Task Team Meeting Minutes 2011-03-04

Task Team Meeting - March 4, 2011

• Those present: Allan Garland, Tina Tenbergen, Laura Kolesar, Marie Laporte, Trish Ostryzniuk
• Visitors: Terrence Styba, p:Randy Martens
• Minutes prepared by: AG

1. There was further discussion about the APACHE rule for being “postop”, and the delineation of this into emergent vs. elective subcategories. It was decided that: (a) postop/surgical status on ICU entry will be defined completely and simply according to whether their immediate pre-ICU location was OR or PACU, (b) only the true operating rooms will be counted, i.e. procedure rooms that are not part of the suite of operating rooms, such as those for angiography and pacemaker placement will NOT be considered to be ORs, (c) in sites where the OR has a prioritization system (E1, E2, E3), emergent surgery will be defined as E1 only, all others will be elective, (d) in sites that do not have the “E” system, then data collectors will use their judgement in designation a postop case as emergent or elective. TT will clarify and clean up the Wiki on this topic.

2. AG informed the group that he presented the draft of the new drug collection schema to the ICU Directors Meeting on March 4, with general agreement on the plan. It was recommended that Dr. Kumar, Zarychanski and Olafson also be given opportunities to provide input. After all input is received, AG will collate it, and present to the Task Group.

3. Randy Martens confirmed that there are funds to pay for a person to work on “pruning” the full ICD10 coding schema into a reduced form that we’d use in the ICU and Medicine databases. Terrence Styba, who completed medical school but never practiced, has been identified as a person to perform much of this task, under the supervision of AG. Mr. Styba said he’d be willing to work on this project if he is able to commensurately reduce his other job time commitments. AG will ask Dr. Marrie whether she can spare 10 hrs/week of Mr. Styba’s time. The group decided that if that does not work out, we’ll seek a current data collector to do the task. It’s estimated this task will likely take 60-100 hrs total.

4. TT reported that she will add to the data collection software a popup that displays the midpoint of the normal range for each APACHE parameter. This will enable collectors to input a uniform value for data elements that are missing, instead of the current pratices, which are not uniform. TT also reported that she is working on a tool to calculate MAP.

5. The group decided to table the idea of having a yearly ½ workshop of data collectors to discuss strategies to increase uniformity of data abstraction. LK will be working over the coming 3–6 months to clarify and simplify and codify topics on the Wiki, and we’ll reconsider the workshop idea after that task is completed.

6. It was decided that the minutes from Task Group meetings will be posted on the Wiki.

7. ML raised the issue of identifying an infective pathogen in the situation when a culture sample is sent, and received by the lab, but for a technical reason (e.g. sample insufficient) no actual culturing is performed. There is no category for this variable that accounts for such a possiblity. It was decided that TO will contact Dr. Kumar and ask him how he thinks we should code/handle such situations.

8. Items for next meeting: (a) followup on changing drug data collection from AG, (b) discussion of information from the Transfer Tracker, (c) discussion of coding of comorbid conditions.

-- Next Meeting of the Task Group will be Friday, March 18 at 1:30 pm --