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Health Information ManagementDiscussion postDatabase design

DNP 805 Topic 5: locating your data in the database

Pinpoint means naming a table and a field for every component, and the useful discovery is usually the component you cannot locate at all.

Editorial process

Last reviewed · August 15, 2026

01

Decompose the question, then find each part in the schema

Take the question you posted in the previous discussion and break it into the smallest pieces that each need their own data. A question about which admission characteristics precede readmission decomposes into the cohort definition, the index admission, the characteristics themselves, the readmission event, and the interval between them — five components, and each one has to come from somewhere. That decomposition is the first half of the task and it is worth doing carefully, because the components you gloss over are exactly the ones that turn out to be missing. Write them as a list before you go looking, so the search is driven by the question rather than by whatever the database happens to contain. List them before you go looking, so the search is driven by the question rather than by whatever the schema happens to contain. Five components is a normal number and two is usually a sign that something has been folded into another.

Then pinpoint, which means naming a table and a field rather than saying the information comes from the electronic record. In a hypothetical schema you might have a patient table holding identifiers and demographics, an encounter table holding admission and discharge timestamps and disposition, a diagnosis table linked to encounters, an observations table for vital signs and laboratory values, and a medications table. Say which of yours holds each component and how the tables join, since a join key you do not have is a real obstacle. The most valuable part of the post is usually the component you cannot locate: an outcome recorded only in narrative, a social factor nobody captures, or a readmission to a different organisation your system never sees. Naming that honestly is better analysis than a tidy table where everything conveniently exists. Name the table, name the field, and someone else could run your extraction without asking you a question.

Likely learning objectives

Inferred from the brief — check these against your own rubric.

  • 01
    Decompose a clinical question into separately sourced components.
  • 02
    Map each component to a named table and field.
  • 03
    Identify the join keys that make a multi-table extraction possible.
  • 04
    Recognise and report components with no data source.
Assignment instructionsQuoted verbatim

Read the full question

Review every instruction before using the planning guidance that follows.

Using the clinical question you identified from above, determine the individual components to that question and pinpoint the location in the hypothetical database where the information you require will be extracted.
Course-wide instructions that accompany this question

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DNP 805 Topic 5 Discussion 2 Using the clinical question you identified from above, determine the individual components to that question and pinpoint the location in the hypothetical database where the information you require will be extracted. I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course! Exit  Grid View  List View Excellent Point range: 90–100 Good Point range: 80–89 Fair Point range: 70–79 Poor Point range: 0–69 Introduction to the case (1 page) Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. 9 (9%) – 10 (10%) The response accurately, clearly, and fully summarizes in detail the case for the Assignment. The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient. 8 (8%) – 8 (8%) The response accurately summarizes the case for the Assignment. The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient. 7 (7%) – 7 (7%) The response inaccurately or vaguely summarizes the case for the Assignment. The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient. 0 (0%) – 6 (6%) The response inaccurately and vaguely summarizes the case for the Assignment, or is missing. The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient. Decision #1 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient- specific resources, including the primary literature. • Why did you not select the 18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. 16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains 14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision 0 (0%) – 13 (13%) The response inaccurately and vaguely explains the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. other two options provided in the exercise? Be specific and support your response with clinically relevant and patient- specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided. why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. Decision #2 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient- specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient- specific resources, including the primary literature. • What were you hoping to 18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. 16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was 14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or 0 (0%) – 13 (13%) The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided. hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. Decision #3 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient- specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient- specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical 18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully 16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations 14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant 0 (0%) – 13 (13%) The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the considerations may impact your treatment plan and communication with patients. Be specific and provide examples. support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided. impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided. response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. Conclusion (1 page) • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. 14 (14%) – 15 (15%) The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient. The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided. 12 (12%) – 13 (13%) The response accurately summarizes the recommendations on the treatment options selected for this patient. The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided. 11 (11%) – 11 (11%) The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient. The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided. 0 (0%) – 10 (10%) The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing. The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing. Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic. 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in- text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) APA format errors. 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors. Total Points: 100

02

Turn the brief into deliverables

  1. 01
    The question restated and broken into components.
  2. 02
    A named table and field for each component.
  3. 03
    The joins required to bring them together.
  4. 04
    An honest statement of any component that cannot be located.
03

Components, tables, fields, then the gaps

01

Restate and decompose

Break the question into the smallest independently sourced components.

02

Map to the schema

Name the table and field for each component in a hypothetical database.

03

The joins

State the keys that link patient, encounter, diagnosis and observation data.

04

What is missing

Identify components with no structured source and say what you would do.

04

What a real clinical schema looks like

Recommended databases

  • Your organisation's data dictionary
  • JAMIA
  • HealthIT.gov
  • An open clinical data model such as OMOP

Search sequence

  1. 1.
    Find a published clinical data model and use its table names rather than inventing your own.
  2. 2.
    Check which of your components would need a derived rather than a stored value.
  3. 3.
    Confirm whether out-of-network events are visible to your system at all.
  4. 4.
    Identify the primary key that links encounters to a patient before writing the joins.
05

Reference shortlist

These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.

Nothing here is cleared for citation until you have read it.

  1. 01

    Interoperability

    Office of the National Coordinator for Health Information Technology · 2024

    Why data recorded elsewhere may be invisible to your extraction, which is the source of the commonest missing component.

  2. 02

    Hospitals' adoption of intra-system information exchange is negatively associated with inter-system information exchange

    Journal of the American Medical Informatics Association · 2018

    Evidence that hospitals exchanging information internally often do not exchange it externally, the concrete form of the out-of-network gap.

  3. 03

    Clinical Decision Support Systems

    Fundamentals of Clinical Data Science, NCBI Bookshelf · 2019

    Shows the data layer a decision support system reads from, which is a working model for naming tables and fields.

  4. 04

    Promoting Interoperability Programs

    Centers for Medicare & Medicaid Services · 2025

    The reporting programme that determines which elements are reliably captured in structured form.

06

Review before submission

Common mistakes

  • Saying the data comes from the electronic record rather than naming a location.
  • Decomposing into two components when the question has five.
  • Ignoring the join keys, so the extraction could not actually be run.
  • Assuming every component exists because the question needs it.
  • Forgetting the temporal component, which is usually the hardest to source.

Submission checklist

  • Does every component have a named table and field?
  • Are the joins between tables stated?
  • Have you dealt with the time interval explicitly?
  • Is any missing component reported rather than assumed away?
  • Could someone with schema access follow your extraction?

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