National Rehabilitation Reporting System (NRS) eBulletin

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National Rehabilitation Reporting System (NRS) eBulletin

Summer 2014

NRS Highlights

NRS Submission Reports—Interpreting Warning Messages

RPG 2014-2015 Grouping Methodology Now in Effect and Available

Body Mass Index and Stroke: Presentation from the GTA Rehab Network Best Practices Day 2014

Brain Injury Association of Canada Annual Conference

Data Submission Deadlines and eReporting Timelines for the NRS

NRS Education and Related Resources

Coming Soon: Reference Guide for Classifying NRS Health Conditions

Validation of the FIM® instrument in French

Basic Tips for Accessing NRS Education

Quarterly NRS Discussion Forum: Most Frequent Mistakes that Hurt your Data

Upcoming NRS Education and Events

NRS Data Quality Corner

Using ICD-10-CA “z-codes”

Expanded Content

NRS Highlights

NRS Submission Reports—Interpreting Warning Messages

NRS Submission Reports provide detailed information about the status of data records submitted to the NRS database. In certain situations, the Submission Report flags an NRS record with a warning message intended to highlight potential data quality issues that should be examined by the facility.

For example, according to NRS standards, a comorbid health condition already recorded on admission should not be repeated on the discharge record. While in select cases there may be a valid reason to do so, the repetition of the same ICD-10-CA code on the discharge record would generate the following warning message in the Submission Report: 
Warning 100001: Duplicate Comorbid Recorded on Admission and Discharge

Warning messages are different from errors in that they do not cause the record to be rejected. A record with only a warning will still be accepted into the NRS database (as long as no error messages exist for the same record). There is no need to contact CIHI to explain the outcome of your subsequent internal review, though submission of updated records may be required. For the example above, it may be a matter of removing the duplicate comorbidity and submitting an update to the discharge record.

For ease of interpreting your NRS Submission Reports, you can access a table that explains all warnings that may be encountered. This table is found in the beginning of the Rehabilitation Minimum Data Set Manual–Module 1, under the Data Submission Requirements section.

RPG 2014-2015 Grouping Methodology Now in Effect and Available

The Rehabilitation Patient Group (RPG) grouping methodology is unchanged for 2014–2015. However, there are updates to the RPG rehabilitation cost weights (RCWRPG) and trim points now in effect for 2014-2015.

· The updated RCWRPG and trim points for 2014-2015 are now available as a stand-alone document titled RPG Rehabilitation Cost Weights and Trim Points 2014-2015<http://emktg.cihi.ca/UrlTracking.aspx?em_key=08jafBPP2lU9Ha/fRgpc89twkWtkwvt7pRYQwdGchCoOfLXGIWW6Y6UWEMHRnIQqBhpWE2CtJ3A5bqfdhCmHXL3vARe3YTEE&em_url=about:http%3a%2f%2fwww.cihi.ca%2fCIHI-ext-portal%2fpdf%2finternet%2fNRS_EREPORTS_RPGWEIGHTS_EN>.

· The complete RPG Grouping Methodology 2014-2015<http://emktg.cihi.ca/UrlTracking.aspx?em_key=08jafBPP2lU9Ha/fRgpc89twkWtkwvt7pRYQwdGchCoOfLXGIWW6Y6UWEMHRnIQqBhpWE2CtJ3A5bqfdhCmHXL3vARe3YTEE&em_url=about:https%3a%2f%2fsecure.cihi.ca%2festore%2fproductFamily.htm%3flocale%3den%26pf%3dPFC2480%26lang%3den%26media%3d0>, including cost weights, trim points, SAS code and detailed flowcharts for the RPG logic is also available free-of-charge for NRS facilities.

Body Mass Index and Stroke: Presentation for the GTA Rehab Network Best Practices Day 2014

Members of the CIHI Rehabilitation team presented on relationships between Body Mass Index (BMI) and outcomes following inpatient stroke rehabilitation. Findings included that underweight patients demonstrated the poorest outcomes overall. Higher BMI groups were not associated with poorer inpatient rehabilitation outcomes when compared with the normal BMI group. Click here<http://emktg.cihi.ca/UrlTracking.aspx?em_key=08jafBPP2lU9Ha/fRgpc89twkWtkwvt7pRYQwdGchCoOfLXGIWW6Y6UWEMHRnIQqBhpWE2CtJ3A5bqfdhCmHXL3vARe3YTEE&em_url=about:http%3a%2f%2fwww.gtarehabnetwork.ca%2fuploads%2fFile%2fbpd%2f2014%2fLiam_Dessureault_Rapid_Podium.pdf> to view the presentation slides.

Are You Attending the Brain Injury Association of Canada Annual Conference?

The Annual Conference of the Brain Injury Association of Canada<http://biac-aclc.ca/2014/01/22/annual-conference-2014/> will take place in Gatineau, QC September 24-26. Members of the CIHI Rehabilitation team will be presenting findings on Outcomes from Inpatient Rehabilitation Following Traumatic Brain Injury in Canada. We look forward to meeting some of our NRS contacts in Gatineau!

Data Submission Deadlines and eReporting Timelines for the NRS

The following is a reminder of NRS submission and comparative reporting timelines:

Quarter

Reporting Period

Data Submission Deadline†

NRS eReports Data Updated*

Quarter 1

April 1 – June 30

July 31

Approximately 4 weeks after the Data Submission Deadline

Quarter 2

July 1 – September 30

October 31

Quarter 3

October 1 – December 31

January 31

Quarter 4

January 1 – March 31

April 30

†The NRS quarterly data cut is taken two weeks after the data submission deadline. This additional time between the submission deadline and the data cut allows facilities to submit corrections for records that were submitted by the submission deadline, but were rejected due to errors.

