Tracking your success

leanne.sterlingleanne.sterling
edited May 2016 in CDI Talk Archive
Does everyone have an automated program that tracks the success of your
CDI program? Does anyone track it manually?

Thanks

Leanne Sterling, RHIT
Clinical Documentation Specialist
Cullman Regional Medical Center


Comments

  • digardskdigardsk
    edited May 2016
    Software - JATA.


  • davisd2davisd2
    We use JATA

    Denise Davis RN
    Clinical Documentation Specialist
    Quality Management
    Sonora Regional Medical Center
    1000 Greenley RD Sonora Ca 95370
    209-536-3290
    davisd2@ah.org
  • fentona@bronsonhg.orgfentona@bronsonhg.org
    edited May 2016
    We track electronically w/ assistance from our consulting company.
    Amy


  • robert.hodges2robert.hodges2
    edited May 2016
    I do it manually but am looking at a system to do automated tracking and
    trending.

    Robert

    Robert S. Hodges, BSN, MSN, RN

    Clinical Documentation Improvement Specialist

    Aleda E. Lutz VAMC

    Mail Code 136

    1500 Weiss Street

    Saginaw MI 48602



    P: 989-497-2500 x13101

    F: 989-321-4912

    E: Robert.Hodges2@va.gov



    "Anyone who has never made a mistake has never tried anything new."
    -Albert Einstein




  • tdavistdavis
    We use 3M
  • leanne.sterlingleanne.sterling
    edited May 2016
    Can you tell me a little bit about how you do it?



    Leanne Sterling, RHIT

    Clinical Documentation Specialist

    CRMC

    Ext: 2508


  • tdavistdavis
    In 3M we use CDIS package for entering our information. We are able to run reports on proposed iand final DRG, queries, etc. We also then send data to 3M where they do statistical analysis of our data including physician response, high and low CMI, CCs/MCCs/None, HAC, and how we compare to same time frame the prior year. They adjust the results according to patient volume for medical/surgical cases for specific DRGs. We are able to actually see where we stand financially, as well as, how we compare to the benchmark.
  • epraczepracz
    edited May 2016
    We would like to know if the person who posted this would talk with us on the phone. We are in the process of upgrading our software and would like to ask a few questions regarding the 3M CDIS package. Please respond back to my email address listed.

    Thank you,
    Eileen Pracz, RN
    Clinical Documentation Specialist
    Oregon Health Science University
    503-418-4023
    fax 503-494-8439
    pracze@ohsu.edu




  • fentona@bronsonhg.orgfentona@bronsonhg.org
    edited May 2016
    We use 3M as well, feel free to contact me directly if I can be of assistance.
    Amy

    Amy Fenton, RN
    Clinical Documentation Specialist
    Clinical Operations Improvement
    Bronson Methodist Hospital
    601 John Street - Box 59
    Kalamazoo, MI 49007
    Office: (269) 341-8442
    Fax: (269) 341-8330
    Pager: (269) 513-3131
    E-Mail: fentona@bronsonhg.org


  • dbutlerdbutler
    edited May 2016
    If you review the vendors at the ACDIS conference (the website has a list), there are a number that provide solutions that may be helpful.

    We started our program with JA Thomas, and use their software. However I am some what of a stubborn sort and want my data analysed the way I want it done, so I dump data from JATA into an access data base, add from one or two other sources and then go at it.

    It is not very difficult to develop an Access data base or an Excel spreadsheet to be adequately track activity and success, and really is all you need.

    Take a look back through the depths of the Forms & Tools Library, I believe there is a sample excel tool there.

    Don

    Donald A. Butler, RN, BSN
    Manager, Clinical Documentation
    PCMH, Greenville NC
    dbutler@pcmh.com



  • bea.smithbea.smith
    edited May 2016
    Robert,

    Would you be willing to discuss on the phone when you have some free
    time? We also do ours manually and would like to discuss your process to
    see if we can better ours.



    Bea Smith, RHIT

    Clinical Documentation Specialist

    Cullman Regional Medical Center

    ph: 256-737-2926

    fax: 256-737-2714



  • robert.hodges2robert.hodges2
    edited May 2016
    Bea,

    Email me directly and we can figure out a time. Robert.Hodges2@va.gov

    Robert

    Robert S. Hodges, BSN, MSN, RN

    Clinical Documentation Improvement Specialist

    Aleda E. Lutz VAMC

    Mail Code 136

    1500 Weiss Street

    Saginaw MI 48602



    P: 989-497-2500 x13101

    F: 989-321-4912

    E: Robert.Hodges2@va.gov



    "Anyone who has never made a mistake has never tried anything new."
    -Albert Einstein




  • robert.hodges2robert.hodges2
    edited May 2016
    Manually, I have a database with all of my reviews, clarification
    requests, responses, etc. I then pull reports with the final coded
    DRG's and ICD-9 codes and enter those manually for each encounter I
    review into my database. After that I run reports from the database
    that I report on. It's time consuming, but it's the only way I have to
    ensure accurate data. I run other reports showing overall DRG frequency
    and case mix index from other systems as well as reimbursement reports,
    but again, it's a manual process. I'm hoping for something better in
    the near future, but am happy now that I simply have access to the data
    I need.

