Over the past nine months, teams have gained some valuable insight and recommendations on how to standardize on-boarding of new hires and ensure annual competencies exist for current birth registrars. Though improvements are still in progress, several barriers were uncovered during this pilot. Specifically, a lack of understanding by leadership as to the breadth of the birth registrar role, lack of awareness of existing resources that exist to support this role, as well as, limited expectations of continued training by their staff. Additionally, the mere lack of chart access to successfully carry out their job was a tremendous barrier at some sites and a successful method for data verification remains elusive.
Teams gathered in Raleigh this month to discuss data findings and spread best-practices. After months of process mapping, reviewing data abstraction methods, and identifying areas of improvement, teams came together to collaborate and share these efforts. There was much discussion with experts from the Field Services division of the North Carolina Department of Vital Statistics to help clarify issues registrars are faced with daily. Each team was provided a PQCNC resource book with their improved process map, hospital specific data results, and a guide to assist them with creating a sustainable orientation process.
Process mapping is done and improvements are underway. Each pilot hospital has not only identified areas to improve that will enable them to abstract birth certificate data more accurately, but they have also become more familiar with variable definitions.
The National Center for Health Statistics has created the Guide to Completing the Facility Worksheets for the Certificate of Live Birth and Report of Fetal Death. This document defines each birth certificate variable, provides tips for entry, highlights the best source in the patient record to obtain information, and provides keywords and abbreviations that may be used by providers when documenting clinical care. This tremendous resource has been reviewed with each registrar to create an awareness on the specific definition for the 11 variables they are aiming to improve.
Taking the time to review current workflows and gaining insights on available resources is proving invaluable to participants in this pilot as they work to optimize their job responsibilities.
Teams have been recruited and the work has begun! Eight pilot hospitals have been chosen to begin improving the accuracy of birth data abstraction and submission. PQCNC has met on site with highly engaged registrars and leaders at all eight hospitals to garner their knowledge and commence resource sharing around the birth certificate process. PQCNC is currently process mapping these activities to identify essential steps and characterize functional relationships between each site that will ultimately lead to best practice around essential birth data acquisition.
The action plan and charter have been created for the Birth Certificate pilot to help guide hospitals in achieving the most accurate process for birth data submission. The stated goal of the pilot is to improve the accuracy of 10 key birth certificate variables to 80% to support public health and quality improvement efforts. The action plan lists vital steps that must be taken to achieve this goal. Teams are engaged and excited to begin partnering, collaborating and doing their part to make North Carolina the best place to give birth and be born.