All Entries Tagged With: "quality"
Three tips to maximize the role of physician advisor
It’s been a year or so since you’ve started your CDI program. So far, so good. The administration thinks your team took miracle-worker training. So much so, they’ve agreed to let you add a physician advisor (PA) to the staff. And you’re all for it. You know a PA will add credibility to your documentation improvement efforts, act as a liason with difficult physicians, and help your staff memebers investigate documentation deterrents. Here’s how:
- Disseminate CDI program goals: CDI specialist’s struggle to strike just the right documentation chord to win physician support. Improved documentation equals better patient care, improved scores on the physician’s scorecard, improved hospital care, and of course the elephant in the room no one’s supposed to mention—better reimburment. While the primary goals of CDI programs are indeed the improved care of the patient, physicians sometime think the facility cares only about the bottom line. A PA who puts his support behind the CDI program explore the benefits in a concrete way that a CDI specialist with coding or nursing background cannot.
- Define communication issues and barriers: Maintain a consistent dialogue with your PA. Allow him or her to bring you constructive criticism from fellow physicians. Maybe cardiologists hate it when CDI specialists bug them at lunch time. Maybe the internists, however, think lunch time is the best time for documentation education. In this way the PA can provide invaluable tips for how to perform better.
- Update CDI team on relevant clinical issues: Ask your PA to review existing physician query forms and offer suggestions for how to improve them. Inaccurate, or clinically vague query forms cause physicians confusion. A PA who can head off these potential disputes can help put your CDI program ahead of the game. It’s a physician’s role to understand the latest clinical research. They can help your team understand it too.
Join Mark S. Michelman, MD, MBA, (Morton Plant Mease Health Care System) and Trey La Charité, MD (University of Tennessee Clinical Documentation Integrity Project) for the ACDIS audio conference “Physician Advisors in CDI: Take a Team Approach to Achieve Success and Credibility” on Tuesday, April 14, at 1 p.m. (Eastern).
On the program, the duo will discuss strategies to establish a successful CDI team structure, types of expectations and limitations you should place on your PA, as well as methods to quantitatively measure the progress of your PA and CDI team.
Appropriate investment in CDI helps programs bloom
Changes in the IPPS (Inpatient Prospective Payment System) led hospitals to develop clinical documentation departments to assist with these changes. Some hospitals hire consultants to initiate their novice CDI staff. They provide generous budgets to facilitate education and growth.
In many cases, the documentation departments outgrow the consultant firms hired to teach them as its staff members become more savvy about the ins and outs of their particular hospitals. As these departments expand, the hospital case mix index grows.
CDI programs need to be nurtured in order to bloom.
Some hospitals hire CDI staff members and provide only minimal education. They keep a tight budget and provide minimal flexibility. These programs grow with the help of available audio conferences and through networking. The staff struggle and grow slowly.
Other hospitals are reluctant to start clinical documentation programs. They hired one or two nurses or add new responsibilities onto their already busy coders. These hospitals provide little in the form of incentives or budget. The CDI staff members are simply told to go out and find MCC’s. These hospitals are often disappointed with the results.
Hospitals must realize that in every successful business, you get what you pay for. A successful clinical documentation improvement program can potentially bring in a great deal of otherwise lost revenue, as well as increase the case mix index.
While appropriate documentation for appropriate documentation’s sake is the clinical documentation improvment team’s mantra, hospitals must do more than plant a seed for documentation improvement results to grow. Similar to a garden, they must water and fertilize their programs in order to see them bloom.
Free CDI white paper for download: Culture of quality
Hi ACDIS members, I hope you’re all doing well. I wanted to let you know about a new white paper that is now available for free download in the Helpful Resources section of our Web site. It’s called “Instill a culture of quality to ensure CDI success,” and you download it by clicking here.
We plan to continue to provide you with additional CDI-related white papers in the coming year. These are intended to provide an in-depth look at various issues in the world of clinical documentation improvement. We’ll also be using them to provide you with opinions of differnet thought-leaders in the field. Not all the opinions expressed in these white papers are necessarily shared by ACDIS, but we hope you find the information beneficial, useful, and thought-provoking.
If you enjoyed this white paper, or have some questions and/or would like to discuss what you read, please post it right here on CDI Blog.
If you’d like to make a suggestion for a future white paper topic, please e-mail me at bmurphy@cdiassociation.com.
Take care,
Brian
In defense of Lumbergh’s TPS report
In one scene from the movie Office Space, the boss (Lumbergh) has to remind his staff members to put a cover sheet on the TPS reports. Company management even writes a memo about it.
To some, documentation queries may seem like that Office Space scene. Who cares about the cover sheet? Unlike that fictitious account of office hijinks however, the nuances of capturing every bit of clinical evidence in patient care documentation is much more important than a cover sheet.
Lack of complete, specific documentation means the potential loss of reimbursement dollars for a facility. It also misrepresents patient needs, facility expenditures, population data, and more-all of which will soon become paramount as payers aggregate data and focus their attention on quality of care.
Physicians will use this data, too. They’ll drill into documentation to spot trends, identify diseases, and develop new treatments for our top health concerns.
That’s why CDI programs can’t be compartmentalized strictly into a DRG capture service or a severity of illness analysis tool, nor a revenue generating program, says ACDIS board member Shelia Bullock, RN, BSN, MBA, CCM, manager of Clinical Documentation Services, at the University of Mississippi Medical Center, in Jackson.
“CDI is very important not just for physician documentation but for the total hospital process. Everyone needs to understand how this little piece affects the global picture of how things work,” Bullock says.
The most appropriate adjective to describe a patient’s condition may seem insignificant. A physician might think everyone knows the differenct between an acute and systolic CHF.
Did I push the Office Space movie metaphor too far? Ah, well. It’s a good movie at any rate. Take it as my suggestion for your next Netflix pick.