Converting Lab Counts to CCI: Difference between revisions

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CCI would allow for the collection of most things we currently collect as counted labs ([[:Category:Manually_collected_labs]]). This page is for the decision process whether we should go this route.

~~{{DiscussTask | Should lab counts move to CCI? }}~~

== Pros of moving to CCI ==

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== Cons of moving to CCI ==

=== time consuming ===

* It is much simpler and faster to count the number of CXR's, ABGs, and other tests in our lab counts than to put a CCI entry for each every day they are done. Also, anything that is currently on the tiss sheet should not have to be included in CCI at least for ICU. For example, CRRT and IHD is clearly marked on the tiss and which days are clearly shown. To have to enter in CCI all tests and procedures every single day they are done is not feasible within the time constraints of our EFT's in my opinion.--[[User:LKolesar|LKolesar]] 08:12, 2018 January 31 (CST)

* It is much simpler and faster to count the number of CXR's, ABGs, and other tests in our lab counts than to put a CCI entry for each every day they are done.

* Laura did a test collection and found this to be much slower. Trish will coordinate more testing for this. Ttenbergen 12:52, 2018 May 9 (CDT)

~~=== losing some detail ===~~

* If we move lab counts to CCI we would likely lose the distinction between [[Albumin 25pct]] and [[Albumin 5pct]]. Discussed at Task and we don't think this would be a problem Ttenbergen 13:13, 2018 May 9 (CDT)

~~== Questions and concerns ==~~

*Who is requesting dates for every single item? There are additional diagnostic procedures on this list that we previously did not count.

*At one time we did not add other diagnostic counts because the data was not requested.

*Is all this additional data being requested now? (ie: EEG's, abdominal xrays, nuclear scans, urodynamic study, cardiac stress test, pulmonary function tests, etc).

*We used to go the steering committee for requests for additional data collection items, has this now changed?

~~==== CXRs and scan counting in CCI concerns====~~

{{Discuss | who = Allan | question = repeated CXRs - if we do collect them it will be a nuisance; if we don't they won't compare to the labs count [[CXR]] we are doing now, that this is supposed to replace. How should we proceed?}}

~~{{Discuss | who = Allan | question = cryoprecipitate - Just checking if you wanted cryoprecipitate counts?-[[User:LKolesar|LKolesar]] 11:56, 2018 June 28~~

*I would say no. We need to consider workload and adding more things that are being collected, with the current EFT's. If someone wants to know we can always do short term audit. [[p:Trish Ostryzniuk | Trish.]]}}

*Do we have to enter a CXR for each day it is done or can we enter CXR once and then keep using the times feature?

*For longer stay patients this could be 50 entries.

*Why do we need to know what day a CXR was done on?

*What is wrong with using the lab count feature we now use? The same for blood gases and scans.--[[User:LBilesky|LBilesky]] 14:05, 2018 January 19 (CST)

** That is what is planned for now, but this might be worth talking about again to confirm it is worth it.

*** Does the pt travel out of the unit for this?

~~==== ABG/VBG counting in CCI & concerns ====~~

~~{{Discuss | who = Allan | question = repeated ABG/VBG counts - to many rows of data in CCI & lots of rows to scroll down to check what has been entered. time consuming.}}~~

* I see arterial blood gases are on the picklist. However, Dr Garland had said that arterial blood gases and venous blood gases will remain in our count list unlike all the other things we count. Should arterial blood gases be removed from the CCI pick list?--[[User:LKolesar|LKolesar]] 13:29, 2018 April 9 (CDT)

*I have tested a few pts and included ABG/VBG counts.

*What is this being used for?

*Is the counting necessary? This is a time Counting is a time consuming task, besides counting now also entering dates.

**Example: I had 2 pts that had 50-100 ABG/VBG's to count and enter dates for. I found there was too many rows of data in addition to the CCI being collected, so lots to scroll through to check what I had entered. [[p:Joanna Velasco]]

~~=== data entry test to determine extra time it takes to enter ===~~

{{Collapsable

| always=testing confirmed that this is tedious

| always=Laura's testing confirmed that this is tedious

| full=

*For example:

Line 59:

Line 25:

*****Entering these tests is very tedious and time consuming and it takes away from our time doing diagnostic coding. It took me 20 mins to enter just CXR's on a patient that was a long stay patient and I was only half done. --[[User:LKolesar|LKolesar]] 14:19, 2018 May 1 (CDT) }}

==== CXRs and scan counting in CCI concerns====

[[CXR (plain film)]] will now be collected as [[CCI collect count each]].