* This date may vary slightly according to CIHI’s internal production schedule.

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NRS Education and Related Resources

Coming Soon: Reference Guide for Classifying NRS Health Conditions

The CIHI Rehabilitation team is preparing a new set of resources for those that are responsible for capturing NRS health conditions. This set will include a reference guide providing detailed coding directives, standards for assigning ICD-10-CA codes using the NRS pick list, as well as tables of health conditions most commonly associated with each Rehabilitation Client Group (RCG). Facility Coordinators will receive information about the availability of these resources in the early Fall.

Validation of the FIM® instrument in French

CIHI is collaborating with external experts on technical and clinical validation reviews of the French translation equivalency of the current FIM® instrument guidelines. As a result, there will be slight changes to the instrument guidelines available to French-speaking NRS Assessors for the 2015-2016 reporting year. The new French version should be easily adopted and the English guidelines will not be affected.

Basic Tips for Accessing NRS Education

· You must log in with a valid Learning Centre account in order to view the complete NRS course listing. Ask your Account Manager/NRS Facility Coordinator for help in creating a personal Learning Centre account.

· Registration is required for NRS courses.

· Forgot your password? If you know the username for your account, you may recover the password using the “email me my password” link on the login page<http://emktg.cihi.ca/UrlTracking.aspx?em_key=08jafBPP2lU9Ha/fRgpc89twkWtkwvt7pRYQwdGchCoOfLXGIWW6Y6UWEMHRnIQqBhpWE2CtJ3A5bqfdhCmHXL3vARe3YTEE&em_url=about:https%3a%2f%2flearning.cihi.ca%2finclude%2flogin.asp%3furl%3d%2fusers%2findex.asp>.

Can’t attend a live event?

The NRS catalogue includes many self-study courses and several web conference recordings. The self-study format – intended to serve as adjuncts to the in-house training programs that facilities already have in place as part of NRS participation – can meet your training needs anytime and anywhere there is an Internet connection!

For further assistance with accessing NRS education, please contact education@cihi.ca<mailto:education@cihi.ca>.

Quarterly NRS Discussion Forum: Most Frequent Mistakes that Hurt your Data

The Summer edition of the 90-minute web conference will be a chance to discuss assessment and coding errors commonly encountered, with particular interest in mistakes that are not identified by the NRS specifications upon submission. As usual, there will be periods for questions and discussion for hospital staff involved in NRS training, data collection, submission and analysis.

When: August 28, 2014 (2:00-3:30 pm EDT)

Participants are encouraged to submit discussion topics or questions in advance by sending them tonrs@cihi.ca<mailto:nrs@cihi.ca>.

No advance registration is required for this event. It is recommended that participants log in at least 15 minutes prior to the start of the session. Exceptionally, this NRS session is not available in the CIHI Learning Centre.

On the day of the event, please use the login information below:

1. 
Event Login: http://cihi.adobeconnect.com/nrsdiscussionforum/ 
2. 
Please login (as a "Guest") with your full name or the full name of your facility (to permit follow up communications, if needed) 
3. 
Audio Dial In Number: 1-888-289-4573 
4. 
Audio Access Code: 6637301

Upcoming NRS Education and Events

Date

Web Conference Title

August 28

NRS Discussion Forum

September 18

NRS for Trainers – Part 2*

September 23

Building Your NRS eReports

September 25

Introduction to Understanding RPG Reports

November 17

Introduction to Understanding RPG Reports

*The following pre-requisites must be completed to register for NRS for Trainers – Part 2 web conference:

NRS for Trainers – Part 1; and 
NRS Data Quality and Training Others

Workshop Location

Date

Workshop Title

Winnipeg, MB

September 10

Building and Using Your NRS eReports Strategically

Kitchener, ON

October 8

Building and Using Your NRS eReports Strategically

Hamilton, ON

October 22

NRS for Trainers – Part 2†

†The following pre-requisite must be completed to register for NRS for Trainers – Part 2 workshop:

NRS for Trainers – Part 1

NRS Data Quality Corner

Using ICD-10-CA “z-codes”

The NRS ICD-10-CA pick list includes a group of “z-codes” which can be used to identify additional factors that influence health status and contact with health services. For example, codes are available to record transplant status of various organs, the dependence on renal dialysis, or the absence of a specific limb.

These z-codes are not intended to be diagnostic in nature and therefore should not be used to identify the NRS Most Responsible Health Condition (MRHC). For example, a client admitted for therapy following a total hip arthroplasty should have the etiological condition for the joint replacement recorded as the MRHC (example: M16 Coxarthrosis [arthrosis of hip Includes: Osteoarthritis of hip]). It is not appropriate to record the MRHC as Z96.60 Presence of artificial hip; as this information is already provided by the Rehabilitation Client Group (RCG). This code could be assigned, however, as a Pre-admit Comorbid Health Condition to identify the presence of the artificial joint in a client otherwise admitted for an unrelated condition.

Contact Us

For additional information or questions about any of the topics presented in this eBulletin, please contact the Rehabilitation team at nrs@cihi.ca<mailto:nrs@cihi.ca>. 
Contact us to subscribe to<mailto:nrs@cihi.ca?subject=Subscribe%20to%20NRS%20eBulletin> or unsubscribe from<mailto:nrs@cihi.ca?subject=Unsubscribe%20from%20NRS%20eBulletin> the NRS distribution list.

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Canadian Institute for Health Information (CIHI)

495 Richmond Road, Suite 600

Ottawa, Ontario K2A 4H6

T: 613-241-7860

F: 613-241-8120

nrs@cihi.ca<mailto:nrs@cihi.ca>

Better data. Better decisions. Healthier Canadians.

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