Appointments: Manual Booking using [ALT-M] in conjunction ...



Obstetric Ultrasound Configuration (XR Settings)

The following XR Settings are available to configure the CRIS Obstetric Ultrasound and Fetal Anomaly modules.

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APPOINT.ObsAdultAge

Age at which patients are considered adults for obstetric ultrasound appointment letters

This setting is used to define at what age Obstetric Appointment letters should be addressed directly to the patient, rather than the ‘Parent or Guardian’. This is typically between 12 – 14 years old rather than the usual 16 years old as per all other modalities.

REPORT.ObsAllowEFWbyACOnly

Calculate the EFW if FL and BPD not entered but AC is present

This setting is turned ‘On’ by ‘Default’ and uses Campbell AC Only Equation. The Trust therefore need to consider if this is a setting which should be Turned Off (i.e. Set to ‘No’) as ‘AC Only’ is often considered to be the least accurate EFW (Estimated Fetal Weight) calculation method. If ‘Turned Off’ the EFW field will not be filled in if only AC is entered.

REPORT.ObsEDDCalcOrder

Order to perform EDD Calculations

It is now possible to change the EDD calculation order for one or more obstetrics forms using the XR setting REPORT.ObsEDDCalcOrder. This can be configured at XRTR (Trust) level to allow the Trust to override default EDD calculations – i.e. prioritise HC over CRL on dating scans.

If left blank CRIS will default to the standard North West scan forms calculations methods for EDD as follows:

EARLY SCAN (ENW) - EDD captured at previous scan, if this is not present then EDD calculated on CRL.

DATING SCAN (DATNW) - EDD captured at previous scan, if this is not present then EDD calculated on CRL, if this is not present then EDD calculated on BPD.

ANATOMY (ANATNW) / DETAILED SCAN (DETNW) - EDD captured at previous scan, if this is not present then EDD calculated on HC, if this is not present then EDD calculated on FL, if this is not present EDD calculated on BPD.

GROWTH SCAN (GROWNW) - EDD captured at previous scan, if this is not present then EDD calculated on HC, if this is not present then EDD calculated on FL, if this is not present EDD calculated on BPD.

Consequently, to override the default EDD calculation of CRL for the Dating scan it would simply be a case of entering the following via the XR Value:

datnw = hc crl fl bpd or to apply this to more than one scan you should use a semi colon – i.e. datnw = hc crl fl bpd ; anatnw = hc fl bpd

REPORT.ObsEDDCutOffDays

Number of days before EDD is validated

This setting is used to determine the No. of Days before the EDD is validated. The Trust will need to define the No. of Days (i.e. 56 Days – 8 weeks) after which the EDD is considered accurate and will be carried through on all subsequent scans. Alternatively, prior to this date EDD will be recalculated on each subsequent scan, but recorded for reference on the original scans.

REPORT.ObsEDDPrintedBelowCutOff - New

Number of days before EDD is validated

This setting is used to control whether or not the EDD is printed on the Obstetric report based on customer preference. The EDD can always be printed, never printed, or printed depending on fetal heartbeat for gestational ages when the scan takes placed prior to the EDD validation cut-off for North West scan forms.

Options are Yes = Always Print, No = Never Print and FHBP = Print only if Fetal Heartbeat Present.

REPORT.ObsEFWPriority

Set the EFW calculation equation priority

The default configuration of CRIS is to calculate the EFW using the equation priority as follows:

If the AC and FL are entered then CRIS uses the Hadlock 1 formula, If AC and BPD are entered then CRIS uses the Shepherd equation, If only AC is entered then CRIS uses the Campbell equation, unless configured so that this equation is ignored.

CRIS can however be configured using this setting to change the order of equation priority from the default. Changing the default priority order will also allow the users to choose a specific equation for calculating the EFW on this report.

Please note: Unless otherwise stated HSS recommend H2,H1,S (Hadlock 2, Hadlock 1 and Shepherd).

