ByBy

Garland LandGarland Land

NAPHSIS Executive DirectorNAPHSIS Executive Director

Performance Measures Performance Measures CommitteeCommittee

Dorothy Harshbarger, AlabamaDorothy Harshbarger, Alabama Barry Nangle, UtahBarry Nangle, Utah Trish Potrzebowski, PennsylvaniaTrish Potrzebowski, Pennsylvania Julia Holmes, NCHSJulia Holmes, NCHS

Performance Measures Purpose Performance Measures Purpose

The collection and release of data on The collection and release of data on vital statistics performance measures is vital statistics performance measures is intended to assist vital records intended to assist vital records jurisdictions in voluntary self-jurisdictions in voluntary self-assessment and to encourage assessment and to encourage improvement of data timeliness, quality improvement of data timeliness, quality and usefulness. If jurisdictional and usefulness. If jurisdictional performance increases as a result of performance increases as a result of these efforts, then the national vital these efforts, then the national vital statistics system will also be enhanced.statistics system will also be enhanced.

2010 NAPHSIS Performance 2010 NAPHSIS Performance MeasuresMeasures

   Timeliness of 2008 birth records Timeliness of 2008 birth records

submitted to NCHSsubmitted to NCHS

Timeliness of 2008 demographic death Timeliness of 2008 demographic death records submitted to NCHS records submitted to NCHS

2007 recorded birth records under 500 2007 recorded birth records under 500 grams linked to a death recordgrams linked to a death record

2008 deaths with underlying cause of 2008 deaths with underlying cause of death codes that are not ill-defined codes death codes that are not ill-defined codes

Performance Measures Performance Measures contcont

Availability of Web-based Data Query System Availability of Web-based Data Query System (WDQS)(WDQS)

Timeliness of issuing certified birth copiesTimeliness of issuing certified birth copies

Restricted access to birth records Restricted access to birth records

Electronic birth records go back to 1935 for Electronic birth records go back to 1935 for EVVEEVVE

Electronic death records go back to 2000 for Electronic death records go back to 2000 for EVVE EVVE

Timeliness of Birth DataTimeliness of Birth Data

Definition:Definition:

Percent of 2008 birth records Percent of 2008 birth records submitted to the NCHS by May 1, submitted to the NCHS by May 1, 20092009

Goal:Goal: 99+%99+%

Range:Range: 0-100% 0-100%

Median:Median: 99.97%99.97%

Met Goal: Met Goal: 50 jurisdictions50 jurisdictions

Timeliness of Death DataTimeliness of Death Data

Definition:Definition:

Percent of 2008 demographic death Percent of 2008 demographic death records submitted to the NCHS by records submitted to the NCHS by May 1, 2009May 1, 2009

Goal:Goal: 99+%99+%

Range:Range: 0-100%0-100%

Median: Median: 99.8%99.8%

Met Goal: Met Goal: 36 jurisdictions36 jurisdictions

Completeness of Completeness of Infant Deaths RecordedInfant Deaths Recorded

Definition:Definition:Percent of 2007 recorded birth Percent of 2007 recorded birth

records under 500 grams linked to a records under 500 grams linked to a death recorddeath record

Goal: Goal: 80+%80+%Range: Range: 46-100%46-100%Median: Median: 89%89%Met Goal: Met Goal: 39 jurisdictions39 jurisdictions

Acceptable Causes of Acceptable Causes of DeathDeath

Definition:Definition:

Percent of 2008 deaths with underlying Percent of 2008 deaths with underlying cause of death codes that are not ill-cause of death codes that are not ill-defined codes (R00-R99)-R95+I469defined codes (R00-R99)-R95+I469

Goal: Goal: 98+%98+%

Range: Range: 93.0%-99.8%93.0%-99.8%

Median: Median: 98.1%98.1%

Met Goal: Met Goal: 26 jurisdictions26 jurisdictions

Web Query SystemWeb Query System

Definition:Definition:

Has an interactive system, whereby a user Has an interactive system, whereby a user can query through a web browser to can query through a web browser to obtain vital statistics tabulations and obtain vital statistics tabulations and statistical computationsstatistical computations

Distribution:Distribution:

Yes: 28Yes: 28

No: 29No: 29

Timeliness of Issuing Timeliness of Issuing Certified Birth CertificatesCertified Birth Certificates

Definition:Definition:Average number of work days to issue certified Average number of work days to issue certified

copies ofcopies ofbirth records for mail requests received in birth records for mail requests received in

January 2010January 2010

Distribution:Distribution:0-3 days: 24-- 0-3 days: 24-- GoalGoal 4-10 days: 224-10 days: 2211+ days: 811+ days: 8Unknown: 3Unknown: 3

Birth Records RestrictedBirth Records RestrictedDefinition:Definition:Certified and non-certified copies of birth records Certified and non-certified copies of birth records

less than 100 years old can only be issued or less than 100 years old can only be issued or inspected at the jurisdiction and local levels to inspected at the jurisdiction and local levels to restricted persons, for research or governmental restricted persons, for research or governmental administrative use.administrative use.

