CDIS Record Review and Query Audits

Debra.Clark@sanfordhealth.org

I am curious to hear from other Supervisors/Managers how often you perform audits and the manner in which you present the information.  I will have impromptu discussions with individual CDIS, but also complete extensive reviews and provide a power point presentation.  Thank you.

Deb Clark

dvitalone1

I would also like to know. I am a new Lead CDIS and I am looking for ways to do this.  Thanks!

evanspx@sutterhealth.org

Lot of factors...I can state, if it is helpful, that we have an established program and we work w/ APR, ROM, HAC, PSI.  Query rate is averaging about 20%.  I am sure this is different at each site and depends greatly upon a number of factors.  (The only issue I have w/ a standard query rate is when someone says it MUST be at least X%, but does not support rationale for the standard they propose).

evanspx@sutterhealth.org

Suggest anyone wishing to investigate use the search feature at our website

Debra.Clark@sanfordhealth.org

I am interested in the auditing piece, as I stated above.  Thank you.

Deb

kathleen.szpak

Hello,

I am looking for feedback on how you audit CDIS?

Who performs the audit?

Do you have a pass/fail score, what is the process if the CDIS fail the audit?

What is the passing score?

How many records do you audit and how often?

How and who provides the feedback from the audit?

thanks,

nameher

https://forums.acdis.org/discussion/comment/20934#Comment_20934

I suspect that this might be a tad controversial but I'm a strong proponent of audits as educational tools and the CQI (or whatever today's acronym is) process depends on review, education, re-review. The hope and expectation in this scenario is an improvement.

There are times when an audit must be performed for administrative purposes. In this scenario, I use as KPI topics for which we might need organizational support, whenever possible. Clinical validation, for example.

nameher