Download presentation
Presentation is loading. Please wait.
1
Our Team… a multidisciplinary approach
Cerebrovascular Clinical Research Office (CCRO) Our Team… a multidisciplinary approach Dr. J Mocco Neurosurgery Dr. Michael Froehler Neurology Bree Burks RN, MSN, CCRP Manager-CCRO Stephanie Smith, MA, CCRP FEAT Project Lead Emily Gilchrist, MPH Cerebrovascular Clinical Improvement and Research Coordinator Dr. Howard Kirshner Neurology Diane Brown, RN, BSN, CCRP Research Nurse Specialist III Jessica Marlin, CCRP Clinical Trials Specialist Andrea Wimsatt Reed, MS Data Collector
2
Vanderbilt CCRO Expertise
Complex Data Capture and Analysis Currently lead coordinating center for 3 multicenter clinical trials Coordinating over 30 active clinical trials Adjudicating complex data sets Analyzing data to assess project milestones REDCap Work closely with creator (Dr. Paul Harris) to implement new functionality Create complex databases storing information for thousands of patients used by institutions across the country Streamlining Clinical Workflow Parallel clinical workflow for cerebrovascular patients in an effort to standardize care (at VUMC and across the country) Experienced in implementing clinical improvement/best practices driven by new evidence
3
Challenges with Our Current Data Retrieval Process
Multiple Disciplines Involved System Issues
4
Challenges DATA StarForms/EMR data is not outcomes specific nor consistent across users Data in EMR is not easily retrievable Structured data in EDW is not user friendly Data is reviewed after patients are discharged using billing and coding criteria
5
Objective, comprehensive perspective is required
Challenges Nursing Radiology Neurology Neurosurgery Consulting Services Point of Care StarPanel EDW REDCap Informatics Measurement Performance Improvement Monitoring Analysts Abstractors Consultants QSRP Clinical improvement at VUMC Accreditation Requirements Complex Reporting Requirements Reimbursement Research Back End Users Multidisciplinary Issues Need for uniformity Objective, comprehensive perspective is required
6
Challenges System Issues How could we repurpose that time in
Abstractors often enter same medical records multiple times while pulling reports Abstractors and Consultants cannot independently generate reports (even routine reports) Coding drives patient selection sometimes weeks after point of care EDW is complex and data is limited, therefore cerebrovascular data is abstracted manually patients a month/approximately minutes per patient Approximately 2 FTE’s a month for cerebrovascular data abstraction ONLY Approximately .7 FTE’s a month for defining patient population How could we repurpose that time in stroke alone to improve patient care?
7
What’s Missing Real-time/Reliable Data Streamlined Clinical Workflow
Streamlined Reporting Properties Automated Dataset (ie: no more manual abstraction)
8
Once finalized implement across VUMC
Proposal Create a new, automated data abstraction process from StarPanel that is outcome specific Pilot this process in one controlled clinical area Cerebrovascular Disease/Stroke Once finalized implement across VUMC
9
Automated Cerebrovascular Data Collection
Solution Created in house/flexible User-friendly Robust analysis and reporting properties Experience with Automation Research Derivative DDP Automated Cerebrovascular Data Collection
10
Solution Real-time Reliable Data
Ability to impact care before discharge and decrease failures VTE Prophylaxis Written educational materials Daily snapshots of clinical workflow Recover time spent identifying patients’ true diagnoses from generic ICD-9 Codes
11
Solution Streamlined Clinical Workflow
Medical record templates are consolidated New templates are outcomes specific, reflective of current best practice, and conducive with clinical workflow
12
Solution Streamlined Reporting Properties Flags missing values
Determines “Failures” based on pre-determined criteria Logic can be built to capture any existing value and used repeatedly or amended Executes reports in seconds Emily Starts
13
Clinical Documentation Occurs Enterprise Data Warehouse
Solution Manual Abstraction Obsolete Clinical Documentation Occurs StarServer Data Parsing Enterprise Data Warehouse REDCap End Users
14
Improving patient care at Vanderbilt
Project Goals Improving patient care at Vanderbilt Increase efforts towards implementing new processes for quality, safety, and risk-prevention Reduce the burden of manual data abstraction
15
Implementation Define CV patient population Define data points
Core measures GWTG Meaningful Use Clinical needs Research needs Define data points Per clinical users Collapse current options Reformat for automation Organize and prioritize new MR templates Review Current form Identify data currently captured and necessary additions Draft Template Approval Construction Update notes and forms Pilot new forms/Delete alternatives Mirror the MR with a calendar design Incorporate vitals, labs, and meds through the DDP Build REDCap database Map data points StarPanel → EDW → REDCap Begin using REDCap to generate reports
16
End Product
17
Benefits DATA Single form reporting will create consistency in the EMR
Data in EMR will be easily retrieved due to standardization Generating reports within the EDW based on ICD-9 codes will be unnecessary Data is retrievable within hours of entry into the EMR
18
Benefits Multidisciplinary and System Issues
Uniformity in data collection will create a system benefitting multiple disciplines and departments System redundancies will be significantly reduced Abstractors and Consultants will be able to independently generate reports Patient population will be predetermined eliminating the need to verify ICD-9 codes against the EMR
19
Improving patient care at Vanderbilt
Recap Improving patient care at Vanderbilt Increase efforts towards implementing new processes for quality, safety, and risk-prevention Reduce the burden of manual data abstraction
Similar presentations
