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{{discussAllan |  
{{discussAllan |  
* various CCI questions, at least some can likely be answered on the spot, others might need to go to task}}
* various CCI questions, at least some can likely be answered on the spot, others might need to go to task}}
* {{Discussion}} ==transfusion suggestion==
*The various transfusion options in our pick list should be written with the blood product first to allow for type recognition and easier entry.  For example, instead of having "transfusion of PRBC"  If it was written "packed cells, transfusion of" that would be easier to get with typing in the usual words for this.  Another example: Instead of "transfusion of FFP" use "FFP, transfusion of".  etc.  --[[User:LKolesar|LKolesar]] 10:47, 2018 May 10 (CDT)


=== additional codes? ===
=== admit vs acquired dxs and the rule to only code if off unit ===
*For the procedures listed specifically like arterial lines, PEG, hemodialysis, etc.  Do you want only if done during their stay or since arrival to the hospital,  or if they already had this done prior to arrival.  There are patients in the community with a PEG and on hemodialysis for example.  --[[User:LKolesar|LKolesar]] 08:07, 2018 March 7 (CST)
** Ah! Yes, will our restrictions for procedures with [[Px Type]] "admit" be the same as for on unit?


===Thoracentesis ===
* There is a diagnostic thoracentesis on the [[CCI Picklist]] but not a therapeutic one.  This should be on the picklist as it is very common.  
* There is a diagnostic thoracentesis on the [[CCI Picklist]] but not a therapeutic one.  This should be on the picklist as it is very common.  
** As opposed to coding it as [[Therapeutic Intervention on Thoracic Cavity, anything inside, NOS]], [[Drainage, Evacuation]]? Ttenbergen 16:11, 2018 April 5 (CDT)
** As opposed to coding it as [[Therapeutic Intervention on Thoracic Cavity, anything inside, NOS]], [[Drainage, Evacuation]]? Ttenbergen 16:11, 2018 April 5 (CDT)


=== Bronchoscopy ===
* I tried putting in a diagnostic bronchoscopy. I put in Diagnostic Intervention on the lung but there is no option in the second component to capture taking a sample of secretions for culture. --[[User:LKolesar|LKolesar]] 12:26, 2018 March 20 (CDT)
* I tried putting in a diagnostic bronchoscopy. I put in Diagnostic Intervention on the lung but there is no option in the second component to capture taking a sample of secretions for culture. --[[User:LKolesar|LKolesar]] 12:26, 2018 March 20 (CDT)
** For diagnostic the only options are [[Inspection, Exploration]] and [[Biopsy]], so you are correct. Are we OK with that? Ttenbergen 19:00, 2018 March 22 (CDT)
** For diagnostic the only options are [[Inspection, Exploration]] and [[Biopsy]], so you are correct. Are we OK with that? Ttenbergen 19:00, 2018 March 22 (CDT)


* Also, at the task group meeting, Dr Garland said that Pacemaker insertion and ICD insertion would be on the picklist because they look the same done in the component entry section.  I guess this item has not been added yet.
=== Insert Pacemaker ===
* {{discussAllan | Also, at the task group meeting, Dr Garland said that Pacemaker insertion and ICD insertion would be on the picklist because they look the same done in the component entry section.  I guess this item has not been added yet}}


===Closure of surgical incision that was left open ===
{{discussion}} how do we code closure of a surgical incision done later.  Many times if a patient bleeds excessively or if they expect a lot of edema or a requirement for further future surgery, they leave the surgical incision open.  When the patient eventually goes back for closure, how do we code this in CCI--[[User:LKolesar|LKolesar]] 13:34, 2018 April 9 (CDT)?   
{{discussion}} how do we code closure of a surgical incision done later.  Many times if a patient bleeds excessively or if they expect a lot of edema or a requirement for further future surgery, they leave the surgical incision open.  When the patient eventually goes back for closure, how do we code this in CCI--[[User:LKolesar|LKolesar]] 13:34, 2018 April 9 (CDT)?   
===Intubation===
*{{discussion}}How do we code an intubation, I used therapeutic intervention on the lung and is it an internal device or external? Lois
*{{discussion}}How do we code an intubation, I used therapeutic intervention on the lung and is it an internal device or external? Lois


