Query check CCI CXR vs LOS

Data Integrity Checks
Summary:	Confirm that a Category:Labs Imaging count is not unreasonably high
Related:	CXR (plain film), LOS, Arrive DtTm, Dispo DtTm
Firmness:	soft check
Timing:	complete
App:	CCMDB.accdb
Coding:	query check_CCI_CXR_vs_LOS
Uses L Problem table:	not relevant for this app
Status:	needs review
Implementation Date:	not entered
Backlogged:	No

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We have had some medical Category:Labs Imaging count entries that are so high that they are likely errors.

What are likely maximum entries?

The count per patient stay is related to the LOS. The threshold limits are either Mean + 3 Standard Deviation or Maximum value of Chest X-ray count per patient day for various LOS category listed in the table below. They are derived from July 1988 to June 2017 Lab data. The LOS is based on calendar dates where partial stay is considered as full day.

• LOS based on calendar dates = Dispo DtTm - (Accept DtTm/first Service tmp entry) + 1
  • if patient is still in the unit, Dispo DtTm is replaced by today's date
    • check is marked as only running on complete records, if that is so then we don't need to replace with today's date
• Chest X-ray (CXR) per patient day = Number of chest X-rays / LOS Based on calendar dates

LOS_days	N	Mean	Std Dev	Minimum	Median	75th Pctl	90th Pctl	95th Pctl	99th Pctl	Maximum	mean + 3 Std Dev	Limits of CXR per patient day
1	4021	1.16	0.42	1	1	1	2	2	3	5	2.42	5
2	23910	0.83	0.31	0.5	1	1	1	1.5	2	4	1.76	4
3-10	52600	0.64	0.34	0.1	0.67	0.88	1	1.25	1.6	3	1.66	3
11-20	7784	0.7	0.31	0.05	0.71	0.92	1.09	1.19	1.42	2.47	1.63	2
21-30	1870	0.68	0.3	0.03	0.69	0.9	1.05	1.14	1.36	2.57	1.58	2
31-40	660	0.62	0.3	0.03	0.64	0.84	1	1.09	1.32	1.67	1.52	2
41-50	311	0.54	0.29	0.02	0.53	0.73	0.93	1.02	1.21	1.58	1.41	2
51-100	347	0.41	0.26	0.02	0.38	0.6	0.76	0.85	1.12	1.2	1.19	1
> 100	101	0.19	0.21	0.01	0.11	0.2	0.48	0.73	0.88	1.09	0.82	1

CCMDB.accdb cross checks triggering for correct values

If the actual correct data leads to a cross-check error CCMDB.accdb will not allow you to send. In that case, enter a value that is acceptable and then email the Data Processor using the "generate email" button.

Checks

CCI collect count each

• AXR (abdominal plain X-ray) 3.OT.10.VA
• Blood gas, arterial 2.ZZ.13.RE
• Blood gas, venous 2.ZZ.13.RA
• CXR (plain film) 3.GY.10.VA

"CCI collect count each" count should not be higher than:

• if LOS < 1, 5
• if LOS 1-50, LOS * 2
• if LOS > 50, LOS

CCI collect count days

"CCI collect count days" should not be higher than LOS

don't we already have a check for that? This can be a hard check, where the others have to be soft checks.

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CCI collect count units

Discussed with Julie that this one is likely uncheckable. Ttenbergen 15:47, 2021 September 2 (CDT)

CCI collect each

Any checks required for these?

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Remaining Discussion - cross check by boarding loc?

... This reminds me of another concern - should this be done vis-a-vis to boarding loc. if pt moves to another loc, enter a separate CXR entry starting on the next boarding loc date. Are we over doing these CCIs - too much work, are they needed? In the CC report, I need only a separation of CXR for HSC MICU and HSC SICU. This would not be a problem if we are handling continuous stay of MICU and SICU service in two records and not as one record in patient follow model. --JMojica 14:36, 2021 September 2 (CDT) additional decision needed from Px Date - if we do collect different dttms for each Boarding Loc then the count needs to be per Boarding Loc LOS, not overall LOS. Ttenbergen 15:52, 2021 September 2 (CDT) I am checking the sum of all counts in CCI since collectors can enter them over time, so for now I can do a cross check over overall LOS. If we want to break the cross check down further, let's discuss. Ttenbergen 16:49, 2021 September 15 (CDT)

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