Well stated Theresa.

Also, cancer registrars are NOT just coders in the sense of reviewing
one record for reimbursement, as 'inpatient' coders do. We are
charged with collecting the entire cancer experience for each
patient, regardless of where their diagnosis/treatment occurred.

We can all very readily come up with the 'exceptions' to the quickie
abstract. That's because there are SO MANY EXCEPTIONS. But, in all
fairness, we should have a benchmark standard. Our supervisors, dept
heads, etc really do not have a handle on the scope of what we have
to do. We must inform them.

At this facility we are required to report up only raw numbers for
new abstracts and follow-up entered each month. We find this is an
inaccurate snap shot of registry activity, and we have told our
superiors this. We in the registry are changing how we report
productivity at our own initiative. We CTRs use the rule of 1 hour
per chart on average. Meaning of course 30 to 90 plus minutes/
abstract.

We do not have quotas at this facility. Our goal is the CoC standard
of abstracting within 6 months of first contact at this facility. We
are respected here to do what needs doing to maintain this standard,
and we are not micromanaged about this.

We registrars have always been valuable Cancer Program members, and
as such trusted to maintain quality and quantity. We do not hesitate
to inform our supervisors if backlog problems arise, etc. We find
they are very receptive when kept in the loop and not blindsided with
hidden problems.

We are an office of two CTRs with 900 - 1000 analytic cases per year.

I urge you 'tpar4u' to gather as much supporting data as possible and
resist quotas, especially the unresonable 7.5 per 8hr day.

Best of luck,
NancyCtr
New York


--- In cancerregistrargroup@yahoogroups.com, "thaydenhome"
<thaydenctrbha@c...> wrote:
>
> Even when "abstracting only", there are so many potential
> interruptions which decrease productivity. Examples:
> 1. Analytic patient shared with 1 or more other facilities (we're
> required to complete the info - does someone round all that up
> before you abstract or do you need to stop and call around to get
> what you need faxed over and then put the case aside while you wait
> for faxes to arrive?)
> 2. Your phone rings (for any reason - I'm sure you can think of as
> many reasons as any of us can but even "oops wrong number"
> interrupts you and slows you down).
> 3. The chart has contradictory or unclear info and you need to
> query someone about it - do you query that person and then
[perhaps]
> wait for a response? How much time does that take you on average?
> In this scenario, do you complete the case as best you can and
> correct it as needed when you get your answer? And how/where does
> entering the corrected info factor in to your abstracting
> productivity?
> 4. What about the type and complexity of a case? Are there
> recurrences to take into account? Do you enter any data which is
> not part of the CoC data set, for example subsequent therapy? Do
> you have a different time standard depending on how many treatment
> modalities a patient receives? What if it happens to be a
pediatric
> case? If it is, odds are the patient was referred to a pediatric
> facility from whom you'll need to request documentation so you can
> complete the case. And I abstracted peds - exclusively - for 12
> years. I can tell you that they just plain take longer as a
general
> rule. So, how are these sort of things taken into account?
> 5. What info is or is not entered ahead of time, and is that
> consistent from case to case? If more or less info is entered, and
> if there is a pattern to that for certain types of cases, those
with
> more info entered in advance will obviously take less time to
> complete.
>
> Yes, there does need to be a baseline for expected productivity.
> However abstracting, as a process, can differ so much from one
> facility to another that it is very difficult to establish a
> universal productivity standard. Abstracting is actually many
> smaller processes taking place from the time we create a case
> through the time we complete it. How we divide those up . . .
> casefinding, creating/adding cases, entering demographics, entering
> staging info, entering text, entering treatment info, entering
> follow up, querying for confusing or missing info, adding a doctor
> to your DB if a patient has a doc you've not used before for any
> other case. I've seen different places organize work flow
> differently for these processes based on what worked best for each,
> and this changes the answer to the question "how much time does it
> take to abstract a case?". You need to identify how you group or
> divide these subtasks and then establish norms - or baselines - for
> YOUR facility, based on objectively collected data about YOUR
> workflow. AND, at the end of the day you need a way of tracking
> productivity that is not such a burden it reduces your productivity.
> All that said, depending on the types of cases, I can do anywhere
> from 4 to 10 cases in one day. Now give me a pile of T1CN0M0
> prostates with perfect documentation and I could probably beat 10.
> But give me some pediatric cases with complex radiotherapy, bone
> marrow transplants, relapses, and subsequent treatment, and info
> needed from other facilities I'll be happy to get through 4 and
will
> go home just beat.
> -- Theresa
>
> --- In cancerregistrargroup@yahoogroups.com, "tpar4u"
> <tlparsons@s...> wrote:
> >
> > Hi all. I know I've asked this question in the past. It is
> extremely
> > important that I gather data on the number of abstracts done per
> day.
> > This is on a day when all 8 hours is spent on abstracting only.
> Do you
> > have an enforeced quota that has to be met daily and if so, what
> is the
> > number of abstracts required? Our employer is requiring us to
> complete
> > 7.5 abstracts daily for an 8 hour day. They are monitoring us on
> a
> > weekly basis and we have been informed that we will be subject to
> > corrective action and discipline if we cannot achieve this
quota.
> We
> > feel this is unreaslistic. Does anyone have any input or help?
> > Tpar4u
> >
>