| DESCRIPTION OF ENHANCEMENTS |
This patch updates the Surgery Risk Assessment software of the Veterans
Cardiac Risk Assessment Modifications
-------------------------------------
- The software is modified to expand the answer options of the PREOP
CIRCULATORY DEVICE field (#474) to include "ARTIFICIAL HEART" and to
transmit "A" to CICSP for new raw value of this answer option.
- This patch modifies all Lab fields under the Laboratory Test Results
(Enter/Edit) [SROA LAB-CARDIAC] option to assume a past date if the user
enters a date without a year.
Non-Cardiac Assessment Modifications
- Reinstitute the default functionality of the CARDIAC SURG PERFORMED
NON-VA field (#472) in the SURGERY file (#130), so that it defaults to
"NO".
- The description is updated and/or other data dictionary changes are made
for the following items:
o CONGESTIVE HEART FAILURE field (#207)
o ON VENTILATOR >48 HOURS field (#285)
o PERIOPERATIVE MI field (#385)
o PREOP CIRCULATORY DEVICE field (#474)
------------------------------------
o AORTIC STENOSIS field (#477)
- Data Quality Queries
The data entry that does not meet the criteria is permitted, but would
cause a warning message to check the data for accuracy.
o The D/T PATIENT EXTUBATED field (#470) should be later than the TIME
PAT OUT OR field (#.232).
o The D/T PATIENT EXTUBATED field (#470) should be earlier than the D/T
PATIENT DISCH FROM ICU field (#471).
o The D/T PATIENT DISCH FROM ICU field (#471) should be later than the
* Note: All fields named below are in the SURGERY file (#130) unless
D/T PATIENT EXTUBATED field (#470).
o D/T PATIENT DISCH FROM ICU field (#471) be equal to or earlier than
the HOSPITAL DISCHARGE DATE field (#419).
o The SURGICAL PRIORITY, DATE field (#414.1) should be earlier than
the TIME PAT IN OR field (#.205).
o The ESTIMATE OF MORTALITY, DATE field (#364.1) should be earlier than
the TIME PAT IN OR field (#.205).
o If TOTAL CPB TIME field (#451) > 0, the CONVERT FROM OFF PUMP TO CPB
field (#469) should not be answered "NO, began off/stayed off".
otherwise indicated.
General Surgery Items
---------------------
- Remedy Ticket #HD0000000152814
This patch addresses two issues related to the Update Assessment Status
to 'COMPLETE' [SROA COMPLETE ASSESSMENT] option missing items list:
(1) For the NUM OF PRIOR HEART SURGERIES field (#352) in the SURGERY
file (#130), the field is corrected to display "Number of Prior
Heart Surgeries" instead of "Prior Heart Surgery (Y/N)".
(2) For the field "PRIOR HEART SURGERIES" field (#485) in the SURGERY
file (#130), the data input functionality is modified to use the
same controlled data input functionality used by the Clinical
Information (Enter/Edit) [SROA CLINICAL INFORMATION] option.
- Remedy Ticket #HD0000000177807
After installing this patch, if procedure and diagnosis coding is not
complete at the time the Update Assessment Status to 'COMPLETE' [SROA
COMPLETE ASSESSMENT] option is run, the software will display "The
coding for Procedure and Diagnosis is not complete" immediately before
asking, "Are you sure you want to complete this assessment ?".
- These updates include functionality for selecting cases for risk
- Remedy Ticket #HD0000000185045
When using the Outcome Information (Enter/Edit) [SROA CARDIAC-OUTCOMES]
option to edit the OPERATIVE DEATH field (#384), entering YES or NO
causes the NEW MECHANICAL CIRCULATORY field (#467) to be changed to the
same value. Editing the NEW MECHANICAL CIRCULATORY field (#467) field
does not change the OPERATIVE DEATH field (#384).
