CRRT Project: Difference between revisions

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The '''CRRT''' project tracks [https://en.wikipedia.org/wiki/Hemofiltration wikipedia-Hemofiltration Continuous Renal Replacement Therapy CRRT] use and reasons. For now the data is collected at [[HSC MICU]] and [[HSC SICU]].

~~== Purposes ==~~

* To identify the reason(s) why CRRT therapy was requested by the attending nephrologist for quality improvement and resource utilization in the Renal Program.

* To track the CRRT usage for workload and resource utilization in the Critical Care Program.

== Data Collection Instructions ==

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Enter

*Project: CRRT

*Item: enter the field marked in the form

*Item / Column N: enter the field marked in the form

**there could be more than than one reason for CRRT, if so, enter additional rows

***enter the number '''1''' or '''2''' as applicable.

****if there is only one reason, enter '''1'''.

****if there is more than one reason, enter '''1''' for the primary reason and '''2''' for the rest of the reason(s)

****if there is more than one reason and the Nephrology '''attending''' did not indicate the ranking, enter '''2''' in all reasons.

**if entry is 'Form Missing' or 'Form not done'

***email '''Ryan Holland''' ~~the info about the patient~~ and ~~the problem (e~~.g. missing ~~Nephroloy consult form, or no~~ sticker ~~in the consult form~~ or ~~unmarked sticker).~~ If the patient is still in your laptop and if you are still working on the chart and then you find a filled-up consult form in it, change the entry with the reason for CRRT. Otherwise, you are not expected to run after the chart or wait for Ryan or the nephrologist until the form is filled up. If the profile is already complete but still the form is missing or not filled up, then submit the profile with 'Form Missing' or 'Form not done'.

*** see [[#follow-up when the data is not on the chart]]

***Tina added the reminder to email Ryan.

***After discussion with Ryan Holland, when emailing him about missing CRRT stickers, it may be more efficient to cc Dr. Herman Lam and Dr. Joe Bueti as well, so they can do the necessary corrections.--[[User:Jvelasco|Jvelasco]] 12:04, 2017 April 18 (CDT) {{discussion}}

=== follow-up when the data is not on the chart ===

**** How about only emailing the Drs and not Ryan at all? Is there value added in including him? Ttenbergen 11:24, 2017 April 19 (CDT)

==== form is present but not filled in ====

**** As per meeting, Ryan is the contact person and in-Charge of the CRRT in ICU and handles the CRRT sticker. I think cc'ing Dr Lam and Dr Bueti will be helpful only when the issue is 'form not filled up' so they will be aware that the nephrologist at that time did not mark the form. However I am not sure about their actions (e.g. talk to the attending nephrologist, go to ICU to fill up the blank form themselves, etc.) . Although Dr Lam mentioned in the meeting that he is willing to go back on the past unfilled forms and do an audit - I just need to provide him the list of chart #. --[[User:JMojica|JMojica]] 13:53, 2017 April 19 (CDT)

If you enter 'Form Missing' or 'Form not done' [[CCMDB.mdb]] will remind you to email

*Column N: enter the number '''1''' or '''2''' as applicable.

* email '''Ryan Holland''', Dr. Herman Lam and Dr. Joe Bueti.

**if there is only one reason, enter '''1'''.

* Include:

**if there is more than one reason, enter '''1''' for the primary reason and '''2''' for the rest of the reason(s)

** Subject: CRRT Info missing

**if there is more than one reason and the Nephrology '''attending''' did not indicate the ranking, enter '''2''' in all reasons.

** minimal patient identifier

** whether sticker is missing or only not filled out

==== follow-up ====

If the patient is still in your laptop and if you are still working on the chart and then you find a filled-up consult form in it, change the entry with the reason for CRRT. Otherwise, you are not expected to run after the chart or wait for Ryan or the nephrologist until the form is filled up. If the profile is already complete but still the form is missing or not filled up, then submit the profile with 'Form Missing' or 'Form not done'.

== Start and Stop Dates ==

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== Form revision start date ==

*Oct 24, 2016 - HSC_ICU consult form will have a sticker pre-attached by unit clerk with list of Reasons for CRRT. See [[Media:HSC ICU 2016 Oct 24 ReasonForCRRT consult form.pdf|HSC_ICU_CRRT Consult form]]

==== Adding STB ====

*If possible, for STB, it would be optimal if the sheet that the renal attending could be put on the electronic chart. It could pop up when the orders are written for CRRT or the doctors could put it into their electronic progress notes. We may find that compliance using a paper sheet may not be good here. --[[User:LKolesar|LKolesar]] 10:48, 2016 February 9 (CST)

** The CRRT project is piloted at HSC for now. There is no discussion yet if to be done at STB. [[User:JMojica|JMojica]] 14:34, 2016 September 16 (CDT)

=={{CCMDB Data Integrity Checks|needs review}}==

None yet

== CFE checks ==

* query ''NDC_zCRRT_tmp_no_TISS'': lists patients who have tmp entry but no TISS

* query ''NDC_zCRRT_TISS_no_tmp'': lists patients who have TISS entry and admission after <when?> but no tmp entry.

