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?

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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. 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.--LKolesar 08:12, 2018 January 31 (CST)
• 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

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?

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cryoprecipitate - Just checking if you wanted cryoprecipitate counts?-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. Trish.

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• 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.--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

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.

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• 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?--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

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)

Suggestion

Currently counted:

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

Packed cells - on CCI Platelets - on CCI FFP - on CCI CXR - CXR plain film CT - on picklist and comp2 MRI - on picklist and comp2 US Echo - Echocardiogram of heart US Abd - comp2 Ultrasound is much more?

Code one line, count for duration, kind of like CCI Procedures coded once per ward admission CXR - CXR plain film ABG - pick Blood gas, arterial VBG - pick Blood gas, venous