The AORN Syntegrity Framework

100 %
0 %
Information about The AORN Syntegrity Framework
Health & Medicine

Published on April 9, 2013

Author: aornsocialmedia

Source: slideshare.net

Description

Learn about the AORN Syntegrity® Framework, standardized clinical content providing a consistent method for documenting perioperative patient care that has been validated by expert perioperative nurses. This framework aligns documentation with nursing workflow enabling reliable and valid data to be captured. Documentation represents the perioperative nursing plan of care via the most up-to-date version of the PNDS language (3rd version) and complements a perioperative information system or Electronic Health Record.

What is the AORN Syntegrity® Framework Standardized clinical content providing a consistent method for documenting perioperative patient care that has been validated by expert perioperative nurses Aligns documentation with nursing workflow enabling reliable and valid data to be captured Documentation represents the perioperative nursing plan of care via the most up-to-date version of the PNDS language (3rd version) Complement to a perioperative information system or Electronic Health Record

What is the AORN Syntegrity® Framework Standardized clinical content creates an information infrastructure for the aggregation of data to: − Report perioperative quality measures − Demonstrate compliance with practice standards, patient safety goals, and regulatory and accreditation criteria − Analyze operational efficiencies − Perform research The clinical content’s health record fields are derived from: – The Perioperative Nursing Data Set (PNDS) – AORN’s Perioperative Standards and Recommended Practices – Regulatory and accreditation requirements – Mandatory data for quality reporting

Founded on the PNDS Language 1993: Development of PNDS started 1999: Recognized by ANA 3rd version consists of – 50 Assessment interventions – 73 Implementation interventions – 25 Evaluation interventions • 148 Interventions total – 39 Outcomes – 156 NANDA Nursing Diagnosis Represents perioperative nursing plan of care

Fits Nursing Workflow (example)

Health Record Fields Mapped to PNDS (example) Associated assessment PNDS codes: A.20 Verifies operative procedure, surgical site and laterality. A.20.1 Verifies consent for planned procedure A.20.2 Assesses the risk for unintended retained foreign body Nursing Diagnosis Determined: Risk for Injury (00035)

Health Record Fields Mapped to PNDS (example) Documentation of counts represents the implementation of nursing care provided to prevent unintended retained foreign objects PNDS Implementation Code = Im.20 Performs required counts

Health Record Fields Mapped to PNDS (example) Documentation represents evaluation of the results of the counts and documentation of the outcome. PNDS Evaluation Code = E.50 Evaluates the results of the surgical count PNDS Outcome Code = O.20 Patient is free from unintended retainedO.20 Patient is free from unintended retained foreignobjects: foreign objects

Derived from Clinical Practice Standards Practices Standards – describe excellent nursing practice – Promote patient and health care worker safety – Guide policy and procedure development Clinical practice standards include those outside of AORN (ex. ANSI Laser Standards, AABB for blood transfusions) Yearly review of perioperative clinical practice standards Crosswalk of health record fields to standards for education and validation of documentation

Derived from Regulatory and Accreditation Criteria Yearly review of − Regulatory requirements (CMS) − Accreditation criteria (TJC, DNV, HFAP, AAAASF, etc) New accreditation agencies added as CMS approves Clinical content complies with elements of performance and requirements for surveys Crosswalk of health record fields to criteria for education and validation of documentation

Crosswalk to Standards and Regulations (example)

Agencies Reviewed

Derived from Mandatory Reporting CMS Quality Reporting: Inpatient, Outpatient, ASC Nurse Sensitive Measures: NQF, NDNQI , The Joint Commission Other Measures: AHRQ Patient Safety Indicators, Physician Quality Reporting Operational Reporting: process and workflow improvements

Mandatory Reporting (example) CMS Reporting: SCIP Measures Card-2 Surgery patients on beta-blocker therapy prior to arrival who received BB during the perioperative period INF-1 Prophylactic antibiotic received within one hour prior to incision INF-2 Prophylactic antibiotic selection INF-3 Prophylactic antibiotic discontinued 24 Hours after surgery end time INF-4 Cardiac surgery patients with controlled 6am postop blood glucose INF-9 Urinary catheter removed POD 1 or POD 2 with day of surgery as day zero INF-10 Surgery patients with perioperative temperature management AORN Measures: Operational Reporting Personnel Patient Times Procedure Specific Environmental