===Albumin 5% & 25% not on picklist? ===
*{{discussion}}I cannot find [[Albumin 5pct]] and [[Albumin 25pct]] on the picklist. Are we not still counting these? Lois
*{{discussion}}I cannot find [[Albumin 5pct]] and [[Albumin 25pct]] on the picklist. Are we not still counting these? Lois


===Lumbar puncture===
*{{discussion}} for a lumbar puncture, I put interventions on the spinal cord or spinal canal. Do I use drainage, evacuation for this? They just take a sample of CSF but there is no sample option.--[[User:LKolesar|LKolesar]] 13:32, 2018 May 2 (CDT)
*{{discussion}} for a lumbar puncture, I put interventions on the spinal cord or spinal canal. Do I use drainage, evacuation for this? They just take a sample of CSF but there is no sample option.--[[User:LKolesar|LKolesar]] 13:32, 2018 May 2 (CDT)


===Isolation===
*{{discussion}}:  I notice that isolation, infectious is now added to the pick list in CCI. We don't have to code reverse isolation? --[[User:LKolesar|LKolesar]] 08:07, 2018 May 9 (CDT)
*{{discussion}}:  I notice that isolation, infectious is now added to the pick list in CCI. We don't have to code reverse isolation? --[[User:LKolesar|LKolesar]] 08:07, 2018 May 9 (CDT)


=== Ability to differentiate in reports ===
=== ECMO ===
{{discussion}}
** Laura, does having [[ECMO, VA]] and [[ECMO, VV]] address this question? If so, please take it out. If not, please clarify. Ttenbergen 17:13, 2018 May 8 (CDT)
* I see you have put ECMO on the picklist. 


** Laura, does having [[ECMO, VA]] and [[ECMO, VV]] address this question? If so, please take it out. If not, please clarify. Ttenbergen 17:13, 2018 May 8 (CDT)
===VAD===
* I see you have put ECMO on the picklist.  How do we put VAD's in the component method?
How do we put VAD's in the component method?


*{{discussion}}: how do we differentiate thrombolytic agents given for PE, MI or stroke?  For component 1: I thought it should be "theuapeutic intervention on circulatory system" for all of these options and then "pharmacotherapy, thrombolytic agent" for component 2.  If the patient has only one of the above diagnosis, one could assume that the treatment was related to that.  Does it matter what it is given for? --[[User:LKolesar|LKolesar]] 13:02, 2018 May 10 (CDT)   
===Thrombolyic agents for PE, MI, stroke ===
*{{discussion}}: how do we differentiate thrombolytic agents given for PE, MI or stroke?  For component 1: I thought it should be "theuapeutic intervention on circulatory system" for all of these options and then "pharmacotherapy, thrombolytic agent" for component *If the patient has only one of the above diagnosis, one could assume that the treatment was related to that.  Does it matter what it is given for? --[[User:LKolesar|LKolesar]] 13:02, 2018 May 10 (CDT)   


===Blakemore vs UGI scope for banding ===
{{discussion}}
{{discussion}}
* How do we differentiate a Blakemore tube from an Upper GI scope with banding or hemostasis?  They both look the same in CCI:  Therapeutic Intervention on Stomach, pylorus... and Control of Bleeding. --[[User:LKolesar|LKolesar]] 14:11, 2018 May 1 (CDT)
* How do we differentiate a Blakemore tube from an Upper GI scope with banding or hemostasis?  They both look the same in CCI:  Therapeutic Intervention on Stomach, pylorus... and Control of Bleeding. --[[User:LKolesar|LKolesar]] 14:11, 2018 May 1 (CDT)
=== admit vs acquired dxs and the rule to only code if off unit ===
*For the procedures listed specifically like arterial lines, PEG, hemodialysis, etc.  Do you want only if done during their stay or since arrival to the hospital,  or if they already had this done prior to arrival.  There are patients in the community with a PEG and on hemodialysis for example.  --[[User:LKolesar|LKolesar]] 08:07, 2018 March 7 (CST)
** Ah! Yes, will our restrictions for procedures with [[Px Type]] "admit" be the same as for on unit?


