Query template for PSI 9
Good morning. We are currently exploring querying for PSI 9 (Perioperative Hemorrhage). Does anyone have any query samples they have been using. Thank you.
Carolyn Lenik Program Coordinator, Lehigh Valley Health Network CDI
Good morning. We are currently exploring querying for PSI 9 (Perioperative Hemorrhage). Does anyone have any query samples they have been using. Thank you.
Carolyn Lenik Program Coordinator, Lehigh Valley Health Network CDI
Comments
Hi Carolyn,
What is the focus of your query? in my experience, there is less query opportunity on PSI 9 now that it requires a procedure. Are you finding it necessary to query for the hematoma itself in these cases, even when a procedure directed at treatment is necessary? Or are you having trouble with the time period designation? intra vs post? Something else entirely?
Katy
Hello Katy: Our CDI Team has been asked to start focus on assisting with documentation of PSI's, beginning with PSI9. We have not done any querying for this topic to date, we just wanted to some feedback from others who have already done so. thanks.
Gotcha. I would start my auditing a subset of records where PSI9 was triggered. These numbers should have dropped SIGNIFICANTLY when the PSI was modified to only include those with post-op hemorrhage requiring surgical intervention. The first step is to know whether you actually have a documentation related issue. Sometimes, in my experience, quality (and/or physicians and other areas), are quick to assume that documentation and coding is the culprit for higher than expected PSI volumes but I would want to determined how big of an issue documentation actually is in order to prevent other necessary interventions from being initiated in timely manner (to prevent everyone from assuming that this can be 'fixed' by CDI alone). This also would allow you to target those documentation areas with your CDI team that will have greatest impact.
My guess is that you will find there is less opportunity than they think you will ;-). However, that doesn't mean CDI cannot have impact, primarily with exclusions (most likely). If that is the case, your queries would not be directed at the hematoma itself but rather on those conditions that would exclude the case. You also may need to query for intra vs post op as intra is excluded . however, I believe that is likely less common.
Katy
One last question - what facility are you with so I can let my management team know.
Hi Carolyn, Do you know what % of this PSI you have at your facility? I, like Katy, would think that this number would have drastically reduced with the modification. I would also focus on exclusion dx's.
Jeff
Hi Carolyn,
Sorry I did not leave contact info. This is Katy Good. I recently transitioned from Northern Arizona Healthcare to consulting.
To reiterate. I am not suggesting CDI cannot or should not be involved in PSI related initiatives. We absolutely should be. This specific PSI used to be a common target until the procedure requirement was added. There is still potential to impact this PSI but for the most part it is less about the clarification of the hematoma itself. I simply feel that often CDI is asked to approached PSI's without full understanding of where the areas of opportunity truly are. Leadership needs to understand the opportunity and limitations of documentation/coding in approaching PSI's and this should only be one part of a strategy to reduce PSI's.