- Short LOCK Timeouts
This patch updates the 1 second LOCK timeouts in the routine SROUTL to
assessment based upon case Current Procedural Terminology (CPT) codes,
use the VA FileMan variable DILOCKTM if it exists.
replacing the use of the Major or Minor surgery definition.
o When selecting a case to be assessed, the software will check the
Health Information Systems and Technology Architecture (VistA) Surgery
case CPT codes and display an informational statement if no CPT codes
have been assigned to the case or if the case should be excluded from
assessment.
o A new report called "List of Eligible Cases" is added to the reports
contained in the List of Surgery Risk Assessments [SROA ASSESSMENT
LIST] option.
o The MAJOR/MINOR field (#.03) is removed from NSQIP input options and
from the Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT]
option.
application as requested by the Executive Board of the National Surgical
- A new field called INTRAOPERATIVE ASCITES (#446) is created:
o Added to the Operation Information (Enter/Edit) [SROA OPERATION DATA]
option
o Added to the Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT]
option
o Added to data set transmitted to the national database
- A new field called CLOSTRIDIUM DIFFICILE COLITIS (#447) is created:
o Added to the Print a Surgery Risk Assessment [SROA PRINT ASSESSMENT]
option
Quality Improvement Program (NSQIP) and by the Cardiac Surgery Consultants
o Added to the PERIOPERATIVE OCCURRENCE CATEGORIES section of the
Surgery Quarterly Report
o CLOSTRIDIUM DIFFICILE COLITIS is added as a new occurrence category
to the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5)
- The description is updated and/or other data dictionary changes are made
for the following items:
o SURGERY SPECIALTY field (#.04)
o WOUND CLASSIFICATION field (#1.09)
o REASON FOR NO ASSESSMENT field (#102)
Board of the Continuous Improvement in Cardiac Surgery Program (CICSP).
o HISTORY OF COPD field (#203)
o WEIGHT LOSS > 10% field (#215)
o BLEEDING DISORDERS field (#216)
o OPEN WOUND field (#218)
o PREOPERATIVE SEPSIS field (#218.1)
o PREVIOUS PCI field (#220)
o SYSTEMIC SEPSIS field (#250) and the SYSTEMIC SEPSIS occurrence
category in the PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5)
o PNEUMONIA field (#251) and the PNEUMONIA occurrence category in the
PERIOPERATIVE OCCURRENCE CATEGORY file (#136.5)
The updates include the addition of new data fields, changes to existing
o PULMONARY EMBOLISM field (#252) and the PULMONARY EMBOLISM occurrence
category in file (#136.5)
o ACUTE RENAL FAILURE field (#254) and the ACUTE RENAL FAILURE
occurrence category in file (#136.5)
o PREGNANCY field (#269)
o PERIPHERAL NERVE INJURY field (#287) and the PERIPHERAL NERVE INJURY
occurrence category in the PERIOPERATIVE OCCURRENCE CATEGORY file
(#136.5)
o DYSPNEA field (#325)
o CURRENT PNEUMONIA field (#326)
data fields, changes to data entry screens, changes to reports used in
o REST PAIN/GANGRENE (Y/N) field (#330)
o CHEMOTHERAPY IN LAST 30 DAYS field (#338.1)
o QUADRIPLEGIA (Y/N) field (#398)
o TUMOR INVOLVING CNS (Y/N) field (#401)
o INTRAOP DISSEMINATED CANCER field (#443)
o DATE COMP NOTED field (#2, sub-file #130.22)
o SEPSIS CATEGORY field (#7, sub-file #130.22)
- Hemoglobin A1c is added to the set of preoperative lab test results.
Surgery Risk Assessment management process and changes to the Surgery Risk
- This patch modifies all Lab fields under the Laboratory Test Results
(Enter/Edit) [SROA LAB] option to assume a past date if the user enters
a date without a year.
- The DATE OF DEATH field (#342) is modified to allow the entry of time as
well as date and is added to the Patient Demographics (Enter/Edit) [SROA
DEMOGRAPHICS] option.
- Airway Trauma, Mallampati Scale and Airway Index are removed from the
set of information collected and transmitted to NSQIP.
Assessment transmissions.
- The letter produced by the Print 30 Day Follow-up Letters [SROA REPRINT
LETTERS] option is modified to display the date of operation and the
local surgical specialty.
