the health roundtable consultant led abf meetings presenter: sharon linton sir charles gairdner...
TRANSCRIPT
The Health Roundtable
Consultant Led ABF meetings
Presenter: Sharon LINTON
Sir Charles Gairdner Hospital
Innovation Poster SessionHRT1215 – Innovation AwardsSydney 11th and 12th Oct 2012
14-4c_HRT1215-Session_LINTON_TCG_WA
The Health Roundtable
KEY PROBLEM
There is currently a disconnect between Clinicians and Clinical Coding
This results in Missed revenue opportunities No education or feedback mechanism for junior staff
to alert them on what is vital / superfluous information for Clinical Coders
No feedback to Consultant staff regarding utility of Junior Doctors entries from a coding/revenue perspective
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AIM OF THIS INNOVATION
To identify, and implement a process that enables Clinical Coders to more accurately capture information regarding a patients episode
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BASELINE DATA
The size of the problem was unknown prior to undertaking this study
There was however a perception amongst Coders, Consultant Staff and Hospital Executive that there was a significant amount of under-coding given issues with current process
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KEY CHANGES IMPLEMENTED
Multidisciplinary Meeting Trial October – December 2011 1x Medical and 1x Surgical Team involved in trial Consultants, Junior Staff and Clinical Coder present
for 45 minute meeting Process
1. Notes gathered for all patients with a LOS of greater than 7 days, who were discharged in the past week
2. Simultaneous projection of discharge summary and coding software3. Revision of all cases for coding together with the discharge letter.4. One set of notes was selected for further analysis of Junior Medical
Staff entries.
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The Health Roundtable
OUTCOMES SO FAR
Immediate advantages evident Medical Teams
100% of Discharge Letters reviewed by Consultants Education direct to Consultants and Junior Staff regarding
‘key terms’ that need to be included to ensure episode can be captured – ie ‘acute exacerbation of COPD’
Quality of documentation for Clinical Care increased as a result of weekly consultant review
Coding Teams Delights of clinical terms, humour and slangs of a surgical team Education of junior and senior staff to coding requirements in the
notes and key words for DRG changes in their specialty 100% coding done within a week Accurate input of medical team as cases very recent or ongoing
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OUTCOMES SO FAR
Financial Outcomes 30% of cases reviewed in the presence of Consultant,
Junior Staff and Clinical Coders had a DRG change The financial outcomes of this change, per case was
Medical - $5,000 Surgical - $10,000
If extrapolated just across General Surgery (2000 annual separations), additional annual revenue = $6m p/a
If extrapolated across all hospital units, a conservative estimate at additional revenue = $50m p/a
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LESSONS LEARNT
Consultant staff need to see the clinical benefit in facilitating these meetings
Dual projection facilitates the simultaneous viewing of Discharge Summaries and Coding software
This meeting format demonstrated significant outcomes such as timeliness and accuracy of letters, revision of late patients results, confirmation of all clinical follow up plans, accuracy and readability of junior staff entries
The Health Roundtable
Contacts
Professor Luc Delriviere
Head of Service – WA Liver and Kidney Transplant Service
Sir Charles Gairdner Hospital
Sharon Linton
Coordinator, Clinical Coding
Sir Charles Gairdner Hospital