Session: (1082–1099) Measures & Measurement of Healthcare Quality Poster I
1085: Utilizing a Maintenance of Certification (MOC) Part 4 Quality Improvement Project to Improve Data Completeness in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry
Children's National Hospital Washington, DC, United States
Disclosure(s): No financial relationships with ineligible companies to disclose
Hemalatha Srinivasalu1, anne dennos2, alan Russell3, Mary Beth Son4 and Mara Becker2, 1Children's National Hospital, Washington, DC, 2Duke University, Durham, NC, 3Duke Clinical Research Institute, Duke, NC, 4Division of Immunology, Boston Children's Hospital, Boston, MA
Background/Purpose: Minimizing missing data in research registries is a universal challenge. Enrolling patients into a research registry with poor data quality is wasteful and potentially unethical, as it incurs risks and cost with minimal to no benefit. Data quality is a central focus for the CARRA Registry, and we aimed to improve data completion rates for the Registry's critical variables using quality improvement (QI) methodology and obtained approval for a large group MOC Part 4 QI project through the American Board of Pediatrics to obtain credit for maintenance of board certification.
Methods: The CARRA Registry Critical Variable MOC 4 Improvement Project is designed to improve data completion rates for critical variables in the CARRA Registry that are required to calculate disease activity outcomes in JIA (Physician Global and Patient/Parent Global scores) and SLE (Calculable SLEDAI Score and SLE Physician & Patient/Parent Global scores). The goal is to close the gap in data completion by 50% over a 12-month period (9/1/2022-8/31/2023).Participation in each project earns 25 MOC part 4 points. Outcome Measures are data completion rates at the Registry level; Process Measures are data completion rates at the site level in addition to completion rates of monthly site engagement surveys where site-specific Plan-Do-Study-Act (PDSA) cycles are documented. At the Registry level, two PDSA cycles were completed thus far: 1) development of site-specific critical variable reports with graphs to illustrate change over time and 2) initiation of monthly office hours/Q&A sessions. Participation is voluntary and each site can choose to participate in one or both projects. The final analysis will include run charts for each sub-project to display improvement over time, and data reflecting overall improvement will be analyzed by chi-square analysis. Data reported herein is an interim analysis as of May 2023.
Results: Out of 71 active CARRA Registry sites, 42 (59%) are participating. Baseline completion rates were calculated from approximately 38,000 visits across participating sites. There have been 5,067 follow up visits entered into the Registry (13% of total) since MOC project initiation. Key drivers and examples of site-specific PDSA interventions are indicated in Fig 1. Interim run charts for each critical variable show a trend towards improvement (Fig 2A-2E). Averaged critical variable completion rates at baseline and May 2023 are noted in Table 1.
Conclusion: Interim analysis reveals a trend towards improvement in completion rates of all targeted critical variables, but the rate of improvement is slower than originally anticipated. This is likely due to the limited cross-section of new visits occurring during the 8-month project period compared to the aggregated visits accumulated from Registry inception to September 2022. As sites accrue additional follow-up visits, and continue to trial site specific interventions, we hope to observe sustained improvement in critical variable completion rates within the CARRA Registry.
H. Srinivasalu: None; a. dennos: None; a. Russell: None; M. Son: None; M. Becker: None.