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Hybrid Outcomes and Analytics Updates

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Hybrid Outcomes and Analytics Updates
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October 2019

SCOAP/Spine COAP Hybrid Outcomes2

October 16, 2019 Release Notes

 

  1. Global update
    1. Deleted all edits (cross-outs) from June 2019 data dictionary for clarity
    2. Crystalloid and Albumin changed globally to mLs where applicable
    3. Added subgroup description to Field Groups throughout data dictionary
  1. Abstractor Name
    1. NOTE: Please disregard until the next release, which will include SCOAP and Spine COAP as options
  1. Risk Factors
    1. Removed: History of Cigarette Use – removed entire cigarette smoking section;
    2. Added: History of Nicotine Use – replaces cigarette smoking questions; the smoking cessation/counseling questions were removed accidentally and we hope to have these added back in the next release
    3. Added: Method of nicotine use – 5 new yes/no fields: smoking, vaping, chewing tobacco, gum, patch
  1. Intra Operative
    1. Anesthesia
      1. Refined General anesthesia definition
      2. Added: Neuraxial (spinal/epidural) with extended definition
      3. Regional – added detail and removed examples of regional anesthesia; deleted “local infiltration,” clarified abstraction notes
      4. NOTE: “Already Intubated” to be deleted in next release, please do not abstract variable.
      5. Added: Prophylaxis for Nausea/Vomiting (Bariatrics and Spine)
  1. Perioperative Interventions
    1. Perioperative Anticoagulation
      1. Anticoag ordered for in-hospital use after the first 24 hrs post-op: Other Interventions
        1. Added: Aspirin
      2. Perioperative Antibiotics
        1. Clarified Definition: Prophylactic Antibiotics Administered
      3. Postoperative Medications
        1. Added Benzodiazepines
      4. Other Interventions
        1. Added: Diet Advanced Beyond Clear Liquids (removed from colorectal)
        2. Added: Post Op Day Diet Successfully Advanced (removed from colorectal section as this is now captured for spine, bariatrics too)
        3. Edited & Expanded: RBC Transfusion in Operating Room
          1. Changed timing: added “RBC transfusion in OR,” and “…within 24 hours after leaving OR”
          2. Note: there is an extraneous “If yes, how many units” after “If yes, how many units within 24 hours after leaving OR” that needs to be deleted in the next release, please do not capture this second variable
  1. Colorectal
    1. Deleted in this section and moved to Perioperative Interventions:
      1. Diet Advanced Beyond Clear Liquids
      2. Post Op Day Diet Successfully Advanced
  1. Spine
    1. Spine
      1. Added: Radiculopathy – Not Documented
      2. Added: Myelopathy – Not Documented
    2. Indications for Surgery
      1. Deleted multiple “Proximal” and “Distal” for clarity in data dictionary; However, you must still indicate levels for each procedure
      2. Deleted: Intertransverse Fusion in Situ – variable rolled up into Fusion option
    3. Spine Instrumentation
      1. Lateral Instrumentation (Lumbar Only)
        1. Deleted: Posterior Lumbar Static Plate
        2. Deleted: Posterior Lumbar Static Cage

 

