query rate

tkreilingtkreiling
in CDI Talk Archive
I am curious about those that have a goal query rate, how often do you evaluate the goal rate of queries? I have noticed my amount of queries to decrease drastically after educating the physicians. Does anyone else's amount of queries seem to be decreasing?

Comments

  • cstukenbergcstukenberg
    edited May 2016
    We really do not have a "query goal rate". However, I have seen the number of queries go down after physician education. However, if you think that you can quit the review process, the documentation goes back to prior habits.

    Colleen Stukenberg MSN, RN, CMSRN, CCDS
    815-599-6820
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  • nbrunson84nbrunson84
    edited May 2016
    Very True! Just when you think you have "stamped out" all Urosepsis...!

    N.Brunson, RHIA
    Clinical Documentation Specialist
    Bay Medical Center
  • dallend@einstein.edudallend@einstein.edu
    edited May 2016
    We are a teaching facility and every July we have new resident. Our query rate is higher than it should be even with the new faces. You would think the seniors and attendings would reinforce the documentation needs, but that does not happen consistently. During the course of the new the query rate for certain diagnoses may decrease but every summer through spring the numbers go up.
  • kelleywalrathkelleywalrath
    edited May 2016
    We don't find the level of queries decreasing since there always seems
    to be clarification issues. We do see a drop off in impact though..
    Since a query often just results in raising rom. After education, they
    write the terms (multiple cc's etc) sometimes but the need to query
    since doctors drop documentation or the IM doesn't pick up what the
    consultant says which could change the drg, is still occurring.
  • dogdog
    When I was first learning the CDS position, one of the early questions I had was, "If I do my job really well, will I put myself out of business?" It goes with my current question, "If my dollar impact is high, even though it makes administration happy, doesn't that mean I'm not doing my job well?"

    Of course I was told the same thing someone here already said, which is that if I weren't doing the reviews, they'd go back to their old, bad ways. Administration is so focused on the dollar impact, though, that I have to keep reminding them that a low dollar impact would mean the doctors are getting the message. :)
  • [Deleted User][Deleted User]
    http://www.hcpro.com/content/232429.pdf
    This is the link to the 2009 Physician Query Benchmarking Report. I'd love some input on what folks think should be included in the 2010 survey.
  • robert.hodges2robert.hodges2
    edited May 2016
    Based on what I'm told your numerator is the number of queries and the denominator is the total number of patients reviewed.

    I used to calculate based on the total number of chart reviews, but based on what I saw at the conference, that is not the recommended way to do it.

    Robert

    Robert S. Hodges, BSN, MSN, RN, CCDS
    Clinical Documentation Improvement Specialist
    Aleda E. Lutz VAMC
    Mail Code 136
    1500 Weiss Street
    Saginaw MI 48602
    P: 989-497-2500 x13101
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  • don.cdi.rn@gmail.comdon.cdi.rn@gmail.com
    edited May 2016
    I calculate slightly different than either.

    Numerator: # of cases with 1 or more queries
    Denominator: # of cases reviewed

    The number of times a case is reviewed is not involved.
    The number of queries that might be asked on a particular case is also
    not involved.

    10 cases reviewed, 2 cases with 3 queries (2 queries on 1 & 1 query on
    1), case query rate = 20%

    Don
  • Linda_RhodesLinda_Rhodes
    edited May 2016
    We calculate Query rate the same as Don.

    Linda

    Linda Rhodes RN, BSN, CCDS
    Manager Clinical Documentation Improvement
    New Hanover Regional Medical Center
    Wilmington, North Carolina
    Office # 910-815-5544
    Cell " 910-777-8344
    e-mail : linda.rhodes@nhrmc.org
  • don.cdi.rn@gmail.comdon.cdi.rn@gmail.com
    edited May 2016
    There has been a long standing variation among programs on how query
    rate, counting reviews vs counting cases, qualifying physician response
    & some others I can't remember at the moment....

    Makes it very interesting to attempt to conduct a survey & then
    interpret the results!

    Don
  • vanessa.falkoffvanessa.falkoff
    edited May 2016
    % of reviewed cases with CDI query with a benchmark of 20%.

    Vanessa Falkoff RN
    CDI Coordinator
    UMC
    vanessa.falkoff@umcsn.com
    702-383-7332
  • sbeattysbeatty
    W also do Numerator: # of cases with 1 or more queries
    Denominator: # of cases reviewed. Our original goal when the program was new was 35%. Now that we have a team of hospitalists, their documentation is often appropriate for our needs to start with, so our rate is running around 17%. We've never gotten around to changing the goal, but can justify the change.
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