=== Coding GI Scopes ===
=== Coding GI Scopes ===
** The GI Scopes are currently on the [[CCI Component]] list only and would be coded as [[Inspection, Exploration]]. The scope part would have been part 3 (how it was done) an we no longer code that.  
** The GI Scopes are currently on the [[CCI Component]] list only and would be coded as [[Inspection, Exploration]]. The scope part would have been part 3 (how it was done) an we no longer code that.  
{{DiscussTask | CCI codes GI scope as (body part), [[Inspection, Exploration]]. So, won't be able to identify those from laparoscopic surgery. Do we care? Ttenbergen 19:00, 2018 March 22 (CDT)}}
{{DiscussTask | CCI codes GI scope as (body part), [[Inspection, Exploration]]. So, won't be able to identify those from laparoscopic surgery. Do we care? Ttenbergen 19:00, 2018 March 22 (CDT)}}
*{{discussion}} For upper GI scope, should it be coded diagnostic/therapeutic interventions on "stomach" or "small intestine"? (since duodenum is first part of small intestine). Also, if biopsy is done with inspection and exploration, but no interventions like clipping or to control bleeding, should that be coded as "biopsy" or "inspection, exploration"? --[[User:Malcudia|Malcudia]] 10:13, 2018 April 11 (CDT)
*{{discussion}} For upper GI scope, should it be coded diagnostic/therapeutic interventions on "stomach" or "small intestine"? (since duodenum is first part of small intestine). Also, if biopsy is done with inspection and exploration, but no interventions like clipping or to control bleeding, should that be coded as "biopsy" or "inspection, exploration"? --[[User:Malcudia|Malcudia]] 10:13, 2018 April 11 (CDT)
** Re whether to code stomach or intestine, see [[#Related Imaging, Diagnostic and Therapeutic procedures performed at the same time]] above in this document. Re whether to code biopsy or exploration. I'll leave that open for now. Ttenbergen 10:57, 2018 April 11 (CDT)
** Re whether to code stomach or intestine, see [[#Related Imaging, Diagnostic and Therapeutic procedures performed at the same time]] above in this document. Re whether to code biopsy or exploration. I'll leave that open for now. Ttenbergen 10:57, 2018 April 11 (CDT)


=== Which codes go on picklist ===
=== Which codes go on picklist ===
* What are the criteria for choosing the picklist items? I thought it was going to be procedures that are difficult to list by the component entry method and then more common procedures.   
==== moving labs to CCI & counting ====
* There are quite a few uncommon (rarely seen) procedures in the pick list, is there a reason for this?  Just wondering what the rationale is for these choices? Maybe these can be left off the picklist and just left to the component entry method.  Just a suggestion. --[[User:LKolesar|LKolesar]] 13:32, 2018 March 15 (CDT)
{{DiscussTask | Lab counts}}
* 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 was not aware that we are moving all our count items to CCI and having to put a date for all blood products, CXR, echos, etc.
*This will definitely be more work than just counting the number of each.   
*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?
==== Criteria for adding CCI's to picklist? - not clear - very uncommon items added ====
{{Discussion}}
{{Discussion}}
*Your instructions for therapeutic procedures done in the unit exclude several important procedures that are commonly done in the unit. Just checking if this is correct... see list below:
*What are the criteria for choosing the picklist items? I thought it was going to be procedures that are difficult to list by the component entry method and then more common procedures?  
* What about chest tubes inserted in the unit?; ECMO inserted in the unit?; CRRT done in the unit?  Intubations and central lines in the unit? Cardioversions and Defibs in the unit?; Pacemakers in the unit? IABP in the unit?etc. --[[User:LKolesar|LKolesar]] 13:59, 2018 April 20 (CDT)
* There are quite a few uncommon (rarely seen) procedures in the pick list, is there a reason for this?  
 
