Clinical Chart Abstraction Improves Pre-Op Pulmonary Function Testing

THE CHALLENGE

Banner Health utilizes Health Catalyst's Tech-Enabled Managed Services (TEMS) for clinical chart abstraction. Health Catalyst supports a variety of clinical chart abstraction efforts, including abstraction for The Society of Thoracic Surgeons National Database. Clinical chart abstractors identified an opportunity to improve the number of patients undergoing thoracic surgery receiving pre-surgical pulmonary function testing (PFTs)—critically important for assessing a patient’s readiness for surgery, patient safety, and the accuracy of reporting risk-adjusted quality measures.

THE PROJECT

Health Catalyst clinical chart abstraction team members brought the improvement opportunity to leaders at Banner Health, using the organization’s high-value data and analytics from the Health Catalyst® Data Operating System (DOS™) platform to illustrate specific improvement opportunities. Respiratory therapy leaders and team members performed additional chart reviews, identifying pandemic-related resource challenges and process issues impeding performance. The organization implemented changes to drive improvement, incorporating PFTs into pre-admission testing, implementing standardized order sets to ensure PFT completion for inpatients, and assessing respiratory history, including smoking history, oxygen use, and inhalers. Additionally, the pre-surgical PFT assessment identifies a patient’s home regimen to ensure accurate pulmonary support for their post-surgical stay, including identification of home medications, CPAP/BIPAP support, etc. Confirmation that these assessments occurred is part of the standard PFT documentation.

THE RESULT

The Health Catalyst clinical chart abstraction team was able to immediately see the positive impact of Banner Health’s changes in its patients’ data, providing timely feedback to the organization about the effectiveness of improvement efforts. Banner Health’s data-informed improvement efforts have improved processes for pre-surgical PFT, meaningfully increasing the number of patients who receive this vital test.

• 50 percentage point increase in the rate of pre-surgery PFT completion.
• Improved patient readiness for surgery and patient safety.
• Improved accuracy of clinical documentation and capture of observed patient risk.

"Our Tech-Enabled Managed Services partnership with Health Catalyst and the clinical chart abstraction team allowed us to improve performance, even when facing substantial resource challenges and a limited number of respiratory therapists during COVID-19."
Michele (Lee) Davenport Lambert, RN, CS-FNP, MS, MBA, LSSBB, CPHQ, FACHE
Director Quality Improvement, Banner University Medical Center - Phoenix

ADDITIONAL READING

• New Analytic Insights Improves Mortality O/E
• Smartsourcing Clinical Data Abstraction Reduces Costs and Improves Value
• Analytics Driven Improvement Efforts Reduces Surgical Supply Costs by $3.2M
• Analytics Accelerates COVID-19 Elective Surgery Restart
• Smartsourcing Clinical Data Abstraction Improves Quality, Reduces Costs, and Optimizes Team Member Engagement