== Data Use ==

* To identify the reason(s) why CRRT therapy was requested by the attending nephrologist for quality improvement and resource utilization in the Renal Program.

* To track the CRRT usage for workload and resource utilization in the Critical Care Program.

== Background ==

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However TISS28 does not contain the diagnostic reasons for CRRT therapy so a request to collect this information separately by the data collectors of the Critical Care Database was made. The Renal Program had identified the possible reasons for CRRT therapy and proposed to list them in a form for the attending Nephrologist to mark. The form has been developed and in Sept 2016 has been placed together with the Nephrologist's consult for the attending Nephrologist to fill up. A meeting has been held Sept 15, 2016 with the Critical Care Manager and Statistician to begin the collection of the CRRT diagnostic reasons in the next three months Oct to Dec 2016 and the group have agreed to have the results presented on Jan 12, 2017.

~~=={{CCMDB Data Integrity Checks|needs review}}==~~

~~None yet~~

~~== CFE checks ==~~

* query ''NDC_zCRRT_tmp_no_TISS'': lists patients who have tmp entry but no TISS

* query ''NDC_zCRRT_TISS_no_tmp'': lists patients who have TISS entry and admission after <when?> but no tmp entry.

== Additional data ==

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* CRRT Days from TISS28 - The SAS program is in X:\Julie\CC Projects\CRRT_Ryan&Bueti\ICU_CRRT_byMonth.sas. The program generates the list of patient names, PHIN, Chart#, Date of Birth, First day on CRRT, year, month and calendar days on CRRT and total CRRT days.

* Reasons for CRRT starting Oct 2016 - are added to the SAS program above and frequencies of the reasons are presented in the report.

~~==== Discussion ====~~

*If possible, for STB, it would be optimal if the sheet that the renal attending could be put on the electronic chart. It could pop up when the orders are written for CRRT or the doctors could put it into their electronic progress notes. We may find that compliance using a paper sheet may not be good here. --[[User:LKolesar|LKolesar]] 10:48, 2016 February 9 (CST)

** The CRRT project is piloted at HSC for now. There is no discussion yet if to be done at STB. [[User:JMojica|JMojica]] 14:34, 2016 September 16 (CDT)

