BC SCR CALLDECEMBER 2011

Outline

• Updates - What is you biggest challenge at this time?• Providence Health – Data Automation• Online Community at BCPSQC Website• CPT Codes• BC NSQIP Timeline and Important Dates

Updates: (1-2 minutes per site)

When did you start your ramp-up?What is your biggest challenge at this time?

Providence Health Authority’s Data Automation and Data Quality Control Strategies

- Paul Smith, Clinical Care Analyst

PHC Automated NSQIP Data

Our TeamLisa Toback Paul SmithJulie Pichur Meghan Macleod

Also Starring…..Karl Newholm & Bruce Nicholson

Decision Support Team

Overview

Background & Context

Where we where & where we are now

Our Current Strategies (What we can do)

Use of the database – OR Log & Crosswalk

Worksheets & Call Sheets

Uploading & Data Cleaning

Our Strategies for the Future

Q & A Session

Background & Context:

• Where we were:– Spending on average 1.5 days each SCR to

– Collate OR Log

– Choose Cases

– Writing up Worksheets & Telephone Scripts

– Entering basic Information into NSQIP Workstation

– Only at the beginning of data cleaning

– We were behind about 6 to 7 cycles

– All charts available electronically

(We are 2 sites collecting 80 cases per cycle with 2.5 SCRs)

Where we wanted to be

Spend far less time on paperwork & more

time collecting the data and analysis

Catch up with our cycles

Enable a long-term robust system for data

collecting and processing

Begin a journey for paperless environment

Spend far less time on paperwork & more

time collecting the data and analysis

Catch up with our cycles

Enable a long-term robust system for data

collecting and processing

Begin a journey for paperless environment

How did we get there?

Facilitation from Leader of Decision Support

Team– Karl Newholm

Karl’s insight for data automation

Karl brought Bruce Nicholson to us to

collaborate for data automation

Bruce developed our database with automation

features based on OUR needs

Built-in capacity for future needs

Main Page

Operating Log

Uploading Data to NSQIP Workstation

Filtering the Data

Worksheet Cover

Procedure Matching

Data Cleaning

Data Cleaning

The Future

Pre – Populated Surgeon Information Letter

Draft Written – waiting final approval

G.P. Letter similar to Surgeon Letter also Pre -

Populated

Wait for Provincial letter first

Strategies for monitoring errors in

Wound Classifications ASA Scores Patient Contact Management

Questions

Online Community- Rebecca Brooke

CPT Code

Open Lap Description44140

44204 Partial Colectomy Partial colectomy

Sigmoid ResectionLeft Hemicolectomy

44160

44205 Right Hemicolectomy Partial colectomy with removal of terminal ileum with ileocolostomy (anastomosis of ileum to colon)

Extended Right HemicolectomyIleocecectomyIleocolic Resection

45111 --- Anterior Resection Partial resection of rectum transabdominal approach

44145 44207 Low Anterior Resection Partial colectomy with low pelvic anastomosis

44139 44213 Splenic Flexure take down Mobilization of splenic flexure

44143 44206 Hartmann’s Resection Partial colectomy + colostomy + closure of distal segment

Common Colorectal CPT Codes:

CPT CodeTissue Expander

19357 - Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion

RVU: ~18Includes Pectoralis Flap

If done concurrent with Simple Mastectomy:Add 19303: RVU~15

If done concurrent with Radical MastectomyAdd 19307 : RVU ~19

If done with Pectoralis Flap + Simple MastectomyMost US coders use 19357+19307 (just because RVU for radical mastectomy is greater

than simple mastectomy)

BC: use 19303, 19357 and 19499: Unlisted Procedure, Breast

Books:

Pocket Guide to the Operating RoomMaxine GoldmanISBN-13: 978-0803600331 $25.00

Netter’s Atlas of Human Anatomy for CPT CodingSecond Edition, AMAISBN#: 978-1-60359-109-6 $71.95

BC NSQIP Timeline and Important Dates

Vacation Cycles

Q&A

Happy Holidays!