Converting Lab Counts to CCI

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.

Should lab counts move to CCI? There are a number of details to address in this one.

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Pros of moving to CCI

• Consistent storage of information, i.e. stored with all other procedures
• more detail (e.g. do we mostly do a lab at admission, or right through stay?)

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.

Laura's testing confirmed that this is tedious

For example: one patient that was in ICMS for 3 weeks on ECMO had 86 ABG's done in their admission. It took me 15 minutes to just enter the ABG's in CCI. It only takes one minute to enter this item in the old count method off of EPR labs. If I spent the time to enter all the blood products, tests and labs, etc. It would have taken much longer. No one has that much extra time in their day to spend it putting in these CCI entries for every lab. It may work for short stay patients with minimal labs and procedures but not for more complex patients. We need to discuss this. --LKolesar 14:13, 2018 April 20 (CDT) Laura, we discussed your testing at task. A question came up in regards to what method did you use to enter these 86 ABG's? Were you counting number of ABG PER day and then enter that count into CCI and assigning a date? or Did you go from EPR to paper then into CCMDB CCI? Did you use the + button? 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. --LKolesar 07:10, 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. --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% - pick Transfusion of albumin - CCI Collection Mode: CCI collect first
  • (not 5 vs 25, and that's OK per Trish)
• Packed cells - pick Transfusion of PRBC - CCI Collection Mode: CCI collect count units
• Platelets - pick Transfusion of platelets - CCI Collection Mode: CCI collect count units
• FFP - pick Transfusion of FFP - CCI Collection Mode:

• CXR - pick CXR (plain film) - CCI Collection Mode: CCI collect count each
• CT - on picklist and comp2
• MRI - on picklist and comp2
• US Echo - pick ECHO (echocardiogram of heart) - CCI Collection Mode: CCI collect each

US Echo is currently collecting the counts - the collection mode should be changed to CCI collect count units or CCI collect each. --JMojica 10:33, 2018 December 20 (CST)

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

• ABG - pick Blood gas, arterial - CCI Collection Mode: CCI collect count each
• VBG - pick Blood gas, venous - CCI Collection Mode:

CT and MRI will not be as straightfwd as before; is that doable? The current CT and MRI are not specific. In reporting, all the CTs and MRIs in CCI will be summed up. --JMojica 10:33, 2018 December 20 (CST) with the new CCI Collection Modes, are there any remaining concerns about replacing our labs collection with CCI collection? Ttenbergen 14:07, 2018 December 19 (CST) except for the US abd (and minor change for US ECHO), all are good to be replaced by CCI collection. --JMojica 10:33, 2018 December 20 (CST)

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US Abd will be a component code - will this cause problems for reporting? The definition is not the same - need to separate upper abdomen only from pelvis if possible. Question to Allan done. --JMojica 10:09, 2018 December 20 (CST)

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