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Birth Certificate Pilot

Collaborative Learning Session


2/26/19
• Taking a second to grasp
the scale of role
• Inherent variability that
exists
• What are we doing about
it?
• Lessons learned
• Sharing Great Ideas
• Audit findings
• Sustainability
Perspective
120,150 + Babies Born 329+ Babies Born 18% of
every year in NC Every day in NC Births in NC

Raleigh
57 BIRTH
13/day
CERTIFICATES
14/day
NEED
Cary
6/day
7/day
TO BE PROCESSED
EVERY DAY
North
10/day 2/day 2/day
3/day
Exercise of Variability
Common Cause Variation Special Cause Variation
Debrief
How does this relate?
Common Cause Variation Special Cause Variation
• Workload: Cannot predict number of • Different chart access
deliveries any given shift
• Different disciplines responsible for part
• Each registrar creating their own tracking of the process
process or organization process
• Different staffing levels on each shift
• Waiting on Mom’s worksheet or signing of
VoF

• Not all registrars utilize the same process


to coordinate data abstraction
Goals
• Promote an efficient and accurate birth information collection
process in 100% of participating sites
• Improve the reporting accuracy to at least 80% for the chosen 11
variables based on auditing of charts at each facility
• Develop a monthly sustainable internal auditing process for data
verification in 100% of participating sites
• Develop and implement consistent on-boarding practices for new
hires and continued mandatory training in 100% of participating sites
Eliminating Waste and Improving Value
START

END
Capturing Value and Eliminating Waste

• Bring value to the birth registrar

• Creates no value to the registrar but is a necessary requirement


within the process

• Something that adds no value to the registrar and is not needed by


any part of the process but brings value to the patient
Lessons and Information Learned
• Variable definitions – paying attention to which unit staff need to
know them
• Birthweight
• Breastfeeding
• Antibiotics for sepsis
• Antenatal steroids
• Capture all events through hospitalization – not just immediately after
birth
• Need to send to EBRS by 10 days after birth
Sharing Best Processes

Orientation Checklist at
Randolph
Sharing Great Ideas

UNC Rex Mom’s


Worksheet Cover Page
Sharing Great Ideas

UNC REX Directions on how to obtain Birth


Whiteboard Communication Record
Sharing Great Ideas
WakeMed Cary Communication folder and Instruction sheet
Goals
• Promote an efficient and accurate birth information collection
process in 100% of participating sites
• Improve the reporting accuracy to at least 80% for the chosen 11
variables based on auditing of charts at each facility
• Develop a monthly sustainable internal auditing process for data
verification in 100% of participating sites
• Develop and implement consistent on-boarding practices for new
hires and continued mandatory training in 100% of participating sites
Definition Review
Birth Certificate Variables

80% line
Submission Accuracy for 11 Variables

ACCURATE
44%
56% INACCURATE
Audit Review

Birthweight…
Goals
• Promote an efficient and accurate birth information collection
process in 100% of participating sites
• Improve the reporting accuracy to at least 80% for the chosen 11
variables based on auditing of charts at each facility
• Develop a monthly sustainable internal auditing process for data
verification in 100% of participating sites
• Develop and implement consistent on-boarding practices for new
hires and continued mandatory training in 100% of participating sites
NC Vital Stats Audit Data
Goals
• Promote an efficient and accurate birth information collection
process in 100% of participating sites
• Improve the reporting accuracy to at least 80% for the chosen 11
variables based on auditing of charts at each facility
• Develop a monthly sustainable internal auditing process for data
verification in 100% of participating sites
• Develop and implement consistent on-boarding practices for new
hires and continued mandatory training in 100% of participating sites
Orientation Resource

Common and equal training for all


Sustaining Knowledge

e-Training