Health Records Administrator

7 months ago

New Westminster, Canada Fraser Health Full time

Detailed Overview

Reporting to the BC Trauma Registry Leader, the Health Records Administrator works within a team-based environment, performs interpretation, abstraction and codification of data and assists in the operation and maintenance of the Trauma Registry for designated acute care facilities. Duties include interpreting and abstracting data, scoring data by injury, entering data into computer, compiling statistical data, performing statistical analysis, generating a variety of reports as directed, communicating with internal and external personnel regarding data retrieval and interpretation, processing approved release of data requests, providing input into the review and revision of policies and procedures, and participating on various committees and in designated projects as assigned. Responsibilities Analyzes, abstracts and codes data by performing duties such as interpreting and abstracting data, scoring data by injury and entering data into the Trauma Registry in accordance with established standards and procedures to maintain the Trauma Registry for designated acute care facilities. Assists with the operation and maintenance of the Trauma Registry by performing database management activities such as identifying duplication of information, performing quality control checks on fields, and running system administration functions in accordance with established procedures. Notifies supervisor and/or Manager, BC Trauma Registry of problems and works with designate team members and information systems personnel to resolve system issues. Transfers Trauma Registry data to the BC Trauma Registry by performing completion checks and uploading data in accordance with established standards, procedures and timeframes to meet BC Trauma Registry time lines. Performs statistical analysis of data as requested for use in research studies or for administrative purposes by methods such as reviewing data fields, extracting required information, organizing and presenting data using spreadsheets, graphs, databases or other software applications as requested. Generates a variety of reports as requested to compile information for continuous quality improvement and quality assurance, epidemiology, planning, utilization, research, and injury prevention. Participates in summarizing and interpreting results of data analysis in reports. Communicates with internal and external personnel by providing information regarding topics such as requests for Trauma Registry data, data interpretation and operation of the Trauma Registry, referring issues or problems such as release of information authorization or Trauma Registry errors to supervisor or Manager, BC Trauma Registry as required. Processes approved release of data requests in accordance with established policies, procedures and legislation by methods such as reviewing information, generating a variety of reports, completing required documentation, and communicating with internal and external requestors. Provides input into the review of the BC Trauma Registry policies and procedures by participating in the examination of the existing policies to determine if updating is required, reviewing work processes to identify problems and inefficiencies for discussion, evaluating technical literature/material to identify new or revised procedures/equipment to improve operations, and making recommendations into the development of, or changes to, selected policies, procedures or protocols. Prepares new or revised forms, policies and procedures for site operation of the Trauma Registry for review and consideration by the supervisor and/or the Manager, BC Trauma Registry. Participates in Trauma Registry meetings to discuss outstanding issues and problems by providing information on topics such as data quality, injury scoring, data interpretation/abstraction and Trauma Registry system to ensure data consistency and quality is maintained. Participates on various internal and external multidisciplinary committees to represent the Trauma Registry and to provide input regarding Trauma Registry information management and related topics to ensure issues affecting the Trauma Registry are considered and standards are maintained. Participates in designated projects as assigned by attending project meetings, assisting with the development of project parameters and providing technical input. Maintains files of Trauma Registry information such as data forms, computerized reports and policies and procedures by filing, replacing and destroying information as directed through established policies. Maintains data dictionaries, information indices, correction notices and automated databases according to established procedures and standards. Prepares and submits workload activity reports by recording, tabulating and summarizing workload activity information as required. Sets measurable goals and objectives within a team or individual environment, incorporating the organization's as well as the BC Trauma Registry's vision and values, goals and corporate plan, through methods such as maintaining and updating knowledge of professional development within area of practice, and developing plan in collaboration with supervisor and/or Manager, BC Trauma Registry. Reviews progress to ensure that goals are achieved within established time frames. Performs other related duties as assigned. Qualifications Education and Experience Graduate from an approved Health Record Administrator or Health Record Practitioner diploma program, successful completion of the Canadian College of Health Record Administrator's examination at the Certificant level plus one year's recent, related experience including data interpretation, analysis and coding in an acute care setting or an equivalent combination of training and experience. Skills and Abilities Broad knowledge of the Abbreviated Injury Scale (AIS) and Injury Severity Scoring. Broad knowledge of Canadian Institute of Health Information's coding and abstracting systems including the International Statistical Classification of Diseases and Related Health Problems (ICD) and the Canadian Classification of Health Interventions (CCI) currently utilized in BC. Comprehensive knowledge of pathophysiology terminology and disease processes. Demonstrated ability in use of advanced computerized databases and related equipment and software applications such as Windows, MS-Word, MS-Excel, MS-Access, MS-PowerPoint, report writers, relational databases, and statistical analysis. Demonstrated ability to analyze and present data effectively. Demonstrated ability to develop policy and procedure protocols and manuals. Demonstrated ability to communicate effectively both verbally and in writing. Demonstrated ability to organize and prioritize work. Demonstrated ability to work independently, and in collaboration with others. Demonstrated ability to deal effectively with others. Physical ability to perform the duties of the job.

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