Quick look at pts with arrive dttm this year in CFE:

* 4147 total

* 3263 had <=3 cxrs

* 81 had >=15 cxrs

* 15 had >=30 cxrs

* none had 50, so not sure where that example came from...

==== ABG/VBG counting in CCI & concerns ====

[[Blood gas, arterial]] and [[Blood gas, venous]] will now be collected as [[CCI collect count each]].

Quick look at pts with arrive dttm this year in CFE:

* 4147 total

* 2276 had <=3 cxrs

* 250 had >=15 cxrs

* 66 had >=30 cxrs

* 27 had >= 50

* max was 147, next 90

== Summary ==

Count in CCI pick or component as any other CCI

* albumin5, 25% - on CCI (not 5 vs 25, and that's OK)

* albumin5, 25% - pick [[Transfusion of albumin]] - [[CCI Collection Mode]]: {{#show: Transfusion of albumin | ?Has CCI Collection Mode}}

* Packed cells ~~- on CCI~~

** (not 5 vs 25, and that's OK per Trish)

* Platelets - on CCI

* Packed cells - pick [[Transfusion of PRBC]] - [[CCI Collection Mode]]: {{#show: Transfusion of PRBC | ?Has CCI Collection Mode}}

* FFP - on CCI

* Platelets - pick [[Transfusion of platelets]] - [[CCI Collection Mode]]: {{#show: Transfusion of platelets | ?Has CCI Collection Mode}}

* CT - on picklist and comp2

* FFP - pick [[Transfusion of plasma products]] - [[CCI Collection Mode]]: {{#show: Transfusion of plasma products | ?Has CCI Collection Mode}}

* MRI - on picklist and comp2

* US Echo - pick [[~~Echocardiogram~~ of ~~heart~~]]

* US Abd - ~~comp1~~ [[~~(I) Abdomen, Pelvis~~]]/[[~~(I) Digestive System, NOS~~]] ~~comp2~~ [[~~Ultrasound~~]] ~~- will this give us the "Abd" count we need~~

~~Code one line, count for duration, kind~~ of ~~like [[~~CCI ~~Procedures coded once per ward admission]]~~

*~~ABG~~ - pick [[~~Blood gas, arterial~~]]

*VBG - ~~pick~~ [[~~Blood gas, venous~~]]

~~Questions:~~

* CXR - pick [[CXR (plain film)]] - [[CCI Collection Mode]]: {{#show: CXR (plain film) | ?Has CCI Collection Mode}}

*CXR - CXR plain film - ~~Laura says tedious~~, ~~but would be nice to have daily~~ - ~~how common are these really~~

* CT - on picklist and comp2 - the [[statistician]] confirmed she can work with this for reporting

* MRI - on picklist and comp2 - the [[statistician]] confirmed she can work with this for reporting

* US Echo - pick [[ECHO (echocardiogram of heart)]] - [[CCI Collection Mode]]: {{#show: ECHO (echocardiogram of heart) | ?Has CCI Collection Mode}}

* US Abd - comp1 [[(I) Abdomen, Pelvis]]/[[(I) Digestive System, NOS]] comp2 [[Ultrasound]]

* ABG - pick [[Blood gas, arterial]] - [[CCI Collection Mode]]: {{#show: Blood gas, arterial | ?Has CCI Collection Mode}}

* VBG - pick [[Blood gas, venous]] - [[CCI Collection Mode]]: {{#show: Blood gas, venous) | ?Has CCI Collection Mode}}

== Related Articles ==

[[Category: CCI]]

[[Category:CCI]]

[[Category: ICD10/CCI Conversion]]

[[Category:ICD10/CCI Conversion]]

[[Category: Manually_collected_labs]]

[[Category:Manually_collected_labs]]

