in the Cancer Registry
With more and more registrars working from home today, and administrators wanting to reduce cost and maximize efficiency, facilities are looking at ways to monitor productivity.
This can prove troublesome for some registry managers, as registries do not solely abstract cases, each case is individual and requires its own time to be completed. Registrars are also involved in other activities aside from abstraction, such as Quality Improvement, report generation, casefinding, follow-up, Cancer Committee and case conferences.
For each of these activities, determining what is considered an acceptable number may not be so easy. How many abstracts should be done in a day? How many cases should follow-up clerks complete? What is an acceptable number of items on a disease index or path reports to review in an hour? To answer these questions, time studies may need to be performed to measure an average number of completed activities in a given time period.
To measure productivity, consider using your software productivity reports. These can show how many cases have been completed during a specified time by an abstractor. They can also be used to monitor the number of follow-ups entered over a given time period. For even more detail, consider running audit logs to see what fields have been changed by a specified user on a given day. Audit logs typically also contain timestamps, which can show continuous work over a given time period, and can show second by second detail of changes made.
There are other registry functions that might not be quantifiable by running a report, and sometimes a log created in Excel or calendar print-outs can best show a use of time. For example, keep a log of every report request received, who ran the report, what day it was requested, and what day it was completed. You could also document the time needed to create the report or parse out the data to the requestor’s specifications. Calendars can show time spent in meetings over a daily/weekly/monthly basis and track the number of conferences or committee meetings attended. Time can also be blocked off to identify all the work that went into getting ready for those Cancer Committee meetings as well.
When monitoring productivity, it is also important to remember that everyone works at a different pace. One productivity number may be hard for some to achieve, or too low for others. Experience also plays an important role. Keep in mind that newer abstractors face a steeper learning curve than more experienced abstractors, instead of holding registrars to a finite number, look at performance improvement from an initial baseline over time. The “goal post” will also have to be moved occasionally. We all know that the time needed to collect required data elements today is far greater than what it was only a few years ago. Consideration must also be given to data items that individual registries require, that other registries do not. Whenever a new data item is added, or multiple items, consider how this may impact productivity. These changes must also be conveyed to administration if they are looking closely at productivity numbers.
It is also important to remember that we are in a quality-driven industry. The work we do impacts the future of cancer care. Although there may be more focus on productivity, there must be a happy-medium that allows for productivity goals, without sacrificing the quality of the data collected.