstract

Purpose

Identification and mitigation of obesity-related risks to staff and healthcare organisations can occur using patient obesity data; however, a 2017/18 audit of obesity data accuracy was assessed to be poor. This study investigates the results of an intervention to improve obesity data recording and coding accuracy at an Australian hospital.

Background

Increasing population obesity rates result in increased organisational and financial risks to hospitals. Australian obesity prevalence has steadily increased since 1995, and 42% of the Australian population is predicted to be obese in 2035. To reduce risks to healthcare staff who care for obese patients, complete and accurate obesity recording is required.

Methods

Following a previous audit of obesity recording and coding accuracy of patients admitted to hospital with Type II diabetes, a 12-month intervention was undertaken, comprising staff education, introduction of tape measures and obesity decision-making tools, recording of patient volunteered height, regular reinforcement of obesity recording requirements and enhanced clinical coding of obesity. A re-audit was subsequently conducted to determine if the intervention impacted obesity recording and coding at the previously audited site.

Results

Improved recording of obesity-related measures and obesity data accuracy were observed, including increased patient BMI, impacted by increased patient height measurements and increased patient weight measurements. Obesity recording accuracy increased due to the intervention, including increased sensitivity, increased negative predictive values and reduced false negatives.

Conclusion

The obesity recording intervention was successful; however, as hospitals increasingly use electronic health records, improvement opportunities should be considered such as compulsory recording of patient weight and height, embedded BMI calculators and “check boxes” for recording impacts of obesity conditions on treatment. Immediate improvement of obesity recording in manual patient files can be achieved in the meantime by implementing targets of 100% weight, height and BMI recording, introducing education programs and auditing compliance.

Keywords:

• obesity
• obese
• patient handling
• coding
• administrative data
• intervention
• training

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author, Kim McClean, upon reasonable request.

Ethics Approval and Informed Consent

This study is approved by the Human Research Ethics Committee of Edith Cowan University (Ethics approval number: 2019-00051-MCCLEAN) and the Human Research Ethics Committee of the WA Country Health Service (Ethics approval number: RGS1359). A waiver of consent under section 2.3.10 of the National Statement on Ethical Conduct in Human Research (Australia) was approved by the Edith Cowan University Human Research Ethics Committee and the WA Country Health Service Human Research Ethics Committee.

Acknowledgments

We are grateful for the assistance and information gained from staff of the WA Country Health Service, particularly the Health Information Managers and Coding staff, and Ms. Meegan Kidd, Project Officer Clinical Coding.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

There is no funding to report.