@@ Line 1: / Line 1: @@
 CCI would allow for the collection of most things we currently collect as counted labs ([[:Category:Manually_collected_labs]]). This page is  for the decision process whether we should go this route.
-{{DiscussTask | Should lab counts move to CCI? }}
 == Pros of moving to CCI ==
@@ Line 9: / Line 7: @@
 == Cons of moving to CCI ==
 === time consuming ===
-* It is much simpler and faster to count the number of CXR's, ABGs, and other tests in our lab counts than to put a CCI entry for each every day they are done.  Also,  anything that is currently on the tiss sheet should not have to be included in CCI at least for ICU.  For example, CRRT and IHD is clearly marked on the tiss and which days are clearly shown. To have to enter in CCI all tests and procedures every single day they are done is not feasible within the time constraints of our EFT's in my opinion.--[[User:LKolesar|LKolesar]] 08:12, 2018 January 31 (CST)
+* It is much simpler and faster to count the number of CXR's, ABGs, and other tests in our lab counts than to put a CCI entry for each every day they are done.
-* Laura did a test collection and found this to be much slower. Trish will coordinate more testing for this. Ttenbergen 12:52, 2018 May 9 (CDT)
-=== losing some detail ===
-* If we move lab counts to CCI we would likely lose the distinction between [[Albumin 25pct]] and [[Albumin 5pct]]. Discussed at Task and we don't think this would be a problem Ttenbergen 13:13, 2018 May 9 (CDT)
-== Questions and concerns ==
-*Who is requesting dates for every single item? There are additional diagnostic procedures on this list that we previously did not count.
-*At one time we did not add other diagnostic counts because the data was not requested.
-*Is all this additional data being requested now?  (ie:  EEG's, abdominal xrays, nuclear scans, urodynamic study, cardiac stress test, pulmonary function tests, etc).
-*We used to go the steering committee for requests for additional data collection items, has this now changed?
-==== CXRs and scan counting in CCI concerns====
-{{Discuss | who = Allan | question = repeated CXRs - if we do collect them it will be a nuisance; if we don't they won't compare to the labs count [[CXR]] we are doing now, that this is supposed to replace. How should we proceed?}}
-{{Discuss | who = Allan | question = cryoprecipitate  - Just checking if you wanted cryoprecipitate counts?-[[User:LKolesar|LKolesar]] 11:56, 2018 June 28
-*I would say no.  We need to consider workload and adding more things that are being collected, with the current EFT's.  If someone wants to know we can always do short term audit. [[p:Trish Ostryzniuk | Trish.]]}}
-*Do we have to enter a CXR for each day it is done or can we enter CXR once and then keep using the times feature?
-*For longer stay patients this could be 50 entries.
-*Why do we need to know what day a CXR was done on?
-*What is wrong with using the lab count feature we now use? The same for blood gases and scans.--[[User:LBilesky|LBilesky]] 14:05, 2018 January 19 (CST)
-** That is what is planned for now, but this might be worth talking about again to confirm it is worth it.
-*** Does the pt travel out of the unit for this?
-==== ABG/VBG counting in CCI & concerns ====
-{{Discuss | who = Allan | question = repeated  ABG/VBG counts - to many rows of data in CCI & lots of rows to scroll down to check what has been entered.  time consuming.}}
-* I see arterial blood gases are on the picklist.  However, Dr Garland had said that arterial blood gases and venous blood gases will remain in our count list unlike all the other things we count.  Should arterial blood gases be removed from the CCI pick list?--[[User:LKolesar|LKolesar]] 13:29, 2018 April 9 (CDT)
-*I have tested a few pts and included ABG/VBG counts.
-*What is this being used for?
