A quality improvement model for healthcare terminologies

Kim, TY; Coenen, A; Hardiker, NR

Abstract

A number of controlled healthcare terminologies and classification systems have been developed for specific
purposes, resulting in variations in content, structure, process management, and quality. A terminology
quality improvement (TQI) model or framework would be useful for various stakeholders to guide
terminology selection, to assess the quality of healthcare terminologies and to make improvements
according to an agreed standard. A TQI model, thus, was formulated based on a review of the literature
and existing international standards developed for healthcare terminologies. The TQI model, adapted
from Donabedian’s approach, encompasses structure, process, and outcome components in relation to
a terminology life cycle – change request, editing, and publication. Multi-dimensional quality outcome
measures also were identified in the areas of terminology content, modeling structure, mapping, and process
management. A case study was developed to validate the TQI model using the International Classification
for Nursing Practice (ICNP). The TQI model represented the complexity of activities involved in
terminology quality management. The ICNP case study demonstrated both the applicability of the TQI
model and the appropriateness of the criteria identified in the TQI model: openness and responsiveness,
clarity and reproducibility, understandability, accessibility and usability, interoperability, and quality of
documentation. The applicability of the TQI model was validated using ICNP. While ICNP exhibits many of
the desirable characteristics of contemporary terminologies, the case study identified a need for further
work on ICNP policy and on documentation.

Citation

Kim, T., Coenen, A., & Hardiker, N. (2010). A quality improvement model for healthcare terminologies. Journal of Biomedical Informatics, 43, 1036-1043. https://doi.org/10.1016/j.jbi.2010.08.006

• Journal Article Type: Article
• Publication Date: Jan 1, 2010
• Deposit Date: May 6, 2011
• Journal: Journal of Biomedical Informatics
• Print ISSN: 1532-0464
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 43
• Pages: 1036-1043
• DOI: https://doi.org/10.1016/j.jbi.2010.08.006
• Publisher URL: http://dx.doi.org/10.1016/j.jbi.2010.08.006