Data entry into a spinal cord injury registry: a qualitative exploration of clinicians’ perceptions, influences and barriers

Abstract

Background In the current health sector there is a demand for high-quality data and research. Registries are a potential source of high-quality data, but whether it is more appropriate for clinicians or clerical staff to enter data remains unclear. In particular, there is a lack of evidence regarding clinicians’ roles and perspectives when entering data into a registry. This study aimed to explore clinicians’ understanding of registries, as well as their perceptions and experiences of entering data into a spinal cord injury registry.

Methods Clinicians involved with data entry during a piloting phase for a spinal cord injury registry were invited to take part in the study. Clerical staff with previous data entry experience were also invited. Focus groups and interviews were conducted using a semi-structured interview format. These were recorded, transcribed and analysed thematically.

Results Sixteen clinicians and two clerical staff participated in four mixed-discipline focus groups and one interview. Three themes were constructed with attention to participants’ subjective perceptions, understandings and experiences. The first theme, ‘I don’t have enough time’, was the most prominent issue raised by clinicians. They felt they were already under pressure, with an increasing amount of administration tasks to complete on top of their clinical workload, and therefore data entry was not seen as a priority. There was a call for extra clinical staff and designated time set aside for data entry, as well as specific registry roles, such as clinical champions and coordinators. Clinicians thought efficiencies could be made regarding ward system and process changes, such as improved use of meeting times and streamlined assessments alongside the registry. The second theme, ‘The dichotomy of registries; advantages and apprehensions’, outlined the many benefits clinicians felt a registry could bring, followed by their trepidation and concerns around its relevance, data quality, and use. Previous experiences had a positive and negative effect on participants and featured strongly throughout the focus groups. The third and final theme, ‘Engaging the clinician’, reveals clinicians’ perceptions regarding engagement and buy-in to the registry processes. They felt decisions were being made from those in authority without clinician consultation and there was a need for feedback from the registry to promote engagement. Many did not see data entry as part of their role, yet conceded clinicians were best at interpreting data for entry, if it was clinically relevant for them.

Conclusions These findings indicate clinicians felt too busy to incorporate data entry into their clinical workload. Prioritisation of data entry into a registry was low, yet complex and influenced by numerous elements. These include clinician attitude, previous experiences and perceived difficulties. If data entry was not prioritised, it was not completed. Prioritisation leads to intent, which leads to action. Despite mixed perceptions and experiences, all clinicians wanted the registry to succeed, however, not necessarily through their own commitment. It appeared change was needed at a personal and organisational level.