-*Is the counting necessary? This is a time Counting is a time consuming task, besides counting now also entering dates.
-**Example:  I had 2 pts that had 50-100 ABG/VBG's to count and enter dates for. I found there was too many rows of data in addition to the CCI being collected, so lots to scroll through to check what I had entered.  [[p:Joanna Velasco]]
-=== data entry test to determine extra time it takes to enter ===
 {{Collapsable
-| always=testing confirmed that this is tedious
+| always=Laura's testing confirmed that this is tedious
 | full=
 *For example:
@@ Line 59: / Line 25: @@
 *****Entering these tests is very tedious and time consuming and it takes away from our time doing diagnostic coding.  It took me 20 mins to enter just CXR's on a patient that was a long stay patient and I was only half done. --[[User:LKolesar|LKolesar]] 14:19, 2018 May 1 (CDT) }}
+==== CXRs and scan counting in CCI concerns====
+[[CXR (plain film)]] will now be collected as [[CCI collect count each]].
+Quick look at pts with arrive dttm this year in CFE:
+* 4147 total
+* 3263 had <=3 cxrs
+* 81 had >=15 cxrs
+* 15 had >=30 cxrs
+* none had 50, so not sure where that example came from...
+==== ABG/VBG counting in CCI & concerns ====
+[[Blood gas, arterial]] and [[Blood gas, venous]] will now be collected as [[CCI collect count each]].
+Quick look at pts with arrive dttm this year in CFE:
+* 4147 total
+* 2276 had <=3 cxrs
+* 250 had >=15 cxrs
+* 66 had >=30 cxrs
+* 27 had >= 50
+* max was 147, next 90
 == Summary ==
 Count in CCI pick or component as any other CCI
-* albumin5, 25%  - on CCI (not 5 vs 25, and that's OK)
+* albumin5, 25% - pick [[Transfusion of albumin]]  - [[CCI Collection Mode]]: {{#show: Transfusion of albumin | ?Has CCI Collection Mode}}
-* Packed cells - on CCI
+** (not 5 vs 25, and that's OK per Trish)
-* Platelets - on CCI
+* Packed cells - pick [[Transfusion of PRBC]]  - [[CCI Collection Mode]]: {{#show: Transfusion of PRBC | ?Has CCI Collection Mode}}
-* FFP - on CCI
+* Platelets - pick [[Transfusion of platelets]]  - [[CCI Collection Mode]]: {{#show: Transfusion of platelets | ?Has CCI Collection Mode}}
-* CT - on picklist and comp2
+* FFP - pick [[Transfusion of plasma products]]  - [[CCI Collection Mode]]: {{#show: Transfusion of plasma products | ?Has CCI Collection Mode}}
-* MRI - on picklist and comp2
-* US Echo - pick [[Echocardiogram of heart]]
-* US Abd - comp1 [[(I) Abdomen, Pelvis]]/[[(I) Digestive System, NOS]] comp2 [[Ultrasound]] - will this give us the "Abd" count we need
-Code one line, count for duration, kind of like [[CCI Procedures coded once per ward admission]]
-*ABG - pick [[Blood gas, arterial]]
-*VBG - pick [[Blood gas, venous]]
-Questions:
+* CXR - pick [[CXR (plain film)]] - [[CCI Collection Mode]]: {{#show: CXR (plain film) | ?Has CCI Collection Mode}}
-*CXR - CXR plain film - Laura says tedious, but would be nice to have daily - how common are these really
+* CT - on picklist and comp2 - the [[statistician]] confirmed she can work with this for reporting
+* MRI - on picklist and comp2 - the [[statistician]] confirmed she can work with this for reporting
+* US Echo - pick [[ECHO (echocardiogram of heart)]] - [[CCI Collection Mode]]: {{#show: ECHO (echocardiogram of heart) | ?Has CCI Collection Mode}}
+* US Abd - comp1 [[(I) Abdomen, Pelvis]]/[[(I) Digestive System, NOS]] comp2 [[Ultrasound]]
+* ABG - pick [[Blood gas, arterial]] - [[CCI Collection Mode]]: {{#show: Blood gas, arterial | ?Has CCI Collection Mode}}
+* VBG - pick [[Blood gas, venous]] - [[CCI Collection Mode]]: {{#show: Blood gas, venous) | ?Has CCI Collection Mode}}
 == Related Articles ==
 {{Related Articles}}
-[[Category: CCI]]
+[[Category:CCI]]
-[[Category: ICD10/CCI Conversion]]
+[[Category:ICD10/CCI Conversion]]
-[[Category: Manually_collected_labs]]
+[[Category:Manually_collected_labs]]