BC SCR Call

1. BC SCR Call December 2011

2. 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

3. Updates: (1-2 minutes per site)When did you start your ramp-up?What is your biggest challenge at this time?

4. Providence Health Authority’s Data Automation and Data Quality Control Strategies- Paul Smith, Clinical Care Analyst

5. PHC Automated NSQIP Data Our Team Lisa Toback Paul Smith Julie Pichur Meghan Macleod Also Starring….. Karl Newholm & Bruce Nicholson Decision Support Team

6. 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

7. 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)

8. 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

9. 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

10. Main Page

11. Operating Log

12. Uploading Data to NSQIP Workstation

13. Filtering the Data

14. Worksheet Cover

15. Procedure Matching

16. Data Cleaning

17. Data Cleaning

18. 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

19. Questions

20. Online Community- Rebecca Brooke

21. CPT Code Common Colorectal CPT Codes:

22. CPT Code Tissue Expander 19357 - 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 19307 : RVU ~19 If done with Pectoralis Flap + Simple Mastectomy Most 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

23. Books: Pocket Guide to the Operating Room Maxine Goldman ISBN-13: 978-0803600331 $25.00 Netter’s Atlas of Human Anatomy for CPT Coding Second Edition, AMA ISBN#: 978-1-60359-109-6 $71.95

24. BC NSQIP Timeline and Important Dates

25. Vacation Cycles

26. Q&A

27. Happy Holidays!