Welcome to Lesson 1 of ACC's Heart Failure Version 4 Accreditation Conformance Database and Calculated Measures course. This learning activity was developed by myself, I am Liza St. Clair and I will also be narrating this presentation. Our objectives for this module is to first demonstrate how to operate the Accreditation Conformance Database or the ACD, then describe the ACD randomization program for those that will continue to use the ACD as their data collection option through the application phase of the accreditation process. And lastly, highlight all resources that are available to support and guide you in utilizing the ACD. As noted in previous workshop modules, this lesson will specifically review the ACD functionalities of the online Heart Failure Accreditation Tool. Heart Failure Version 4 Accreditation, the Accreditation Conformance Database. Before we begin, users may find it helpful to access and review the following guides, the ACD Guide and the ACD Data Dictionary. These guides can be easily accessed by going to Additional Resources on the left menu section into the References and Resources tab. So first, let us review when to utilize the ACD. There are three phases to the accreditation process. In the first phase, all facilities must use the ACD to enter 30 patient encounters to comply with the baseline gap analysis phase. This must be completed within the first 60 days after initial access is granted into the tool. In the next two phases, facilities will then have various options to report their performance measures using the Accreditation Conformance Database, a National Regional Database or Registry, or a Facility Database and Reporting Tool. The ACD is not an electronical medical record and should only be utilized for the purposes of achieving and maintaining heart failure accreditation. The purpose of the ACD is to monitor clinical flow and daily patient-level processes, but not meant to guide real-time therapy. It is designed to track the level of care provided and patient movement through the continuum of care. The ACD was revamped for Heart Failure Version 4 to improve flow and user interface and will allow your facility to assess your compliance with mandatory items with minimal data abstraction efforts. For detailed ACD patient selection requirements, refer to the Patient Selection Criteria document under the References Resources tab within Additional Resources. The Patient Selection Criteria document provides detailed definitions on the patient population and volume that should be captured and included for data entry into the ACD. All patients captured into the ACD should be 18 years of age or older and have a primary diagnosis of heart failure and with any of the following ICD-10 codes. To access the ACD, click on the ACD on the left navigation bar of the Heart Failure Accreditation Online Tool. This will then open the ACD Patient Summary page. The table in the main body of the page will populate with any ACD patient encounters that have already been entered. In this example, there are several patient encounters that have been entered into the facility's ACD. To edit an existing ACD patient encounter, click on Details to enter or review that patient record. On the top left-hand side, there is an option to return to the main Heart Failure homepage by clicking on Return to Tool. Now moving to the far right-hand side, there is a three-line icon and a drop-down menu will appear when selected. Click on Help to access the ACD Guide. Selecting the Heart Failure Version 4 Data Collection Form provides a blank ACD Data Collection Form in PDF format to facilitate data collection. To enter a new patient into the ACD, select the Add Record button. When adding the new patient episode of care, the next screen will require the Patient ID, Encounter ID, and Date and Time of Arrival. Once entered, click on the Create Record button. The episode of care information may now be entered into the ACD. Information entered is saved upon entry. However, when working in the patient record, it is best practice to use the Save icon frequently. Click on the Save icon and allow a few seconds for the information to save. A pop-up window will then appear to confirm that the record is successfully saved. The purpose of the ACD is to track clinical flow and care that was provided to the patient. Therefore, logical algorithms within the Heart Failure Version 4 ACD were built within the data collection tool so that the user will only access and enter pertinent information that needs to be collected. Thus, this will decrease the data burden abstraction. Consequently, while entering the patient episode of care info, the Emergency, Department, Observation, and Inpatient tabs will only appear if warranted. The data points that impact this feature are the Arrival Location data field within the Admissions Arrival section, as well as the Disposition option in the Emergency, Department, and Observation tabs. If the incorrect Arrival Location, ED, or Observation Disposition is selected and needs to be changed, a warning message will appear to verify this change is intended. The option to cancel is provided and the current data entered will be preserved. However, if the change is necessary and the Continue button is selected, information collected previously within the Emergency, Department, Observation, or Inpatient tabs could be deleted. So please ensure that when performing this function, it is intentional to avoid any data that must be re-entered into the ACD again. Recall that earlier within the Heart Failure Accreditation Workshop Module 2, it was mentioned that within the facility profile and foundational information provided, the facility must elect which version of the ACD that will be utilized. Deciding which option was chosen will determine which data fields must be completed. Although the limited ACD option allows for minimal data abstraction to meet the mandatory clinical quality essential component requirements, all facilities are encouraged to utilize the full ACD dataset, as this option will provide a more robust set of performance metrics to analyze and provide a greater opportunity of insight and true operation of the facility's heart failure program. If electing to utilize the limited ACD, facilities will only need to capture the data elements denoted with a red asterisk and yellow highlight. These specific fields will populate the mandatory calculated measures and comply with 14 of the clinical quality mandatory essential components. If electing to utilize the full ACD, facilities must capture all data elements denoted with a red asterisk. These specific fields will populate the mandatory and recommended calculated