  1. In Hospital Events
    1. Post Operative Occurrences
      1. Deleted “Atrial Arrythmia”
      2. Added “New Onset Cardiac Rhythm Abnormality Requiring Treatment”
      3. Clarified: Unplanned admission to ICU
      4. NOTE: Acute Kidney Injury to be deleted in next release, please do not abstract variable. We are creating an auto-calculating algorithm (on the backend) so abstractors don’t have to calculate this variable
      5. Redefined Renal Failure (Acute Kidney Failure) so that it is in line with RIFLE criteria – stage 3
      6. Clarified Definition: Surgical Site Infection
        1. Removed reference to “Antibiotics for SSI.”
        2. Made “Organ Space” available for Spine population infections. For the purposes of Spine abstraction: the brain and spinal cord are considered organ space. For reporting this will be rolled up with deep SSI.
    2. Non Operative Interventions
      1. Added: Non-Operative Wound Intervention
      2. Deleted: Percutaneous Drainage. Will be included in new variable: Drainage for Bleeding/Hematoma/Seroma/Abscess(see Operative Intervention)
    3. Operative Intervention
      1. Deleted: Abscess Drainage. Will be included in new variable: Drainage for Bleeding/Hematoma/Seroma/Abscess
      2. Deleted: Operative Drainage Placement. Will be included in new variable: Drainage for Bleeding/Hematoma/Seroma/Abscess
      3. Deleted: Wound Revision
      4. Deleted: Reoperation for Bleeding/Hematoma. Will be included in new variable: Drainage for Bleeding/Hematoma/Seroma/Abscess
      5. Added new variable: Drainage for Bleeding/Hematoma/Seroma/Abscess. Past cases that included one or more than one of the deactivated variables will be taken into account when calculating prior data.
  1. Discharge
    1. Discharge Analgesia
      1. Added: Benzodiazepines
  1. Post-Discharge Events
    1. Post Discharge Occurrences
      1. Deleted “Atrial Arrythmia”
      2. Added “New Onset Cardiac Rhythm Abnormality Requiring Treatment”
      3. Redefined Renal Failure (Acute Kidney Failure) so that it is in line with RIFLE criteria – stage 3
      4. NOTE: Acute Kidney Injury to be deleted in next release, please do not abstract variable. We are creating an auto-calculating algorithm (on the backend) so abstractors don’t have to calculate this variable
      5. Clarified definition of New Neurological Deficit (Spine)
      6. Clarified Definition: Surgical Site Infection
        1. Made “Organ Space” available for Spine population infections. For the purposes of Spine abstraction: the brain and spinal cord are considered organ space. For reporting this will be rolled up with deep SSI.
    2. Non Operative Interventions
      1. Added: Non-Operative Wound Intervention
      2. NOTE: Operative Wound Revision to be deleted in next release, please do not abstract variable. Please use the new variable Drainage for Bleeding/ Hematoma/Seroma/Abscess
      3. Deleted: Percutaneous Drainage – included in new variable: Drainage for Bleeding/ Hematoma/Seroma/Abscess
    3. Operative Intervention
      1. Deleted: Operative Drainage Placement. Included in new variable: Drainage for Bleeding/ Hematoma/Seroma/Abscess
      2. Deleted: Abscess Drainage. Included in new variable: Drainage for Bleeding/ Hematoma/Seroma/Abscess
      3. Deleted: Reoperation for Bleeding/Hematoma. Included in new variable: Drainage for Bleeding/Hematoma/Seroma/Absces
      4. Added new variable: Drainage for Bleeding/ Hematoma/Seroma/Abscess. Past cases that included one/more than one of the deactivated variables will be taken into account when calculating old data
      5. NOTE: Operative Wound Intervention to be deleted in next release, please do not abstract variable. Please use the new variable, Drainage for Bleeding/ Hematoma/Seroma/Abscess
    4. ReOperative Intervention
      1. Deleted: Wound Revision

September 2019

Hybrid Analytics (Reporting): 

  1. Aggregate Reports: For those that are able to run reports, you should now have the ability to run the Aggregate Report Comparisonas it is finally fixed in Hybrid.  You just have to choose the dropdown, “Surgical Care and Outcomes Assessment Program” at the very top rather than your specific site, then choose your site under Group 1 and “All Sites” under Group 2 to compare to the aggregate.  Please let me know if you need a copy of the Hybrid report manual.
  2. Data tables: are available to those reporting users who would like them.  These provide the user an ability to query the live database at the site level.  I’ve promised canned queries to analysts that would like these for both the denominator population as well as the outlier group for each metric (old and new).  I’m continuing to build these out; please let me know if you’re looking for a specific metric and I can prioritize it in the build process.
  3. Spine COAP variables now available in Hybrid. Updated definitions are in the data dictionary.
    1. Antibiotics Given within 60 minutes of Incision
    2. Antibiotics Discontinued within 24 hrs of Closure
    3. DVT Prophylaxis w/in 24 hrs of Incision
    4. DVT Prophylaxis Post-op
    5. Mechanical DVT Prophylaxis

Hybrid Outcomes (Data Entry):

  1. Surgeon Aliases: Most surgeon aliases have been updated for those surgeons with NPIs that did not have such an identifier assigned to them in the database. Surgeon aliases are used for de-identified reporting at the surgeon level. If a surgeon does not have an NPI, they cannot obtain a surgeon alias, so please be sure that this information is filled in appropriately in the data collection tool for your site. 
  2. Database Updates as of Monday, September 23: 
    1. Duplicate NPIs have been merged. Please let us know if you see any more duplicates.
    2. The crystalloid and albumin fields in the perioperative section have an updated field description that reflects the capture of the number of milliliters rather than liters.  We will be following up with sites that we’ve noted as capturing Liters up to this point.
    3. The data label for highest creatinine during hospital stay now is updated to show that we need to capture the highest postoperative creatinine during the hospital stay (this was always in the data definition, but just not spelled out in the label).
    4. The data label for Date/Time of Surgery now indicates that this should be the time of incision (again, always in the data definition, but just not spelled out in the label on the online collection form)
    5. The data label for Reoperation due to Bleeding/Hematoma is now updated to “Drainage for Bleeding/Hematoma/Seroma/Abscess.”
    6. The data label for Regional anesthesia is now updated to “Regional (tap block, brachial plexus, wound block)”
    7. The data label for the “Post Discharge Drainage for Bleeding/Hematoma” is updated to “Post Discharge Drainage for Bleeding/Hematoma/Seroma/Abscess.
    8. The long name for woundreop originally noted as WoundReop is changed to Wound Revision.
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