“There’s three sides to every story, babe: there’s yours and there’s mine and the cold hard truth.”
—Don Henley, Long Way Home
If
there is an upside to the mushrooming of “fake news,” it is the increased
awareness that reliance on a single source of information (even a trustworthy
source) is inferior to seeking multiple perspectives. Facts or data points are
(generally) more credible when derived from diverse data sets.
In
the 1970s, Norman Denzin, a sociology professor, investigated the concept of triangulation—long
used for navigation purposes—as a research technique. He and subsequent
investigators understood that arriving at the same conclusion via different
pathways boosts our confidence that we are accounting for the bias or
limitations of any individual route. This is particularly poignant in the study
of patient safety, where a single safety study or report draws attention, or an
isolated tragedy triggers calls for action before the breadth and depth of the
problem is understood.
Of
course, health care providers cannot simply ignore a single patient safety data
point—or dismiss it as “fake news.” But raising alarm or directing resources to
a potential problem that has not been verified or validated or triangulated
with other data sources can be counterproductive. Enthusiasm for process
improvement or behavior change will wane without confirmation that that single
incident or data point is borne out by other information. Optimally, multiple
information sources highlight a common, fertile issue or risk that paves the
way for the sustained attention of multiple parties.
Fortunately,
health care leaders have access to a rapidly expanding array of data sources to
tap into. In addition to malpractice data, many organizations (including PSOs) can employ incident reports, patient complaints,
root cause analyses, and a whole raft of quality and regulatory metrics. With
some forethought, the terms and taxonomies used to populate these databases can
be standardized (or mapped) so that apples can be compared to apples.
When
feasible, advanced analytic studies pulling from multiple data sets offer extraordinary
opportunities to tease out precise risk factors and hidden vulnerabilities. But
in many circumstances, you might just want to be able to point to the fact that
three or four independent databases highlight the same broad problem area. At a
minimum, triangulation puts your patient safety efforts on the right track to
the points where you need to dig deeper.
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