NCRA is looking at paying for a formalized study to determine these
workload issues, such as we did in hiring professionals for the
workforce study (looking at the shortage of registrars, and other
issues).

Go to the NCRA website and tell them this issue is important to you -
click on "raise your voice" and tell them this is a "cause" you want
them to address.

Attend the national meeting to hear the latest Strategic Management
Plan for the next five years to see how this issue is addressed, or
watch The Connection for more information.


--- In cancerregistrargroup@yahoogroups.com, "Nancy" <nancyctr@y...>
wrote:
>
> 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
> > >
> >
>