St James' Hospital - Ms Miriam Horan (pdf, 817KB) - RCPI
St James' Hospital - Ms Miriam Horan (pdf, 817KB) - RCPI
St James' Hospital - Ms Miriam Horan (pdf, 817KB) - RCPI
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MIRIAM HORAN<br />
SENIOR MEDICAL SCIENTIST<br />
HISTOPATHOLOGY<br />
ST JAMES HOSPITAL
HISTOPATHOLOGY<br />
ST JAMES HOSPITAL<br />
LIS: TELEPATH<br />
SINCE 1990
DEPARTMENTAL ROLE<br />
APPLICATION CONTROLLER<br />
QUALITY COORDINATOR<br />
MATCH MADE IN HEAVEN FOR FACULTY QA<br />
PROGRAME ???????
FROM LIS<br />
TO<br />
HEALTH ATLAS
FROM THIS………
.<br />
TO THIS……….
A LONG LONG ROAD………..<br />
WITH A FAIR FEW BUMPS AND TURNS
TIMELINE<br />
• First guidelines: September 2009<br />
• Original Extract Validation : November<br />
2010<br />
• Telepath Pilot :March 2011<br />
• Implementation/Go Live: Feb 6 th (ish)2012
Vendor: iSoft (CSC)<br />
Contact David Ford ( Saint!!!!)<br />
1st Extract February 2011<br />
Original extract set up and validated( 20<br />
cases)<br />
Set to print from Telepath to file on server<br />
Was originally .xls file<br />
• Nothing missing from these cases in LIS<br />
Extract….Yippee
And then came HSE ICT and validation….<br />
Contact: James Carton ( a very patient man)<br />
Histopathology QA ICT System Implementation<br />
plan<br />
<strong>St</strong>art Up: No major issues. Filled out forms, set up<br />
mapping tables<br />
Set Up: Access to NQAIS, installed encryption<br />
software, mapping tables were correctly set up
TESTING ISSUES<br />
Encryption was first problem encountered<br />
Was unable to encrypt extract and upload<br />
Telepath extraction file was set up with csv.1<br />
extension.<br />
This was a feature of Telepath<br />
Required renaming file to just .csv extension<br />
Took a while to figure this one out
File Matching……Took a long time<br />
Ran lists from telepath looking for various P<br />
and Q codes to match them to numbers in<br />
extract.<br />
RUDE AWAKENING<br />
Not all matching as we would have<br />
thought….why?<br />
Number of different reasons
Some of our problems<br />
Referred material: extract originally set up on<br />
basis that all cases would have a procedure<br />
against them<br />
Special <strong>St</strong>ains: numbers not matching as<br />
mapping tables have all special stains including<br />
cytology<br />
David Ford set up a DAT file from the extract to<br />
allow a quick check on numbers<br />
Level of discrepancy…what is acceptable
Going Live<br />
not really an issue once fields were<br />
matching and we ( James and I) were<br />
happy that correct information was in<br />
extract.
CODING………….<br />
Ongoing issue.<br />
Pathologists responsibility in SJH<br />
Quarterly Audit discussed at Lab exec<br />
and quality meeting to raise level of<br />
awareness and hopefully compliance<br />
Programme only as good as information<br />
put into it
SIGNING OFF<br />
No issue ,but once signed off has been put<br />
on back burner, other more pressing<br />
issues<br />
Problems are local in relation to coding<br />
and areas we are discrepant in e.g<br />
Autopsies, MDTs
HUGE TIME COMMITMENT<br />
Why did it take so long????<br />
Goalposts moving ;e.g in relation to specimen grouping and<br />
coding, time wasted recoding items that are still<br />
unresolved<br />
Work patterns ( job sharing etc)<br />
Expectations differed<br />
Not being intuitively numbers based…<br />
Workload and demands of department, never able to focus<br />
solely on QA programme and not always able to work on<br />
it when planned.
Easy to work with<br />
NQAIS<br />
Can look up extract file if necessary<br />
Can print PDF<br />
<strong>St</strong>ill not sure about ‘diamonds and triangles’<br />
but with more info up should be able to<br />
see and understand more
FUTURE<br />
• CPA surveillance inspection<br />
June 26th June 26 moving to<br />
th moving to<br />
INAB 2013<br />
• Coding Compliance
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