Title Harmonizing Internal Practices: Supporting Data Integrity across Multiple NCDR® Registries Authors Katie Haas BS (RT) R CCA, Jill Gall BS CCA, Miriam Groh MS CCRP CCA, Andrea Price MS RCIS CCA Affiliations Indiana University Health, Indianapolis Indiana Background The CathPCI Registry® released a Qualitative Quantitative Crosswalk during Q3 2017, to support the lesion abstraction for the anticipated CathPCI V5.0 release. This release prompted an internal discussion for approaches to standardize internal CathPCI lesion reporting policies across seven participating centers. Upon further discussions, an opportunity was identified to ensure data integrity in reporting coronary lesions and percent stenosis, through the adoption, education, and harmonization across multiple registries. Prior to the release of the NCDR® Qualitative Quantitative Crosswalk, data registry coordinators from different respective registries (ICD RegistryTM, ACTION Registry® and CathPCI Registry) were required to interpret physician documentation to the best of their ability or within facility based policies. This was significantly problematic at facilities within Indiana University Health (IUH) that have yet to adopt procedural structured reporting, therefore, requiring data registry coordinators to interpret common language dictations into registry definitions. The historical process allowed for variance and inconsistencies across registries as well as data coordinators. The staffing model at IUH supports a “regionalized” approach to registry abstraction, where data coordinators are trained in one to two registries, and support abstraction across multiple facilities in a region. The developed tool is helpful to ensure lesion reporting integrity across data coordinators as well as multiple registries. It is felt the same efficiencies and data integrity opportunities can be accomplished for similar staffing models where one data coordinator supports multiple registries at one facility. Methods Given the varying backgrounds of specific subject matter expertise amongst a widespread organization and its data registry coordinators, the team leveraged both the clinical and registry expertise of the data coordinator team to develop a working document (Figure 1) for data integrity around coronary anatomy and lesion reporting. The Qualitative Quantitative Crosswalk, registry data definitions, and registry FAQ’s were reviewed by the team. A working document was developed to guide data registry coordinators in coronary anatomy, including degree of stenosis abstraction. The team was comprised of data coordinator representatives within the organization from the ICD Registry, ACTION Registry, and CathPCI Registry, and included active involvement from director and manager level representatives from the Quality Database department. The creation and operational adoption of this tool was shared with physician leaders as an update during their clinical effectiveness council meetings. Development of this tool began in mid Q3 2017, and had a primary focus of ICD Registry regarding metric sequence number 4300 “Coronary Angiography” and subsequent child fields. Implementation of this tool took effect only in a sub-section of the organization at the end Q3 2017. Within the IU Health’s regionalization structure, many data coordinators abstract any combination of ICD Registry, ACTION Registry, and CathPCI registry. Quickly, the team realized there would be value to extend this tool into ACTION Registry lesion abstraction. Results Figure 1 Coronary Anatomy and Lesion Abstraction Guide The primary goal of this tool was to increase data integrity and interpretation across multiple registries. Success was demonstrated during the Q4 2017 internal inter-rater reliability audits, where more matches to coronary disease were observed compared to prior audits. Additional successes were observed through department staff education and increased awareness for harmonizing opportunities across multiple registries. An unintentional success was decrease in abstraction time. Coordinators are no longer spending non-value added time consulting individual policies or asking providers to clarify documentation. Conclusions The developed document is a working document and subject for on going updates as FAQs and registry enhancements are communicated. Next steps for the project are to determine a point person for on-going maintenance and department communication. References ACTION Registry Data Definitions v2.4.2 2017 https://www.ncdr.com/WebNCDR/docs/default-source/action---data-collectiondocuments/action_v2_datadictionaryfullspecifications_2-424FE453A7ED6A2AE94CF5E070.pdf?sfvrsn=5 ACTION Registry FAQ’s 2017 https://www.ncdr.com/WebNCDR/ACTION/resources/faqv2 CathPCI Registry 2017 v5 https://www.ncdr.com/WebNCDR/docs/default-source/cathpci-v5.0-documents/qualitativequantitative-crosswalk_8-8-17.pdf?sfvrsn=5 ICD Registry Data Definitions V2.2 2016 https://www.ncdr.com/WebNCDR/docs/default-source/icd---v2.2-data-collectiondocuments/icd_v2_datadictionaryfullspecifications_2-2.pdf?sfvrsn=5 ICD Registry FAQ’s 2017 https://www.ncdr.com/WebNCDR/icd/resources/FAQv2
