2022.11.02 EQRS Program Working Group Meeting

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Discussion of the Peritonitis Module (Continued)

PDAP Event Denominator Form_FINAL.pdf

• Antimicrobial Treatment
  
  • • Dr Dinesh Chatoth wants to make sure we're talking about the antibiotics administered for the peritonitis event
    • Suggested to reword the question; it should say "Antimicrobial treatment for the peritonitis b/c there are antimicrobial ointments used around the PD catheter
  • Might need multiple lines to reflect multiple treatments/medications; there could be several medications prescribed
• Outcomes
  • We already document hospitalizations and modality switches in EQRS (even temporary), entries here may be redundant (may pull patient info in from different area when looking at the data); no need document twice
  • "Loss of PD catheter" should reflect related to peritonitis event as there are other reasons to lose of PD catheter
  • Pathogens on p. 3-4 can be made drop-down menus/selections
  • "Select all that apply within 50 days from the date from peritonitis event" - We need to determine if we wait until you have all of the information.  Theoretically, if we're looking at the outcome 50 days out, you should be able to report that at the 60th day.  So, they would look at reporting 60 days after the event (Action Item Lisa)
• Custom fields
  • Meant to put identified pathogens in this space
• Organisms
  • Can be in drop-down field, categorized
  • The pathogens are related to the blood stream infection and to the peritonitis event
  • EC=fluid culture / ESI=Exit site infection TI=tunnel infection / BSI=blood stream infections
  • Fungal organisms are on the last page
  • Nathan expressed concerns about volume of options on the physical sheet and questioned the expectations of an XML file - hoping for just relevant information and not "a bunch of N/As." Not have to report everything
  • Need to ask CDC how many pathogens they want identified for a single event? Do they want every organism that was related? (Action Item Lisa)
  • Per Yvette, those fields would be optional, that way they would only send what was necessary

Discussion/Questions

Vlad

• There is no problem to submit peritonitis and data related to peritonitis.  The bigger issue is submitting some additional information on every patient, every month (See the Risk Factors section of the form)
  • Per Lisa, she understood it to be if there was a peritonitis event that happened, were these risk factors involved. Lisa will go back to the CDC and confirm (Action Item Lisa)
• Vlad pointed out that even though we are talking about peritonitis, infections overall is a quality issue.  Eventually we will be required to document other infections.  When we do the development for peritonitis, we should keep in mind we may need to expand the development to other infection types
  • Per Yvette, they have considered that. In the future if another infection is added, we can easily add it under the infection module
  • Nathan pointed out that b/c we are looking at events that span time and trying to capture all the details at once, we need to understand both system behavior and when a record can or can't be updated versus what information we have at the time that reporting is to be expected.  How do we get additional information in and make changes if needed?
• Question: When will we close August?
  • Answer: One week extension was granted, 11/7 is new closure date

Revathy

• Will this data be sent to the CDC NHSN, or EQRS?
  • Per Lisa this will be in EQRS
  • Development had started in EQRS and then asked the CDC to partner with CMS.  The PDAP Event Denominator form is what the CDC developed
  • Per Revathy, a lot of the information on the form is similar to the information they submit to the NHSN dialysis surveillance
  • Is this form both for Event and Denominator?
    • Per Lisa, the denominator will be in EQRS b/c they will know the number of patients that are doing peritoneal dialysis
    • Therefore, the whole form will not need to be completed, information can be pulled from different areas in EQRS
  • Revathy asked if Lisa has in mind a plan such as dates, implementation of the peritonitis module?
    • Per Lisa, she will need to go back to the team/ADO and discuss a plan, dates, etc

Nathan

• Wanted to talk through the clinical updates (redshift, etc). There were some system issues with clinical data that may have impacted the data that the NCC gets in redshift.  In addition, this past weekend and maybe 2-3 weeks ago, redshift wasn't updated.
  • This overall impact was that they do not get the clinical compliance file from the NCC
  • Without that data, they do not truly see where their reporting stands for month closes
  • Is there a way to ensure patches to the redshift feed are made?
  • If the weekend run doesn't work, make it possible to run in the week.  Getting the data Wednesday or Thursday is better than not getting the data at all
  • Per Lisa, she will be meeting with that team (ADO and NCC) this afternoon and will discuss it with them (Action Item Lisa)
  • Per Nathan, that weekly file is key to their workflows and their submissions, manual entry that their clinics do
• Peritonitis: how do we let clinics/EDIs/ORGs know what's missing from the peritonitis data from the beginning as opposed to just collecting all data? Nathan will circle back with his clinics/reps to determine what important information they'd like to see in the reports prepopulated. (Action Item Nathan)

Next meeting scheduled for 16 Nov 2022