Distribution:Distribution:Restricted and may be open after 100 years: 40 Restricted and may be open after 100 years: 40 GoalGoalRestricted and may be open before 100 years: 3Restricted and may be open before 100 years: 3Restricted but provide information copies: 7Restricted but provide information copies: 7Restricted by knowledge of information but not by Restricted by knowledge of information but not by

relationship: 1relationship: 1Open: 4Open: 4Open locally and restricted at state: 2Open locally and restricted at state: 2

EVVE Birth DatabaseEVVE Birth Database

Definition:Definition:Has electronic birth database with EVVE Has electronic birth database with EVVE

verification data items back to 1935verification data items back to 1935

Distribution:Distribution:1935: 401935: 401936-1944: 1936-1944: 441945-1954: 41945-1954: 41955-1974: 21955-1974: 21975-2009: 71975-2009: 7

EVVE Death DatabaseEVVE Death Database

Definition:Definition:Has electronic death database with Has electronic death database with

EVVE data items back to 2000EVVE data items back to 2000

Distribution:Distribution:Yes: 55Yes: 55No: 2No: 2

Number of Measures MetNumber of Measures Met

Number of Number of Number of Number of

Measures Met Measures Met Jurisdictions Jurisdictions 00 0011 0022 0033 5 5 44 66 55 8866 161677 111188 9999 22

Number of Jurisdictions Met Number of Jurisdictions Met GoalGoal

MeasureMeasure Number Met GoalNumber Met Goal

Timeliness of BirthsTimeliness of Births 5050

Timeliness of DeathsTimeliness of Deaths 3636

Completeness of infant deathsCompleteness of infant deaths 3939

Acceptable causes of deathAcceptable causes of death 2626

WDQSWDQS 2828

Timely issuance of birth certificatesTimely issuance of birth certificates 2424

Restricted issuance of birth recordsRestricted issuance of birth records 4040

EVVE data for birthsEVVE data for births 4040

EVVE data for deathsEVVE data for deaths 5555

Outstanding StatesOutstanding StatesStateState Measures Met Measures Met (9 possible(9 possible))

KansasKansas 99

MissouriMissouri 99

AlabamaAlabama 88

ColoradoColorado 88

FloridaFlorida 88

MarylandMaryland 88

MississippiMississippi 88

New HampshireNew Hampshire 88

New York CityNew York City 88

North DakotaNorth Dakota 88

VermontVermont 88

Suggested Ways to Suggested Ways to Improve TimelinessImprove Timeliness

Eliminate paper based state or local Eliminate paper based state or local registration where possibleregistration where possible

Allow local registrar access to central vital Allow local registrar access to central vital record database for online local registrationrecord database for online local registration

Accept electronic record for the jurisdiction Accept electronic record for the jurisdiction before the paper record is received from the before the paper record is received from the local registrar or hospitallocal registrar or hospital

Do not delay registration to conduct QA; Do not delay registration to conduct QA; perform QA after records have been submitted perform QA after records have been submitted to NCHS; provide corrected records to NCHS; provide corrected records subsequently if neededsubsequently if needed

Suggested Ways to Suggested Ways to Improve TimelinessImprove Timeliness

Develop reports that show the number of events by Develop reports that show the number of events by hospital, funeral home, local registrar by month for hospital, funeral home, local registrar by month for the previous year and monitor the events submitted, the previous year and monitor the events submitted, particularly for November and December events. particularly for November and December events.

Develop a report that tracks the timeliness of Develop a report that tracks the timeliness of submission of records by local registrars if submission of records by local registrars if applicable.applicable.

Contact hospitals and funeral homes in March to Contact hospitals and funeral homes in March to determine if all records have been fileddetermine if all records have been filed

Follow up with hospitals/funeral directors in Follow up with hospitals/funeral directors in February and March on any unfiled infant death February and March on any unfiled infant death certificatescertificates

Suggested Ways to Suggested Ways to Improve TimelinessImprove Timeliness

Do not delay birth registration when Do not delay birth registration when paternity documents are not received within paternity documents are not received within two weekstwo weeks

Submit birth records to NCHS even if the Submit birth records to NCHS even if the paternity affidavits have not been returned paternity affidavits have not been returned by the parents or hospitalby the parents or hospital

Notify the NCHS by the end of April of the Notify the NCHS by the end of April of the final certificate numbers, voided numbers final certificate numbers, voided numbers and that the files are closed even if there are and that the files are closed even if there are a few records that are awaiting corrections.a few records that are awaiting corrections.

Submit all available records by May 1Submit all available records by May 1

Suggested Ways to Suggested Ways to Improve Causes of DeathImprove Causes of Death

Identify the physicians, coroners and Identify the physicians, coroners and MEs that use ill-defined causes more MEs that use ill-defined causes more frequently than 2% and provide frequently than 2% and provide statistical reports to them on the statistical reports to them on the frequency of ill-defined causes in relation frequency of ill-defined causes in relation to other providersto other providers

Identify the physicians, coroners and Identify the physicians, coroners and MEs that use ill-defined causes most MEs that use ill-defined causes most frequently and provide training to them frequently and provide training to them

Allow for pending causes of deathAllow for pending causes of death

Suggested Ways to Suggested Ways to Improve Causes of DeathImprove Causes of Death

Query death records with ill-defined Query death records with ill-defined causescauses

Ask state ME (if state ME exists) to Ask state ME (if state ME exists) to follow-up with physicians and coroners follow-up with physicians and coroners that frequently use ill- defined causesthat frequently use ill- defined causes..

Train hospital personnel where ill-defined Train hospital personnel where ill-defined causes are most frequently used.causes are most frequently used.

Recommend physicians use an EDRS with Recommend physicians use an EDRS with front end cause of death editsfront end cause of death edits

RecommendationsRecommendations

Share the report with your staffShare the report with your staff

Share the report with your Share the report with your supervisorsupervisor

Contact NAPHSIS if assistance is Contact NAPHSIS if assistance is needed to improve your needed to improve your performanceperformance

Past and the Future Past and the Future

Performance measures Performance measures (2009, 2010)(2009, 2010)

NAPHSIS Standards (2011)NAPHSIS Standards (2011)

AccreditationAccreditation