    Robert

    Robert S. Hodges, BSN, MSN, RN

    Clinical Documentation Improvement Specialist

    Aleda E. Lutz VAMC

    Mail Code 136

    1500 Weiss Street

    Saginaw MI 48602



    P: 989-497-2500 x13101

    F: 989-321-4912

    E: Robert.Hodges2@va.gov



    "Anyone who has never made a mistake has never tried anything new."
    -Albert Einstein




  • epraczepracz
    edited May 2016
    Amy,
    Thank you, it will be great to have a contact person. We will take your offer up when we start using the new the software in 3 months.
    Eileen Pracz, RN
    Clinical Documentation Specialist
    Oregon Health Science University
    503-418-4023
    fax 503-494-8439
    pracze@ohsu.edu

  • angelamckee@uh.organgelamckee@uh.org
    edited May 2016
    We are just now setting up monitoring our CDI metrics. Please let me know how all of you are measuring query rate. Are you using the total number of queries divided by number of records reviewed, or total of records with queries divided by number of records reviewed.   Thank you in advance.

    Angie Mckee, RHIT, CCDS, CCS, CCS-P
    Clinical Documentation Specialist
    Performance Improvement
    University Health Care System
    Augusta, Ga.  30901
    706-774-7836  


  • kelleywalrathkelleywalrath
    edited May 2016
    i divide the total # of queries by # of patients seen to get the query
    rate %. Then my ID inc. systems allows me to see the accounts with
    answered vs. non-answered queries. I first add each doc specs total
    queries, then divide by the # of their pts. To then get an accurate
    query answer rate, i look at each unanswered case and check to see if it
    should be counted against the doctor and/or the doc spec. for ex. if
    written on last day, i will delete it. if two queries on same pt and
    one is answered, i will not ding the doc spec. hope that helps.

    Kelley Walrath
    Documentation Specialist Coordinator
    Munroe Regional
    Ocala, FL
    BSN - CCDS
    352-671-2589





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  • leanne.sterlingleanne.sterling
    edited May 2016
    Do you track the financial impact?



    Leanne Sterling, RHIT

    Clinical Documentation Specialist

    CRMC

    Ext: 2508


  • kelleywalrathkelleywalrath
    edited May 2016
    yes i do. ID Inc. has taken away the manual labor of that.




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  • leanne.sterlingleanne.sterling
    edited May 2016
    Our main question is is the financial increase (or decrease) based
    strickly on first DRG that is entered compared to the final? I'm not
    sure if that makes since but what we try to do is look at the final DRG
    and determine if our query made an impact on that DRG. Several years
    ago when case managers worked the program they would look at beginning
    and ending DRG regardless if the query had any impact on the DRG. We
    feel our way gives a better picture of our efforts. Any opinions ?



    Leanne Sterling, RHIT

    Clinical Documentation Specialist

    CRMC

    Ext: 2508


  • robert.hodges2robert.hodges2
    edited May 2016
    I use number of queries compared to total number of charts reviewed.
    Then I break down that data to include who was queried, response type
    and impact on coding.



    Robert



    Robert S. Hodges, BSN, MSN, RN

    Clinical Documentation Improvement Specialist

    Aleda E. Lutz VAMC

    Mail Code 136

    1500 Weiss Street

    Saginaw MI 48602



    P: 989-497-2500 x13101

    F: 989-321-4912

    E: Robert.Hodges2@va.gov



    "Anyone who has never made a mistake has never tried anything new."
    -Albert Einstein




  • kelleywalrathkelleywalrath
    edited May 2016
    yours makes more sense. i look at the final drg and consider what the
    drg would have been most likely if we had not queried. it's an
    assumption but it's probably pretty close.



    Kelley Walrath
    Documentation Specialist Coordinator - Munroe Regional Ocala
    BSN - CCDS
    352-671-2589 or x8426





    DISCLAIMER:
    Confidentiality Notice:This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
  • paula.sonnpaula.sonn
    edited May 2016
    We track it manually using an excel spreadsheet.


  • Unknown
    edited May 2016
    That's how we do it too. We see if our query made an impact on the DRG.



    Gina Spatafore, RN

    Clinical Documentation Integrity Specialist




  • dbutlerdbutler
    edited May 2016
    We do the opposite -- % of cases with one or more queries. Also look at a second % of queries for financial impact (remove the queries that were for severity...no potential DRG impact, which is part of the data finalization process after discharge. cc/mcc not identified by CDS but coded will change a query to severity)

    Calculate response rate and agree rate based on the total # of queries -- looking at provider behavior and CDS success. Want complete effort on each query.

    Don


  • dbutlerdbutler
    edited May 2016
    Agreed.
    Part of the process after discharge to finalize and clean data has to be to affirm that the query actually resulted in it's intent. Was the asked for & anticipated new ICD9 code actually present on the coding summary, is the query the only reason for the coded DRG? or was there an additional cc/mcc identified by coder.

    In the same way, the initial DRG needs to be adjusted. Simple examples, ask for MCC, did not see an cc, so initial DRG changes to with cc and 'gain' credited is that cc to mcc. Also, if the initial pdx changes (for example, complex vs simple pneumonia when query was for cc, would need to change the DRG to reflect that difference in pdx)

    Don


  • kelleywalrathkelleywalrath
    edited May 2016
    Interesting to see how we all have come up with something different --
    what to measure and how.

    Kelley Walrath
    Documentation Specialist Coordinator
    BSN - CCDS
    352-671-2589 or x8426



  • NormaBNormaB
    edited May 2016
    We do the same.

    We use an Access-based software for gathering Query (Agree/Disagree/Unanswered/etc) data but we use an Excel Spreadsheet to record accounts which were strictly impacted financially by the CDI's Query.

    But as our program has aged and our physicians are picking up slowly in documentation, I wonder if this will be a useful tool in the future.






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