CCI Volumes 2019: Difference between revisions

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There have been concerns about the volume of work generated by CCI entries. Here are some numbers.
There have been concerns about the volume of work generated by CCI entries. Since we had already reduced certain entries earlier in 2019, the numbers referenced here are only for pts admitted during the third quarter of 2019.  


{{DT | working on}}
== Summary ==
== CCI Picklist ==
A small number of records have a high CCI count. On reviewing a small sample of high-count records, it appears that repeated entries of same things account for most of the high-count records.  
program Site Min Average SD Max
The few records with high counts of CCIs are generally complicated and/or high LOS patients. It doesn't look like further combination of actual procedures would bring down the number of entries.  
CC GRA 1 4.215384615 4.095982655 48
HSC 1 5.127358491 4.115048329 48
STB 1 4.57199211 3.386600846 38
Total 1 4.710877477 3.769457235 48
Med GRA 1 1.867674858 1.532923454 20
HSC 1 1.695810216 1.234187258 14
STB 1 1.896293778 1.49731842 14
VIC 1 1.505555556 1.262253466 14
Total 1 1.790450495 1.399507115 20
Grand Total 1 2.631367526 2.689638158 48


== CCI Combination ==
We will need to review further what is really causing collectors so much time in collecting CCIs.
 
== General numbers ==
=== CCI Picklist - 2019-3Q ===
  program Site Min Average SD Max
  program Site Min Average SD Max
  CC CON 1 1.80 1.24 6
  CC GRA 1 3.82 2.24 11
  GRA 1 2.03 1.59 15
HSC 1 5.09 3.20 29
  HSC 1 2.92 2.78 22
STB 1 4.26 2.71 29
  OAK 1 1.64 1.09 6
  Total 1 4.43 2.83 29
  STB 1 1.94 2.13 37
Med GRA 1 1.46 0.88 7
  Total 1 2.26 2.33 37
HSC 1 1.70 1.15 8
  Med GRA 1 1.73 1.19 10
STB 1 1.78 1.48 14
  HSC 1 2.22 1.76 19
Total 1 1.65 1.19 14
  STB 1 2.12 1.76 19
Grand Total 1 2.58 2.31 29
  VIC 1 1.49 0.87 5
 
Total 1 2.01 1.59 19
=== CCI Combination - 2019-3Q ===
  Grand Total 1 2.11 1.90 37
program Site Min Average SD Max
CC GRA 1 2.15 1.60 10
HSC 1 2.84 2.40 17
OAK 1 1.53 1.22 6
  STB 1 1.96 2.45 37
Total 1 2.21 2.35 37
  Med GRA 1 1.74 1.16 9
  HSC 1 2.04 1.38 10
  STB 1 2.15 1.90 14
  Total 1 1.99 1.49 14
  Grand Total 1 2.08 1.90 37
 
 
== Review of some high counts ==
===Big Picklists - 2019 3Q ===
* HSC_MICb-2327
** 29 picklist, 26 are transfusions; just one component CCI, LOS25
* STB_MICU-32416
** 13 pick (this is not the highest for STB); this one has a great variety of things done, 2 components, LOS ~4
* HSC_H4-18287
** 8 pick, great variety, just 1 Component, LOS 24
*STB_E6a-967
**9 in combined; 14 picklist, all transfusions except 1; LOS 9


=== Big Component - 2019 Q3 ===
* GRA_MICU-10655
** 10 component entries, CT and Ultrasounds, repeated; Picklist also has usual transfusions, blood gases, CXRs; LOS ~25
At HSC the 10 with highest component counts are SICU
* HSC_SICa-2436
** 17 component entries, looks like a trauma, 5 entries are imagings on different days, rest see below, LOS 12
*** Pleura (T); Drainage, Evacuation
*** Lung (T); Drainage, Evacuation
*** Lung (T); Excision, Resection
*** Spleen (T); Excision, Resection, total
*** Tibia, Fibula (T); Fixation
*** Bronchi (D); Inspection, Exploration (endoscopic)
*** Abdominal, Pelvic or Peritoneal Cavity, NOS (D); Inspection, Exploration (non-endoscopic)
*** Anything Inside Thoracic Cavity, NOS (D); Inspection, Exploration (non-endoscopic)
*** Abdominal, Pelvic or Peritoneal Cavity, NOS (D); Inspection, Exploration (non-endoscopic)
*** Stomach, Pylorus (T); Repair
*** Diaphragm (T); Repair
*** Lower Limb (I); Ultrasound
At STB there is a mix of CICU and MICU for biggest Component counts
* STB_CICU-16664
** 29 Picklist, 37 component, '''about half are imaging''', LOS > 50; seems like a very sick patient, with a legitimately high number of entries.
* STB_MICU-32376
** 8 picklist, 13 component, LOS 7; picklist are all different entries, 7 of 13 component entries are imaging, much is on different days
* HSC_D4-17086
** 7 picklist, 10 component, LOS ~25; all different picklist, 7 of the components are imaging, and the other 3 drainages on different days