REPORT.ObsLMPEDDMargin

Difference in days before measurement EDD overrides LMP EDD

This setting is used to define the maximum number of days variance allowed between the EDD calculated by LMP, and by Measurements. This is ‘10 days’ by default but can be modified by the Trust to specify the No. of Days before the EDD by LMP calculation is ignored in favour of measurements.

REPORT.ObsOutcomeExam (For Use with Fetal Anomaly Module Only)

The examination used to record Pregnancy Outcomes

This field is used to define the examination which should be used for Obstetric ‘Postnatal’ Outcome Reports.

It is recommended that the Trust add the examination ‘ZOUTFA’ - Fetal Anomaly Outcome Report to the Examination Codes table via all CRIS instances (i.e. Live, Test and Training) and ensure that the Modality is set as ‘O’ in order for this feature to function correctly.

REPORT.ObsRescanDays / REPORT.ObsRescanDays2 and REPORT.ObsRescanTitle / REPORT.ObsRescanTitle2 – New

Number of Days after which an Anatomy or Growth Scan should be booked with user definable description.

It is now possible to configure the system to include projected rescan dates for Anatomy / 20 week and Growth Scans and to define the description displayed against these fields via the Dating Scan forms.

If fields are left blank the default is Anatomy Scan 20 weeks (i.e. 140 Days). However the following 20 Week Scan and Growth Scan projected dates have been configured via XRTR (Trust):

|20 WEEK SCAN |GROWTH SCAN |

|REPORT.ObsRescanDays = 140 |REPORT.ObsRescanDays = 238 |

|REPORT.ObsRescanTitle = 20 Week Scan |REPORT.ObsRescanTitle = Growth Scan |

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REPORT.ObsSDValue

The standard deviation modifier for the obstetric graphs

This setting is used to override ‘Centile Display on Graphs’ should the Trust wish to change the displayed values. The lower and upper centiles as displayed on the graphs show 3rd and 97th centiles by ‘Default’. For 3rd and 97th this would be blank (default) or 1.88. For 5th and 95th this should be set to 1.5. For 10th and 90th this should be set to 1.28.

REPORT.ObsSacVolume

Does the obstetrics module calculate sac volume instead of mean sac diameter?

Used to control if the CRIS Obstetrics system should calculate the ‘Sac Volume’ from measurements rather than displaying the mean value. Set to ‘No’ by ‘Default’.

REPORT.ObsShowMeasurementRange

Replace the + / - days on an obstetric report with a measurement range indicator

This is set to ‘Yes’ by ‘Default’ and displays a graphical representation of the normal measurement range. If set to ‘No’ CRIS will instead display Measurement variance as +/- 2 days although HSS do not recommend this approach unless discussed with the HSS PM or CRIS Helpdesk.

REPORT.ObsUseLMPForEDD

Use LMP when generating suggested EDD

The use of LMP to calculate EDD is not enabled on the North West Scan forms by ‘Default’. This setting is therefore designed to enable this if required by the Trust, and on condition that the ‘LMP’ field is completed via the ‘Event Details’ prior to reporting.

Document Control

|Title |2.09.10 Obstetric Reporting Configuration |

|Author |Emma Savage-Mady |Date Created |30/04/2010 |

|File Ref. |RIS_CRIB296_2.09.10e_Obstetric_Reporting_Configuration_v1.2 |

|Approval Sign-off |

|Owner |Role |Method of approval |Date |

|Emma Savage-Mady |Training / Documentation Manager |Verbal |30/04/2010 |

|Approver |Role |Method of approval |Date |

|David Costin |Trainer / Application Specialist |Verbal |14/06/2010 |

|Change History |

|Issue |Date |Author / Editor |Details of Change |

|1.0 |30/04/2010 |Emma Savage-Mady |First Issue |

|1.1 |14/06/2010 |Emma Savage-Mady |Amendment to XR configuration screenshot |

|1.2 |04/07/2011 |David Costin |Amendment to show version number for 2.09.10e |

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|Review Date |14/06/2010 |

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