== Requestor ==

@@ Line 9: / Line 9: @@
 The '''CRRT''' project tracks [https://en.wikipedia.org/wiki/Hemofiltration wikipedia-Hemofiltration Continuous Renal Replacement Therapy CRRT] use and reasons. For now the data is collected at [[HSC MICU]] and [[HSC SICU]].
-== Purposes ==
-* To identify the reason(s) why CRRT therapy was requested by the attending nephrologist for quality improvement and resource utilization in the Renal Program.
-* To track the CRRT usage for workload and resource utilization in the Critical Care Program.
 == Data Collection Instructions ==
@@ Line 23: / Line 19: @@
 Enter
 *Project: CRRT
-*Item:  enter the field marked in the form
+*Item / Column N:  enter the field marked in the form
 **there could be more than than one reason for CRRT, if so, enter additional rows
+***enter the number '''1''' or '''2''' as applicable.
+****if there is only one reason, enter '''1'''.
+****if there is more than one reason, enter '''1''' for the primary reason and '''2''' for the rest of the reason(s)
+****if there is more than one reason and the Nephrology '''attending''' did not indicate the ranking, enter '''2''' in all reasons.
 **if entry is 'Form Missing' or 'Form not done'
-***email '''Ryan Holland''' the info about the patient and the problem (e.g. missing Nephroloy consult form, or no sticker in the consult form or unmarked sticker). If the patient is still in your laptop and if you are still working on the chart and then you find a filled-up consult form in it, change the entry with the reason for CRRT.  Otherwise, you are not expected to run after the chart or wait for Ryan or the nephrologist until the form is filled up.  If the profile is already complete but still the form is missing or not filled up, then submit the profile with 'Form Missing' or 'Form not done'.
+*** see [[#follow-up when the data is not on the chart]]
-***Tina added the reminder to email Ryan.
-***After discussion with Ryan Holland, when emailing him about missing CRRT stickers, it may be more efficient to cc Dr. Herman Lam and Dr. Joe Bueti as well, so they can do the necessary corrections.--[[User:Jvelasco|Jvelasco]] 12:04, 2017 April 18 (CDT) {{discussion}}
+=== follow-up when the data is not on the chart ===
-**** How about only emailing the Drs and not Ryan at all? Is there value added in including him? Ttenbergen 11:24, 2017 April 19 (CDT)
+==== form is present but not filled in ====
-**** As per meeting, Ryan is the contact person and in-Charge of the CRRT in ICU and handles the CRRT sticker.  I think cc'ing Dr Lam and Dr Bueti will be helpful only when the issue is 'form not filled up' so they will be  aware that the nephrologist at that time did not mark the form. However I am not sure about their actions (e.g. talk to the attending nephrologist, go to ICU to fill up the blank form themselves, etc.) . Although Dr Lam mentioned in the meeting that he is willing to go back  on the past unfilled forms  and do an audit - I just need to provide him the list of chart #. --[[User:JMojica|JMojica]] 13:53, 2017 April 19 (CDT)
+If you enter 'Form Missing' or 'Form not done' [[CCMDB.mdb]] will remind you to email
-*Column N: enter the number '''1''' or '''2''' as applicable.
+* email '''Ryan Holland''', Dr. Herman Lam and Dr. Joe Bueti.
-**if there is only one reason, enter '''1'''.
+* Include:
-**if there is more than one reason, enter '''1''' for the primary reason and '''2''' for the rest of the reason(s)
+** Subject: CRRT Info missing
-**if there is more than one reason and the Nephrology '''attending''' did not indicate the ranking, enter '''2''' in all reasons.
+** minimal patient identifier
+** whether sticker is missing or only not filled out
+==== follow-up ====
+If the patient is still in your laptop and if you are still working on the chart and then you find a filled-up consult form in it, change the entry with the reason for CRRT. Otherwise, you are not expected to run after the chart or wait for Ryan or the nephrologist until the form is filled up.  If the profile is already complete but still the form is missing or not filled up, then submit the profile with 'Form Missing' or 'Form not done'.
 == Start and Stop Dates ==
@@ Line 45: / Line 49: @@
 == Form revision start date ==
 *Oct 24, 2016 - HSC_ICU consult form will have a sticker pre-attached by unit clerk with list of Reasons for CRRT. See [[Media:HSC ICU 2016 Oct 24 ReasonForCRRT consult form.pdf|HSC_ICU_CRRT Consult form]]
+==== Adding STB ====
+*If possible, for STB, it would be optimal if the sheet that the renal attending could be put on the electronic chart.  It could pop up when the orders are written for CRRT or the doctors could put it into their electronic progress notes.   We may find that compliance using a paper sheet may not be good here. --[[User:LKolesar|LKolesar]] 10:48, 2016 February 9 (CST)
+** The CRRT project is piloted at HSC for now.  There is no discussion yet if to be done at STB. [[User:JMojica|JMojica]] 14:34, 2016 September 16 (CDT)
+=={{CCMDB Data Integrity Checks|needs review}}==
+None yet
+== CFE checks ==
+* query ''NDC_zCRRT_tmp_no_TISS'': lists patients who have tmp entry but no TISS
+* query ''NDC_zCRRT_TISS_no_tmp'': lists patients who have TISS entry and admission after <when?> but no tmp entry.
+== Data Use ==
+* To identify the reason(s) why CRRT therapy was requested by the attending nephrologist for quality improvement and resource utilization in the Renal Program.
+* To track the CRRT usage for workload and resource utilization in the Critical Care Program.
 == Background ==
@@ Line 54: / Line 73: @@
 However TISS28 does not contain the diagnostic reasons for CRRT therapy so a request to collect this information  separately by the data collectors of the Critical Care Database was made. The Renal Program had identified the possible reasons for CRRT therapy and proposed to list them in a form for the attending Nephrologist to mark.  The form has been developed and in Sept 2016 has been placed together with the Nephrologist's consult for the  attending Nephrologist to fill up. A meeting has been held Sept 15, 2016 with the Critical Care Manager and Statistician to begin the collection of the CRRT diagnostic reasons in the next three months Oct to Dec 2016 and the group have agreed to have the results presented on Jan 12, 2017.
-=={{CCMDB Data Integrity Checks|needs review}}==
-None yet
-== CFE checks ==
-* query ''NDC_zCRRT_tmp_no_TISS'': lists patients who have tmp entry but no TISS
-* query ''NDC_zCRRT_TISS_no_tmp'': lists patients who have TISS entry and admission after <when?> but no tmp entry.
 == Additional data ==
@@ Line 71: / Line 83: @@
 * CRRT Days from TISS28 - The SAS program is in X:\Julie\CC Projects\CRRT_Ryan&Bueti\ICU_CRRT_byMonth.sas. The program generates the list of patient names, PHIN, Chart#, Date of Birth, First day on CRRT, year, month and calendar days on CRRT and total CRRT days.
 * Reasons for CRRT starting Oct 2016 - are added to the SAS program above and frequencies of the reasons are presented in the report.
-==== Discussion  ====
-*If possible, for STB, it would be optimal if the sheet that the renal attending could be put on the electronic chart.  It could pop up when the orders are written for CRRT or the doctors could put it into their electronic progress notes.   We may find that compliance using a paper sheet may not be good here. --[[User:LKolesar|LKolesar]] 10:48, 2016 February 9 (CST)
-** The CRRT project is piloted at HSC for now.  There is no discussion yet if to be done at STB. [[User:JMojica|JMojica]] 14:34, 2016 September 16 (CDT)
 == Requestor ==