== Related articles ==  
== Related articles ==  

Latest revision as of 11:24, 2022 February 17

There have been concerns about the volume of work generated by CCI entries. Since we had already reduced certain entries earlier in 2019, the numbers referenced here are only for pts admitted during the third quarter of 2019.

Summary

A small number of records have a high CCI count. On reviewing a small sample of high-count records, it appears that repeated entries of same things account for most of the high-count records. The few records with high counts of CCIs are generally complicated and/or high LOS patients. It doesn't look like further combination of actual procedures would bring down the number of entries.

We will need to review further what is really causing collectors so much time in collecting CCIs.

General numbers

CCI Picklist - 2019-3Q

program	Site	Min	Average	SD	Max
CC	GRA	1	3.82	2.24	11
	HSC	1	5.09	3.20	29
	STB	1	4.26	2.71	29
	Total	1	4.43	2.83	29
Med	GRA	1	1.46	0.88	7
	HSC	1	1.70	1.15	8
	STB	1	1.78	1.48	14
	Total	1	1.65	1.19	14				
Grand Total	1	2.58	2.31	29

CCI Combination - 2019-3Q

program	Site	Min	Average	SD	Max
CC	GRA	1	2.15	1.60	10
	HSC	1	2.84	2.40	17
	OAK	1	1.53	1.22	6
	STB	1	1.96	2.45	37
	Total	1	2.21	2.35	37
Med	GRA	1	1.74	1.16	9
	HSC	1	2.04	1.38	10
	STB	1	2.15	1.90	14
	Total	1	1.99	1.49	14				
Grand Total	1	2.08	1.90	37


Review of some high counts

Big Picklists - 2019 3Q

  • HSC_MICb-2327
    • 29 picklist, 26 are transfusions; just one component CCI, LOS25
  • STB_MICU-32416
    • 13 pick (this is not the highest for STB); this one has a great variety of things done, 2 components, LOS ~4
  • HSC_H4-18287
    • 8 pick, great variety, just 1 Component, LOS 24
  • STB_E6a-967
    • 9 in combined; 14 picklist, all transfusions except 1; LOS 9

Big Component - 2019 Q3

  • GRA_MICU-10655
    • 10 component entries, CT and Ultrasounds, repeated; Picklist also has usual transfusions, blood gases, CXRs; LOS ~25

At HSC the 10 with highest component counts are SICU

  • HSC_SICa-2436
    • 17 component entries, looks like a trauma, 5 entries are imagings on different days, rest see below, LOS 12
      • Pleura (T); Drainage, Evacuation
      • Lung (T); Drainage, Evacuation
      • Lung (T); Excision, Resection
      • Spleen (T); Excision, Resection, total
      • Tibia, Fibula (T); Fixation
      • Bronchi (D); Inspection, Exploration (endoscopic)
      • Abdominal, Pelvic or Peritoneal Cavity, NOS (D); Inspection, Exploration (non-endoscopic)
      • Anything Inside Thoracic Cavity, NOS (D); Inspection, Exploration (non-endoscopic)
      • Abdominal, Pelvic or Peritoneal Cavity, NOS (D); Inspection, Exploration (non-endoscopic)
      • Stomach, Pylorus (T); Repair
      • Diaphragm (T); Repair
      • Lower Limb (I); Ultrasound

At STB there is a mix of CICU and MICU for biggest Component counts

  • STB_CICU-16664
    • 29 Picklist, 37 component, about half are imaging, LOS > 50; seems like a very sick patient, with a legitimately high number of entries.
  • STB_MICU-32376
    • 8 picklist, 13 component, LOS 7; picklist are all different entries, 7 of 13 component entries are imaging, much is on different days
  • HSC_D4-17086
    • 7 picklist, 10 component, LOS ~25; all different picklist, 7 of the components are imaging, and the other 3 drainages on different days

Related articles

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