*Just wondering what the rationale is for these choices?   
=== counts, and moving labs to CCI ===
*Maybe these can be left off the picklist and just left to the component entry method? Just a suggestion.-[[User:LKolesar|LKolesar]] 13:32, 2018 March 15 (CDT)
{{DiscussTask | Lab counts}}
*  I was not aware that we are moving all our count items to CCI and having to put a date for all blood products, CXR, echos, etc. This will definitely be more work than just counting the number of each.  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?


===CCI counting conerns ===
==== CXRs and scan counting in CCI concerns====
{{DiscussAllan | 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?}}
{{DiscussAllan | 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?}}
*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?  
*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.  
*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)
*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.
** 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?
*** Does the pt travel out of the unit for this?


===== ABG/VBG counts tests in CCI & concerns =====
==== ABG/VBG counting in CCI & concerns ====
 
{{DiscussAllan | 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.}}
{{DiscussAllan | 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.   
*I have tested a few pts and included ABG/VBG counts.   
*What is this being used for?   
*What is this being used for?   
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***Did you use the + button? [[User:TOstryzniuk|Trish Ostryzniuk]]
***Did you use the + button? [[User:TOstryzniuk|Trish Ostryzniuk]]
****I did the CCI entries exactly as directed using the + button for new entries and putting the # for each day in the column for that.  I did it as efficiently as I could, I never use paper. You can likely see it in the profile if you would like to look at it.  I think it was MICU profile #31216.  I sent it in after April 17th. --[[User:LKolesar|LKolesar]] 07:10, 2018 April 26 (CDT)
****I did the CCI entries exactly as directed using the + button for new entries and putting the # for each day in the column for that.  I did it as efficiently as I could, I never use paper. You can likely see it in the profile if you would like to look at it.  I think it was MICU profile #31216.  I sent it in after April 17th. --[[User:LKolesar|LKolesar]] 07:10, 2018 April 26 (CDT)
***** I had a look and there is nothing for CCI for profile indicated above. Only 19 row of label ACQUIRED, but no data.  I will talk to Tina.[[User:TOstryzniuk|Trish Ostryzniuk]] 15:06, 2018 April 26 (CDT)
*****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)
****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)
 
 


== Common items done in a unit that are missing from Picklist ==
* also check out: [[CCI procedures we don't code]].
{{Discussion}}
*{{DiscussAllan | Your instructions for therapeutic procedures done in the unit exclude several important procedures that are commonly done in the unit.  Just checking if this is correct... see list below:}}
*chest tubes inserted in the unit
*ECMO inserted in the unit
*CRRT done in the unit (is on TISS)
**to be added by Allan Garland as per task meeting - May 9.18.[[User:TOstryzniuk|Trish Ostryzniuk]] 14:50, 2018 May 14 (CDT) 
*intubations (is on TISS)
*central lines in the unit
*cardioversions and Defibs in the unit
**cardioversion, elective to be added, but not for arrests.  Defib not added as per task meeting May 9.18[[User:TOstryzniuk|Trish Ostryzniuk]] 14:50, 2018 May 14 (CDT)
*Temp Pacemakers in the unit (is on TISS)
*IABP in the unit --[[User:LKolesar|LKolesar]] 13:59, 2018 April 20 (CDT)
*foley - is this one that we want to leave of?
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And the content below here will need to stay as well
And the content below here will need to stay as well
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