benchmarking metric

sbeattysbeatty
edited May 2016 in CDI Talk Archive
Don, you had discussed working on something to use as a program
benchmark. I'm doing the same thing using Table 7A from the Final Rule.
Have you worked out anything more on your project? We're meeting this
afternoon to evaluate our reporting methodology, at which time I will
share an update on my work with our director.



Does anyone else have their own benchmark against which they measure
their program? I'd be very glad to hear what others are doing besides
contracting for a consultant group to provide reports. MEDPAR is
available to purchase, but becomes a yearly expense to be budgeted. I
think the information is available without cost, but needs to be
formatted to be useful. I think that can be done for less investment
than the MEDPAR purchase. If I am mistaken, will someone please
enlighten me? :-)







Sandy Beatty, RN, BSN, C-CDI

Columbus Regional Hospital

2400 E. 17th Str.

Columbus, IN 47201

(O) 812-376-5652 (M) 812-552-6997



"Great leaders are almost always great simplifiers, who can cut through
argument, debate, and doubt to offer a solution everybody can
understand."

General Colin Powell






Comments

  • arobinsoarobinso
    edited May 2016
    I would like to see your process too!

    Mandi Robinson, BS, RN, CPC
    Clinical Documentation Specialist
    Trover Health System
    270-326-4982
    arobinso@trover.org
    "Excellent Care, Every Time"



  • dbutlerdbutler
    edited May 2016
    Sandy,

    Thanks for remembering.
    I am also using 7A (great suggestion from you!) from the final rule along with a couple of other items (developed a base DRG data element along with an element to identify and group the DRGs by type (triplet w/o, w/ cc, w/mcc, pair w/o & w/ mcc, single, etc.). It is not yet complete, but getting there.

    This is something I am thinking would be a good piece to present at the next conference -- either alone or as part of a larger bench marking presentation.

    There was a blog or Journal article awhile back by Dr Gold that was discussing bench marking against the PEPPER report groupings as well as some of the other obvious groupings of DRGs (for example, ratio of sepsis vs UTI). Will be looking at that to further refine the basic tool once completed.

    Don

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


    Never give in. Never, never, never, never--in nothing, great or small, large or petty--never give in, except to convictions of honor and good sense. Never yield to force. Never yield to the apparently overwhelming might of the enemy
    Sir Winston Churchhill



  • sbeattysbeatty
    edited May 2016
    It's Friday and I've been at it since 6:30 am. We met for 1.5 hrs to
    discuss metrics today. I'm too brain dead to share right now, but I'll
    get back to the group and share what we decide. I also owe the group my
    impressions of CDIS software. We implemented on July 1 and I think by
    the week after La bor Day I will have had enough time to make some
    pertinent observations.

    Sandy Beatty, RN, BSN, C-CDI
    Columbus Regional Hospital
    2400 E. 17th Str.
    Columbus, IN 47201
    (O) 812-376-5652 (M) 812-552-6997


    "Great leaders are almost always great simplifiers, who can cut through
    argument, debate, and doubt to offer a solution everybody can
    understand."

    General Colin Powell


  • NormaBNormaB
    edited May 2016
    Sandy,

    The CDIS software is through META, correct? I keep googling and not coming up with anything. I would be interested in your observations as it is something we are currently looking into as well.

    Thanks,

    Norma Brunson, RHIA, CCDS


  • sbeattysbeatty
    edited May 2016
    CDIS is a 3M product. We originally implemented their DRG Assurance
    program in 2002. We have 3M encoder in HI and the CDIS program includes
    that as well as the references of Coding and Reimbursement.

    Sandy Beatty, RN, BSN, C-CDI
    Columbus Regional Hospital
    2400 E. 17th Str.
    Columbus, IN 47201
    (O) 812-376-5652 (M) 812-552-6997


    "Great leaders are almost always great simplifiers, who can cut through
    argument, debate, and doubt to offer a solution everybody can
    understand."

    General Colin Powell


  • NormaBNormaB
    edited May 2016
    Ithink ntthat iss the software we are looking at to license their CDI program. Does it have an area to enter notes on each patient? Or is it basically a product to keep up with queries and stats?

    Its for recording useful info. On each patient and the CDS's input as to what is needed for the next review. Really assists in reconciliation and audits.

    N.Brunson, RHIA, CCDS


  • angelamckee@uh.organgelamckee@uh.org
    edited May 2016
    I would like to see your process too. angelamckee@uh.org.
    Thank you,

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



  • sbeattysbeatty
    edited May 2016
    What I've done so far is copy the Table 7A from the Final Rule report
    for FY2010 into an Excel spreadsheet. I then went through the MS-DRGs
    and put lines between the clusters (MCC/CC/no MCC- CC, etc.). After
    that, I totaled all of the clusters, and then divided each MS-DRG in
    that cluster by total cases/cluster to determine what percentage of
    cases within that cluster fell within each MS-DRG. For example:



    MS-DRGs 193-194-195 constitute a cluster for simple pneumonia

    Table 7A shows the total for each MS-DRG, so I added the three totals
    together for 193-194-195 to find total cases/per simple pneumonia
    cluster.

    I divided each MS-DRG total by the cluster total to see what percent of
    the cases were in MS-DRG 190, % in MS-DRG 192, etc.

    We are now pulling our own data for Medicare cases by MS-DRG and doing
    the same-calculating the percent of our cases that fall into the MS-DRG
    193 with MCC, etc.

    We will compare ourselves to the national average as calculated from
    Table 7A, and also use the PEPPER report to measure our performance and
    identify any perceived under-or over-coding situations. Those will then
    be audited on a regular basis to assess for any compliance issues.



    I'm waiting to get the spreadsheet back from the data analyst with our
    data, and then I'll see what we look like preliminarily. I'll keep all
    of you posted.



    Sandy Beatty, RN, BSN, C-CDI

    Columbus Regional Hospital

    2400 E. 17th Str.

    Columbus, IN 47201

    (O) 812-376-5652 (M) 812-552-6997



    "Great leaders are almost always great simplifiers, who can cut through
    argument, debate, and doubt to offer a solution everybody can
    understand."

    General Colin Powell


  • dong.lidong.li
    edited May 2016
    Wow, it was little complicated. We are currently using the 3M documentation system, and it can analysis those data for us.


  • sbeattysbeatty
    edited May 2016
    We also have 3M's CDIS product. Some of the reports have benchmarking
    metrics and some don't. I'd like to have a more in depth analysis. We
    don't contract for 3M reporting any longer, we do our own.



    Sandy Beatty, RN, BSN, C-CDI

    Columbus Regional Hospital

    2400 E. 17th Str.

    Columbus, IN 47201

    (O) 812-376-5652 (M) 812-552-6997



    "Great leaders are almost always great simplifiers, who can cut through
    argument, debate, and doubt to offer a solution everybody can
    understand."

    General Colin Powell


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