Participation in multiple cardiac registries made possible

By employing expert data abstraction resources

Introduction

This hospital is a 140-bed, acute care facility located California. With 300 affiliated physicians, over 600 employees, and 170 volunteers, opened in 2013, defining a new era in healthcare with its advanced technology and patient-focused care.

The hospital is among the more than 5,000 U.S. hospitals that participate in clinical registries. Today, the hospital offers major specialty services, including open heart surgery through a clinical collaboration agreement with UC San Diego Health. It is also designated as a STEMI Receiving Center and Stroke Ready Hospital by the Riverside County Emergency Medical Services Agency. The Joint Commission has also designated the hospital as an Advanced Primary Stroke Center.

In late 2015, they began developing an exceptional cardiac program. The facility already participated in California CABG Outcomes Reporting Program (CCORP) and the National Cardiovascular Data Registry (NCDR) ICD Registry to collect data on implantable cardioverter defibrillator procedures, as required by the state. Then, they added the NCDR ACTION Registry®- GWTG™ for high-risk ST-elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) patients; the NCDR CathPCI Registry® for cardiac catheterization and PCI procedures; the NCDR IMPACT Registry™ for adult and pediatric congenital heart conditions; and the Society for the Thoracic Surgeons (STS) registries.

Challenges

Completing the required abstraction would be difficult for existing staff

  • The clinical team had competing, critical responsibilities
  • On-site staff lacked the appropriate training to complete the abstraction accurately
  • Growing registry participation as the hospital expanded would require more staff, but finding the appropriately-skilled registrars would be a challenge

Limitations of technology consumed precious staff time

  • The clinical data submission platform they were using was not intuitive, with a clunky and slow interface
  • The technology was unreliable, with parent child field problems forcing data to be re-entered repeatedly into forms
  • Staff reported consistent errors in the code and other quality issues
  • Valuable time was wasted downloading and submitting files, often taking more than a day to resolve issues

Inefficiencies hampered quality improvement initiatives

  • Nurses were completing printed forms with patient data without understanding specific element definitions and other complex details of each registry. The clinical data manager then entered the sometimes inaccurate clinical data into submission tools for the registries
  • The process of abstracting, entering, and submitting clinical data left no time to review the results or implement performance improvement initiatives — the intended goal of clinical registry participation
  • Registry staff waited two months after the clinical data was submitted before gaining access to the registry report. Quality improvement initiatives were based on events three months prior, plus the team would wait an additional three months to view reports to determine the results of their earlier changes

Solutions

By employing Q-Centrix as a third-party vendor, staffing and technology problems could be solved, thus facilitating quality initiatives.

On-site staff can focus on insights

  • Accurate and efficient processes freed up staff time for other clinical tasks, reduced multi-tasking, and alleviated the conflicting demands on critical staff
  • The ability to easily pull up reports allows registry staff to take the time to interpret the results
  • Committees, directors, and physicians can access clinical data to improve their area of accountability rather than struggling to apply outdated information

Appropriate technology facilitates registry work

  • Submitting registry files now takes seconds rather than days
  • Time is not wasted troubleshooting coding errors
  • The ease of reviewing intuitive reports benefits staff at all levels of the enterprise

Accessible reports allow timely quality improvements

  • Trusted third-party expertise assures data integrity: accurate, timely, and complete information to inform decision-making
  • With Q-Centrix’s Universal Registry Solution, staff could easily access reports once the data management and curation process was complete
  • Clinical data staff can now engage physicians in quality improvements with more current data

Impact

The partnership resulted in:

Improved clinical data accuracy
Greater physician engagement
40+ hours a week for the on-site team to dedicate to quality improvement
45% return on investment
$103,871 in savings

Employing the Q-Centrix Universal Registry Solution, this partner hospital increased and improved their clinical registry participation and ultimately positioned their organization as a leader in cardiovascular patient care.

Conclusion

To achieve their goal of engaging physician teams in accurate clinical data to improve patient care, the partner partnered with Q-Centrix. The Q-Centrix Universal Registry Solution offered modern technology and a team of clinical experts to alleviate the burden of data management and make actionable data insights quickly and easily available. Today, the staff benefit from the insight, support and partnership from Q-Centrix. While the goal to become a leader in cardiovascular patient care has already been achieved, the partner continues to discover data-driven improvements, and they look forward to adding more clinical data to their reporting as they continue to expand.