BC SCR CALL DECEMBER 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 Team Lisa Toback Paul Smith Julie 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

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 OpenLap Description Partial ColectomyPartial colectomy Sigmoid Resection Left Hemicolectomy Right Hemicolectomy Partial colectomy with removal of terminal ileum with ileocolostomy (anastomosis of ileum to colon) Extended Right Hemicolectomy Ileocecectomy Ileocolic Resection Anterior Resection Partial resection of rectum transabdominal approach Low Anterior Resection Partial colectomy with low pelvic anastomosis Splenic Flexure take downMobilization of splenic flexure Hartmann’s ResectionPartial colectomy + colostomy + closure of distal segment Common Colorectal CPT Codes:

CPT Code Tissue Expander Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion RVU: ~18 Includes Pectoralis Flap If done concurrent with Simple Mastectomy: Add 19303: RVU~15 If done concurrent with Radical Mastectomy Add : RVU ~19 If done with Pectoralis Flap + Simple Mastectomy Most US coders use (just because RVU for radical mastectomy is greater than simple mastectomy) BC: use 19303, and 19499: Unlisted Procedure, Breast

Books: Pocket Guide to the Operating Room Maxine Goldman ISBN-13: $25.00 Netter’s Atlas of Human Anatomy for CPT Coding Second Edition, AMA ISBN#: $71.95

BC NSQIP Timeline and Important Dates Jan 2012 “Doug’s Challenge” J. Berkowitz on BC SCR Call Online community Feb 2012 Workshop with Kathy Rowell (Feb 8, 2012) Mar 2012 NSQIP’s SAR Release (Jul 2010-Jun 2011 Data) Apr 2012 Submit 2011 Excel Spreadsheet for Data Analysis (April 30, 2012) May 2012 First BC NSQIP Report (Jan-Dec 2011 Data)

Vacation Cycles

Q&A

Happy Holidays!