Finger Lakes Region HELPER Guidelines
The attached include additions to the Guidelines for the New York State Certificate of Live Birth & Quality Improvement 2011. These additions were included after seeking increased clarifications from The NYSDOH Bureau of Vital Records Department and the Finger Lakes Region Primary Investigator.
2017 HELPER Guidelines
Registrar Questions Asked and Answered
What is a Coder/Registrar?
Birthing hospitals are required to have a staff member who is certified with the New York State Department of Health and is trained to enter birth data into the Statewide Perinatal Data System. For infants born at home or at a non-birthing hospital, parents work directly with their local Office of Vital Statistics to obtain birth certificates for their infants. Birth Coders, staff who collect and enter birth data, are known by different names: Coders, Birth Registrars, and Birth Certificate Registrars to name a few.
Birth Certificate Process
The Birth Registrar's job responsibilities include gathering information about the new mother's prenatal, intrapartum and delivery experience, as well as her immediate post-partum course and the infant's newborn experience until discharge or the 1st 5 days of life whichever is longer. In addition, the Registrar collects information directly from all new mothers related to their experiences prenatally including information and materials gained from the prenatal care provider. Obtaining information from the new mother can be time consuming for the Registrar as the new mothers are busy with their new infant and answering questions regarding their prenatal period is not a top priority. In addition to collecting the birth data the Registrar can assist the mother in obtaining a Social Security number for her infant and when appropriate she assists in the filing of an Acknowledgement of Paternity form if requested by those who are not married.
Over 300 data fields are collected on each birth to complete the birth certificate. These include fields required for all United States births by the Center for Disease Control and Prevention as well as additional New York State required fields.
Once the birth information is collected, the Registrar enters the data into the Statewide Perinatal Data System (SPDS) after which an abstraction of the entered data is printed which is then attached to a Certificate of Live Birth and is then signed by the certifying/delivering provider. The Registrar, then, sends the Certificate of Live Birth with any added forms to the Office of Vital Statistics. Six to eight weeks later the Office of Vital Statistics mails a formal Birth Certificate to the new parents.
Initial and Ongoing Training
New Registrars are asked to complete seven (7) training modules which correspond to the different sections of the Birth Certificate workbook as part of their orientation to the position of Birth Registrar. These modules allow the new Birth Registrars to self-study as they learn the basics of birth information collection, requiring less of the hospital staff's time. The modules were created with input from the Data Coordinator, Registrars, and the physician who oversees the Birth Certificate project for New York State.
Monthly "scenarios" serve as an ongoing training tool. They are distributed via email to all Birth Registrars. These scenarios include a brief description of a "situation" and require the Registrar to make a decision based on the information presented and send their response to the SPDS Coordinator. This exercise requires little of the Registrar's time and assures that everyone in the Finger Lakes Region is collecting and entering the required information in the most uniform manner possible.
Quarterly Registrar Meetings are a combination of in-service training and staff meeting. They provide a forum where Birth Registrars, who often work in isolation from other Birth Registrars, can ask questions and discuss issues. All questions raised by the Region's Registrars since the previous Registrar Meeting are discussed. These meetings help Registrars gain a better understanding of the fields they are asked to fill in while increasing their confidence in their decision making ability.
Faculty from the Regional Perinatal Center and guest speakers are asked to present information at Registrar Meetings on topics related to their research using birth data or to some aspect of medical information that the Registrars encounter (e.g., Birth Certificate infection fields). The outside presentations reinforce the valuable role played by the Birth Registrars to our understanding of how to improve care and pregnancy outcomes.
Annually the Regional Perinatal Center (RPC) is required to meet with each Regional hospital's Obstetrics and Nursery / NICU personnel. This is generally lead by the Primary Investigator (from the RPC) and an attending NICU pediatrician. The previous years' birth statistics are reviewed and many of the transferred mothers and babies are discussed (transfers from the outlying hospital to the RPC). Changes and intended changes in care are, also, discussed.
The Data Coordinator is available, if needed, to answer questions on the coding of the data presented.
The Birth Registrars are encouraged to attend. As the Data Coordinator is required to make an annual "home" visit with the hospital's Registrars. This is a perfect opportunity to combine the two meeting attendance and the annual Registrar review.
All training is directed toward increasing the accuracy, completeness and reliability of the data collected and entered into the Statewide System.
Acknowledgement of Paternity
A good resource for Registrars and families -
Paternity establishment - What and Why
Instructions for Completing the Acknowledgement of Paternity