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TRANSCRIPT
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BMT Data AccuracyFulfilling Audits and Assuring Top Quality Data
Lindsay Dozeman
BMT Database Administrator and Data Coordinator
Blood & Marrow Transplant Program
University of Iowa Hospitals & Clinics
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Disclosure
Some of the features I will be discussing today are part of the University of Iowa Blood and Marrow Transplant Database©
which is being licensed through the University of Iowa Research Foundation. (Licensing questions can be directed to [email protected])
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Background2012 to current
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UIHC BMT
CY 2005-2015
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Excel LandRemedy/Excel
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Revision 2 (2010-2012 Revision 4 (current)
Pre-TED Fields
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Data Accuracy Dilemmas
• Can we fulfill reporting requirements and always report accurately?• When meeting CPI trumps reporting data accurately, its time to reevaluate demands and
expectations
• Is maintaining and reporting accurate data a luxury that only programs with adequate data management staff and/or the latest systems can enjoy? (No)
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Data Accuracy: Not a Choice
• Maintaining and reporting inaccurate data is not an option• Consequences range from severe to more severe
• New CIBMTR audit requirements June 2015• Reporting accuracy more important than ever before
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Quality is More Important than Quantity
• Focus on what is possible with current staff and resources• Maintaining comprehensive forms data on all program transplants when facing a 6+ months
backlog may not be possible with 1.25 data coordinators and/or if we want to meet CPI, fulfill physician requests, and maintain an accurate database
• Focus on critical fields first, additional data collection after
• Determine if requirements can be satisfied with a different approach• Example: Meeting FACT standard regarding TED accuracy
• May not be able to audit all transplants data, but we can approach the process differently to maximize outcome
• Audit data by form section and require all questions to be reported correctly in order for the section to be considered acceptable.
• Fewer errors cause higher error rate percentage, allowing us to identify unacceptable error rates sooner
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Clean Data In, Clean Data Out
• User-friendly forms and smart data entry
• Initial data entry generates subsequent entry - cascading drop-downs standardized to CIBMTR options, rules to reject incorrect reporting• Example: Selecting disease cascades specific disease classification, status at transplant and
best response drop-down menus• Example: If in CR at transplant, cannot enter “never in CR” post-transplant
• Strategically placed free-text fields, used sparingly• Allows team to communicate about reporting/documentation issues while keeping critical
fields standardized• Example: Disease status at transplant cannot include notes such as “VGPR – see SPEP”
• Hyperlinks for all supportive documentation used for reporting not found in Epic
• Query-generated HCT-CI score, ASBMT Risk, Disease Risk Index, readmissions, etc.
• Auto populated QA dashboard
• SOP-driven flags to highlight unusual outcomes or outliers
• Example: Greater than 27 days to ANC engraftment
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Auditing Macro
• Tracks additions, deletions, changes to critical data fields• Serves multiple purposes
• Highlights what fields are being changed , how often, and when
• Provides insight into possible improvements in documentation
• Activity tracking
• Empowers data staff
Screenshots from the University of Iowa Blood and Marrow Transplant Database©
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Tracking Audits and Reviews
• CIBMTR Audits• CIBMTR Error Corrections• TCSA Queries• FACT Audits• TED Accuracy Audits
Screenshots from the University of Iowa Blood and Marrow Transplant Database©
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Audit Summaries: View Errors by Coordinator, field, quarter, etc.
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Screenshots from the University of Iowa Blood and Marrow Transplant Database©
776767361
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TED Accuracy Audit Results Generate in QA Dashboard
Screenshots from the University of Iowa Blood and Marrow Transplant Database©
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Data Accuracy: Critical and Attainable
Setting realistic expectations and taking advantage of readily available tools can greatly improve accuracy of collected and reported data, allowing staff the ability to fulfill a multitude of demands and requirements with efficiency and ease