measures. While answering the ACD data fields, please refer to the Heart Failure Version 4 Data Dictionary for additional clarification or intent on the target value to code each data element. In addition, there is helpful information available and embedded within the ACD. For example, if the blue question mark icon is selected beside a data element, a pop-up window will appear with additional information regarding that data field. Once all data fields have been entered and saved into the Patient Episode of Care, a facility has the option to activate the Record Complete feature. To activate this function, click on the three-line menu bar, select Complete, and then click Save. The Patient Episode of Care will now be saved as a completed record and can be noted on the Patient Summary page. By utilizing this feature, it provides a visual cue for tracking the completion of each individual patient record. For optimal accountability, each individual record should be checked Yes once data is completed. To delete a record, click on the three-line icon, and then select the Delete option. Clicking the Delete button will redirect to a confirmation window where verification to delete the record occurs in two locations. Check the small box on the upper left, Are you sure you would like to delete the record? Then click the Delete Record button. When entering the data into the Patient Episode of Care, a facility can easily reference the ACD Data Dictionary by selecting the Data Dictionary after clicking the three-line icon. In addition, the ACD Guide can be accessed as well by clicking on Help. Lastly, within the three-line menu bar, there is the option to select Heart Failure Version 4 Patient Data Report. This will allow the facility to print an ACD form, populated with any answers that the abstractor may have coded or saved to the record. As a facility is entering and completing the 30 baseline ACD patient encounters, the progress can be tracked on the Heart Failure homepage on the top right-hand side under the Facility Progression information. Once all 30 episodes of care have been successfully entered, saved, and marked as complete into the ACD, and all other components of the Baseline Gap Analysis are completed, the facility will go back to the Heart Failure homepage and select Submit Baseline. The ACD Randomization Program Option Before we begin this section of the workshop modules, users may find it helpful to access and review the Randomization How-To Guide. This guide can be easily accessed by going to Additional Resources and going to the References Resources tab. This document complements the topic that will be reviewed and provide a more comprehensive overview of the areas that will be covered. Therefore, it may be helpful to have this guide available as a reference while attending this portion of the module. After completing your Baseline Gap Analysis submission, the facility will now complete the next steps towards Heart Failure Accreditation, which includes the Application and Accreditation phases. As noted earlier, in these two phases, facilities will then have various options to continue to report their performance measures, which includes the Accreditation Conformance Database, a National or Regional Database or Registry, and or a Facility Database and Reporting Tool. If the facility elects to use the ACD as a method to continue their data collection, the patient selection criteria will remain the same in both phases. However, the facility will now have the option to select the volume of cases that are entered, either 100% of their patient volume or employing the ACC Randomization Program, which allows the site to enter only samples of their discharge heart failure population. If a facility elects to enter 100% of their heart failure patient volume, the facility will manually enter all records monthly. If the randomization option is chosen, then a CSV file will need to be generated and uploaded into the ACD. In both cases, all patients eligible to be entered into the ACD should be done so within 60 days of the final discharge diagnosis. Once the patient record is created, all data abstraction should be completed within 30 days. The randomization option allows for flexibility to accommodate small and large healthcare organizations and promote any heart failure data collection processes that a facility may already have in place. It is an automated process and requires minimal effort. A facility will submit a CSV file monthly to the ACD with all eligible patients meeting the patient selection criteria. The ACD heart failure accreditation tool will then randomly choose the sample of patients to be entered into the ACD. Given the background and purpose of the ACD randomization option, the facility will now select and declare their data submission plan. The randomization option will then select 30 patients or a number greater than 30 as selected by your facility. If the facility volume is under 30 records, all will be selected. If a facility needs to change after declaring their data submission plan, the facility will need to contact ACC Customer Care at CustomerCareAtACC.org. To upload a CSV file into the accreditation tool, select the three-line icon from the ACD Patient Summary page, then select Upload Sample File. This now directs the user to the CSV Sample Upload page. A Microsoft Excel template of the CSV file is available on the right-hand side of the CSV Sample Upload page. The CSV file must be formatted exactly as shown on the required CSV file structure sample. Any alteration from the stated format will force the program not to accept the patient list, which will slow down the required monthly data entry process. Then the user will select the collection sequence specific to the month the CSV file represents. Select the file to upload using the drop-down menu and click on the Upload key. Once the upload is complete, the system will immediately build a case in the ACD, representing which record was selected for sampling. Next, enter the patient record by clicking on Details and populate the information in the appropriate data fields to reflect care the patient received. If additional assistance is needed with uploading the CSV file, then reference the Collection Sequence Download Issue document. This document contains helpful information which may troubleshoot and assist in resolving technical issues. This concludes Lesson 1 of 2. Thank you for your participation. For more information, please visit www.cdc.gov. Thank you. For more information, please visit www.cdc.gov.

ACC Heart Failure Version 4

Accreditation Conformance Database

ACD randomization program

heart failure accreditation

patient data tracking