Process improvement: a multi-registry database abstraction success story

Area of Science:

• Cardiovascular research
• Healthcare quality improvement
• Medical record management

Background:

• The St. Joseph Hospital/Marshfield Clinic Cardiac Database Registry faces challenges with delayed chart abstraction.
• Hospital policy restricts medical record clarifications to within 1 month post-discharge, impacting data submission to the National Cardiovascular Data Registry (NCDR) and Society of Thoracic Surgeons (STS) National Database.
• A significant backlog of 3.5 months existed for retrospective postdischarge case abstraction.

Purpose of the Study:

• To implement a process improvement plan to shorten the delay of postdischarge chart abstraction.
• To reduce the abstraction delay from 3.5 months to the hospital policy limit of 1 month.
• To maintain same-day abstraction efficiency and prevent future backlogs.

Main Methods:

• Assessed daily demand for incoming cases and abstraction capacity for 4 employees.
• Matched daily demand to abstraction capacity.
• Allocated remaining employee time to reduce the existing backlog of cases.

Main Results:

• Daily demand for new cases was 17.1 hours, with a daily abstraction capacity of 24 hours.
• An average of 7 hours per day was dedicated to reducing the backlog.
• The backlog was reduced by 60% within the predicted 10 weeks, achieving the 1-month abstraction target.

Conclusions:

• The implemented process improvement plan successfully reduced postdischarge chart abstraction delays to 1 month.
• The institution achieved its goal of shortening the abstraction timeline.
• Future efforts will focus on maintaining efficient same-day abstraction to prevent backlog reaccumulation.