Mandatory Reporting (example) Nurse Sensitive Measure NQF Measures NQF-0515 Ambulatory surgery patients with appropriate hair removal NDNQI Perioperative Staffing Hours required for Magnet hospitals starting end of 2013 The Joint Commission Measures NSC-02 Pressure Ulcer Prevalence Other Measures AHRQ Patient Safety Indicators PSI-21 Rate of Foreign Body Left During Procedure Physician Quality Reporting System NQF-0454 Perioperative temperature management ACO Reporting ACO-17 Preventive Care & Screening; Tobacco Use: Screening and Cessation Intervention

Standardized Procedure List Over 1900 procedures Standardized naming convention Mapped to – SNOMED CT – CPT 4 – ICD-9 – ICD-10 Used by CMS for retooling of SCIP measures into eMeasures

Example of AORN Procedure List AORNAORN Name Synonym CPTs ICD9s SCT_IDsAmputation Arm Lower ArmLower Amputation 25905, 25900 84.05 400136002 33533, 33534, 36.14, 36.11, 33535, 33536, 36.13, 36.12, Coronary Artery 33510, 33511, 36.17, 36.10,Bypass Graft Bypass Graft 33512, 33513, 36.16, 36.19,Coronary Artery (CABG) 33514, 33517 36.15 232717009

Why the Framework

The Benefits of the Framework AORN Syntegrity® framework integrates a mix of standards, nursing process and outcome measures – Documentation aligned with health care standards – Documentation represents up-to-date perioperative nursing care planning – High quality, evidence-based clinical content at the point of care to support clinical decisions – Measures perioperative nursing contribution to patient care – Reliable and valid data for quality reporting – A tool to standardize documentation throughout an organization Standardization aids data collection, aggregation and benchmarking – Data collection that supports aggregation for quality reporting – Provides consistent and reliable data for formulation of organizational and public policy – Enhance ability to meet mandatory surgical reporting (SCIP, NQF) – Meet surgical regulatory compliance reducing the risk for citations

Value of the Framework Saves money. Reduces the amount of time clinical staff spends in the development, validation and management of perioperative documentation and keeps valuable clinical resources at the bedside providing direct patient care Accelerate the time-to-value. Unlock the value of the standardized nursing documentation as a foundation for reporting and benchmarking on performance improvement initiatives within the perioperative area Data-driven clinical decision making. Capitalize on the standardized data to perform more accurate analytics to improve performance, quality and efficiency while reducing cost

Value of the Framework Harmonization. AORN’s involvement in the development and ongoing review of standards related to perioperative nursing practice, patient safety, quality outcomes, health information technology and regulation enables harmonization of the clinical content with these standards Right strategic decision. Ensures the organization is producing valuable data from perioperative documentation that meets information and knowledge needs to improve the safety and quality of patient care Reduce care disparities, minimize errors, and save staff time. Potential to improve communication through consistent, clear documentation which enhances the continuity of patient care, minimizes errors and saves staff time

THANK YOU

Add a comment

Related presentations

Related pages

The AORN Syntegrity Framework - Computer Sciences Corporation

CSC Proprietary and Confidential The AORN Syntegrity® Framework . HIMSS 2014
Read more

The AORN Syntegrity Framework - assets1.csc.com

The only perioperative nursing language recognized by the American Nurses Association ; AORN’s Perioperative Standards and Recommended Practices
Read more

Picis Supports AORN SYNTEGRITY ™ Standardized ...

Picis supports AORN SYNTEGRITY Standardized Perioperative Framework. The collaboration helps perioperative clinicians share information and benchmark
Read more

CSC And AORN Bring Standardized Electronic Health ...

CSC and the Association of periOperative Registered Nurses (AORN) recently announced the launch of the AORN Syntegrity Standardized Perioperative...
Read more

Surgical Information Systems (SIS) Offers AORN SYNTEGRITY ...

Surgical Information Systems (SIS) Offers AORN SYNTEGRITY Standardized Perioperative Framework (SPF) March 8, 2010. Surgical Information Systems (SIS ...
Read more

Using SYNTEGRITY to determine qualification for the SCIP

The SYNTEGRITY Framework will place the PNDS code into the correct phase of care and ... AORN SYNTEGRITY™STANDARDIZED PERIOPERATIVE FRAMEWORK
Read more

A New Era - AORN Journal

A New Era With the SYNTEGRITY™ Standardized Perioperative Framework, AORN brings a new kind of standardized documentation to the perioperative profession.
Read more

Read CSC AORN Syntegrity FAQ text version

Readbag users suggest that CSC AORN Syntegrity FAQ is worth reading. The file contains 4 page(s) and is free to view, download or print.
Read more

AORN - Association of periOperative Registered Nurses

The Association of periOperative Registered Nurses (AORN) is the leader in advocating for excellence in perioperative practice and healthcare.
Read more