Houston-Galveston's Administrative Database

In the spring of 1990, Roy Aruffo, astute in the administrative use of technology, began his first term as president of the Houston-Galveston Psychoanalytic Institute. Our movement into twenty-first century information processing began. We updated our computers and adopted an accounting program.

Aruffo offered me the chair of the Curriculum Committee and casually suggested I look into database management of the curriculum. He probably wishes he had never planted this creative administrative idea. Over the ensuing decade, that offer and my earlier candidate seminar experience at the Topeka Institute were the stimuli for a complete revision of the Houston-Galveston Institute's curriculum and the ultimate adoption of an inclusive database for administration of an institute.

Such technology can create every imaginable doubt and suspicion among the staff and members of an institute. The issues that surround its use may give rise to righteous indignation in both its creators and its detractors. I rapidly learned that change takes place with ease and alacrity. I gradually learned that acceptance of change is laborious and slow. As psychoanalytic process goes, so goes organizational process.

Our next president, James Robinson, another man of foresight regarding the future of information technology, envisioned the efficacy of the use of databases in all administrative functions of an institute. The institute passed an extensive budget for new hardware, standard office software, data entry, and program design of database software.

When I succeeded Robinson as president of the institute, I sought and received the approval of our Education Committee to budget additional monies for programming and ultimately for data entry. This database development project now has an accumulated programming expense of $75,000.

Having committed myself to this work, I spent virtually every weekend at our institute refining its program features as they were developed. Much greater credit goes to our institute administrator, Jean Gates, who willingly suffered the changes that occurred each weekend in her main work tool. Often she arrived on Mondays finding that her monitor or computer had been moved, her password suddenly didn't work, or the database had developed new glitches where the old ones had been “repaired.”

With my help, our administrator began demonstrating our evolving database to other administrators and ultimately to anyone who would listen at the spring meeting of the American in 1998. Some seemed enthusiastic about its possibilities, some anxious about new software, and some fearful of the data entry work. Fortunately, this past spring, with the help of Harvey Rich, who visited us for a demonstration of the database, the American Psychoanalytic Foundation agreed to fund a pilot project for distribution of the 2000 version of our database to five institutes that applied for grants to receive it. As with all software releases, it was delayed, but it has now been distributed. Our administrator and I are providing software support, this time to other administrators instead of to each other. We hope to apply to the Foundation for approval of additional grants to other interested institutes.

What Does It Do?

Houston-Galveston's Psychoanalytic Administrative Database (PsaAdminDB2000) provides every kind of report used to determine and track the progression of trainees and faculty through the institute, from application to graduation to certification, faculty appointment, and promotion. It also lists reports due from trainees and faculty, provides statistics on faculty and trainee activities for reports to the American and to state agencies and universities if applicable, publishes institute and society rosters, stores seminar bibliography listings and enables seminar scheduling, aids in continuing education reporting, follows clinic patients, facilitates mass mailings, and tracks library check-out and check-in.

PsaAdminDB2000 stores faculty and trainee data in dozens of relational tables. This approach, standard in all large data systems, eliminates the need to enter the same data repeatedly, a chronic problem of storing such information in spreadsheets. It also provides simple access to data across time periods and for groups of faculty members or trainees, in a way not possible with data stored in word processing documents.

The database consists of 65 tables, 210 queries, 170 forms, and 131 reports. These reports are designed specifically for the tasks listed above. The database also includes 42 audit queries for rapid assessment of data entry errors. Faculty members and trainees, however, can use word processing documents to submit

their reports. Text can be copied from these documents and pasted directly into appropriate records in the database. It is secure and encrypted, requiring users to log on at specific security levels. It is programmed in Access 2000, part of the Microsoft Office 2000 Professional software suite.

Integrating Columbia Database

Although it has rudimentary forms and reports for process research, our database has lacked a more definitive capacity for research. Some time after Houston-Galveston began developing its database, the Columbia University Center for Psychoanalytic Training and Research began to develop an Access database of its own to track progression of candidates. The Columbia database clearly adds significant quantitative and research aspects to Houston's database; Columbia's database includes a data-summarizing function in its tracking of candidates from the time of application through the selection process to graduation. It also tracks all training cases from evaluation through termination (even termination after the candidate has graduated) with a focus on diagnosis, medication use, assessment of the impact of analysis, etc.

Steven Roose, co-director of Columbia's Neuropsychiatry Research Clinic, is working with the Columbia center and our institute to develop additional relational tables, queries, forms, and reports that will append these invaluable Columbia functions to the Houston-Galveston database. The new hybrid database will be called the Houston-Columbia Administrative Database.

One Database for the American

Both Houston and Columbia believe that the American Psychoanalytic Association and individual institutes will be well served if a standard database were used by all. Such a database will provide the American with restricted but easy access to information to characterize psychoanalysis in America: demographics of candidates, length of training and clinical immersion before graduation, faculty development, and the like.

One can compare progression as well as uniformity of curricula and reading lists across institutes. If particular institutes elect to become degree-granting, they can readily follow faculty development for reporting to parent institutions. A uniform database will make easily accessible information about psychoanalytic education and psychoanalytic practice that heretofore has been difficult to assemble.

However, as Houston-Galveston and I have painfully learned, the advent of sophisticated database programs also creates certain problems that need to be anticipated and addressed. Access to any database must be protected. Such data availability calls for research in analytic education. However, the questions of who determines which investigators and which hypotheses have merit and who adjudicates confidentiality vs. research conflicts must be answered. If a standard database is adopted and implemented, a policy committee to address such issues should be created concomitantly. Our goal is that the American will endorse a database that will be used by all institutes.