- The Monthly Surgical Case Workload Report [SROA MONTHLY WORKLOAD REPORT]
option is modified to replace references to major/minor with eligible or
excluded.
|
| FILE |
-
- DD NUMBER:
-
-
- SURGERY (File-top level)
- FIELD NUMBER:
-
-
- SURGERY SPECIALTY
-
- WOUND CLASSIFICATION
-
- REASON FOR NO ASSESSMENT
-
- CURRENT SMOKER
-
- HISTORY OF COPD
-
- CONGESTIVE HEART FAILURE
-
- WEIGHT LOSS > 10%
-
- BLEEDING DISORDERS
-
- OPEN WOUND
-
- PREOPERATIVE SEPSIS
-
- PREVIOUS PCI
-
- PREOPERATIVE HEMOGLOBIN, DATE
-
- SYSTEMIC SEPSIS
-
- PNEUMONIA
-
- PULMONARY EMBOLISM
-
- ACUTE RENAL FAILURE
-
- PREGNANCY
-
- ON VENTILATOR >48 HOURS
-
- PERIPHERAL NERVE INJURY
-
- PREOP SERUM CREATININE, DATE
-
- PREOPERATIVE BUN, DATE
-
- PREOP SERUM ALBUMIN, DATE
-
- SGOT, DATE PERFORMED
-
- PREOP TOTAL BILIRUBIN, DATE
-
- PREOP ALK PHOSPHATASE, DATE
-
- PREOPERATIVE WBC, DATE
-
- PREOP PLATELET COUNT, DATE
-
- PREOPERATIVE PT, DATE
-
- PREOPERATIVE PTT, DATE
-
- PREOP HEMATOCRIT, DATE
-
- PREOP SERUM SODIUM, DATE
-
- HIGH SERUM SODIUM, DATE
-
- HIGH POTASSIUM, DATE
-
- HIGH SERUM CREATININE, DATE
-
- HIGH CPK, DATE
-
- HIGH CPK-MB, DATE
-
- HIGH TOTAL BILIRUBIN, DATE
-
- HIGHEST WBC, DATE
-
- LOW HEMATOCRIT, DATE
-
- DYSPNEA
-
- CURRENT PNEUMONIA
-
- REST PAIN/GANGRENE (Y/N)
-
- CHEMOTHERAPY IN LAST 30 DAYS
-
- DATE OF DEATH
-
- ESTIMATE OF MORTALITY
-
- PERIOPERATIVE MI
-
- QUADRIPLEGIA (Y/N)
-
- TUMOR INVOLVING CNS (Y/N)
-
- LOW SODIUM, DATE
-
- LOW POTASSIUM, DATE
-
- CARDIAC SURGICAL PRIORITY
-
- INTRAOP DISSEMINATED CANCER
-
- PREOP ANION GAP, DATE
-
- HIGH ANION GAP, DATE
-
- INTRAOPERATIVE ASCITES
-
- CLOSTRIDIUM DIFFICILE COLITIS
-
- HIGH SERUM TROPONIN I, DATE
-
- HIGH SERUM TROPONIN T, DATE
-
- HDL, DATE
-
- SERUM TRIGLYCERIDE, DATE (CAR)
-
- SERUM POTASSIUM, DATE(CARDIAC)
-
- SERUM BILIRUBIN, DATE (CARD)
-
- LDL, DATE (CARDIAC)
-
- TOTAL CHOLESTEROL, DATE
-
- CONVERT FROM OFF PUMP TO CPB
-
- PREOP CIRCULATORY DEVICE
-
- AORTIC STENOSIS
-
- PREOPERATIVE INR, DATE
-
- HEMOGLOBIN A1C
-
- HEMOGLOBIN A1C, DATE
-
- POSTOP OCCURRENCE (sub-file)
- FIELD NUMBER:
-
-
- DATE COMP NOTED
-
- SEPSIS CATEGORY
- UPDATE THE DATA DICTIONARY: YES
- SEND SECURITY CODE: YES
- SEND FULL OR PARTIAL DD: PARTIAL
- DATA COMES WITH FILE: NO
- MAY USER OVERRIDE DATA UPDATE: NO
-
- UPDATE THE DATA DICTIONARY: YES
- SEND SECURITY CODE: YES
- SEND FULL OR PARTIAL DD: FULL
- RESOLVE POINTERS: NO
- DATA COMES WITH FILE: YES
- SITE'S DATA: OVERWRITE
- MAY USER OVERRIDE DATA UPDATE: NO
-
- UPDATE THE DATA DICTIONARY: YES
- SEND SECURITY CODE: YES
- SEND FULL OR PARTIAL DD: FULL
- DATA COMES WITH FILE: NO
|
