Long Term Outcomes
🤔 Question: What is the best way to document the LTO for patients in the registry who are discharged with follow-up at another facility/clinic? This happens sometimes because of insurance requirements, or because a patient is being discharged with family who live closer to another burn center, and follow-up is arranged there. It seems odd to say "lost to follow-up" because they have been arranged to receive follow-up elsewhere, but the other options of "follow-up continued/ongoing" and "follow-up complete" don't seem to fit either.
🌱 Answer: If you send them to another facility for follow up, then you should check "Lost to Follow Up" because the patient is no longer coming to your facility, and you are no longer doing the follow-up on the patient. This is not a negative for your facility as there are many facilities that must refer patients to other facilities for follow-up because of distance and other issues.
🤔 Question: Should LTOS be tracked for non-burns too?
🌱 Answer: Yes, LTOs should be collected on all patients entered into the registry that continue to be followed by the Burn Service.
🤔 Question: For patients who have clinic procedures and then are later admitted for an initial inpatient stay for care of their initial injury, would you include those procedures under Hospital Procedures in LTOs or only those that occur after the initial admission?
🌱 Answer: Include Hospital Procedures performed only after the discharge from their initial inpatient stay.
🤔 Question: Will there be reporting available in BCQP for registrars to keep track of patient registry records that have ongoing LTO follow-up vs. those that have been lost to follow-up? It would be helpful if this were available as a standard report already built for us in the reporting environment and available for use at the time of the LTO roll-out.
🌱 Answer: Yes, once bData releases the fields in data entry they can develop reporting. They will follow up with everyone in Spring 2024 so you can see a couple reports they will be adding to our library: 1) To keep track of worklist (ongoing follow up on) and 2) summarizing those metrics and evaluation data.
🤔 Question: Are LTO entered for patients who are admitted or for all burn patients seen in the outpatient clinic at a burn center (therefore including patients who have not and may never be admitted)?
🌱 Answer: Enter LTO only for patients who were originally inpatients and entered in your registry.
🤔 Question: If a patient was an outpatient and was admitted to have a procedure, we are not required to document LTO data for these patients since they were not originally inpatients?
🌱 Answer: If the patient has been entered in your registry, which they would be for an inpatient procedure, then yes, you would enter LTO data on them.
🤔 Question: Do LTOs (Long Term Outcomes) need to be completed on all patients in the registry or only burn patients.
🌱 Answer: All patients should have Long Term Outcomes entered. If the patient has a non-burn injury such as friction/ road rash, you should complete the data point.
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Introduction
Date of 95% Wound Closure
🤔 Question: Is the Variable "Date of 95% wound closure" required for non-burn patients as well?
🌱 Answer: No, this field is only required for burn patients. The next update of the Data Dictionary will reflect this but for the time being, only record this information for burn patients and click "Not applicable" for patient with inhalation injury or non-burn patients.
Outpatient Follow Up Status
🤔 Question: If patient is from out of state and follow-up care after inpatient stay does not occur at the burn center clinic/outpatient department, what should be entered for follow up status?
🌱 Answer: If the patient will not be returning for follow up care, and that care is still needed, they should be recorded as lost to follow up. This is true even if they were referred to another care center for follow up.
🤔 Question: Are long term outcomes collected for a specified period of time?
🌱 Answer: Long Term Outcomes are collected for 12 months from the time of the patient's initial discharge.
Operative or Outpatient Procedure Date
🤔 Question: Procedure types- Are pinch grafting, kenalog injections included under Procedure types? Are irrigation and debridement’s excluded under the current definition?
🌱 Answer: Include all incisional procedures and laser procedures. Kenalog injections are not incisional and not included.
🤔 Question: Question: Is ABA defining the onset of PTSD after ASD - our facility refers to ASD as converting to PTSD after 30 days.
🌱 Answer: If the patient has ASD within the 1st 30 days and then continues to have PTSD after 30 days, you will select both of these. Some patients may have one or the other or both.
🤔 Question: Question: For patients who might be repeatedly coming to clinic, is it required that they be reevaluated for symptoms at every clinic visit? If a screening tool at the first clinic visit is used, would questions about mood, or self-disclosure be enough to document presence of ASD/PTSD/Depression?
🌱 Answer: ASD and PTSD must be diagnosed by a medical professional, depression may be either by patient/parent report or medical professional. A screening tool may be used to document depression, but not ASD/PTSD. No, you do not have to do this every visit and if you don’t for a selected visit, select “Not Documented in Outpatient Record”.
Operative or Outpatient Procedure Type
Operative or Outpatient Procedure Location
Operative or Outpatient Facility Location
Date of Outpatient Visit
🤔 Question: Is every LTO visit being recorded for a defined period of time or based on a triggering event?
🌱 Answer: Record every outpatient visit for the first 12 months post-discharge.
Scar Appearance Evaluated
Scar Assessment
Pressure Garment Was Used
Patient has Return to Pre-Burn Injury Activities
🤔 Question: When answering if patient has returned to pre-burn injury activities would you select “yes fully” for a situation in which a patient returns to work even if they are in a different vocation? Also, for patients that may not be employed are we correct in assuming that this includes activities, such as school, past times, and general life responsibilities?
🌱 Answer: Yes, that’s correct. Yes, it’s whatever the patient/parent considers fully returned to pre-burn activities.
Presence of Depression
Presence of Post-traumatic Stress Disorder (PTSD)
🤔 Question: Can a social worker document PTSD or ASD?
🌱 Answer: A medical professional can document the presence of PTSD or ASD - a psychologist or psychiatrist should be involved in the diagnosis of these conditions.
Presence of Acute Stress Disorder
🤔 Question: Are we specifically coding for ASD/PTSD/ Depression with onset at or near time of event? Would pre-existing diagnosis be included in this definition?
🌱 Answer: ASD/PTSD/Depression should be recorded regardless of time of onset, so yes, include pre-existing diagnosis.
Presence of Pain
🤔 Question: Which LTO presence of pain option would we choose for the presence of pain for a patient who says they have pain, but are not taking either prescription or over the counter pain medication? They are choosing to just live with what they have, they don't like taking medications, or it doesn't bother them enough to take something.
🌱 Answer: Please select "Yes, requiring over the counter pain medication" for those patients who say they have pain but are not taking any pain medication.