CDS Productivity

Hello - we are researching best practice CDS productivity standards (we have done a review of the literature including the ACDIS White Paper). I'm curious what others are counting as a "follow up" review.  Do you count only concurrent follow up reviews done while the patient is in house - or do you include DRG reconciliation, mortality reviews, etc as part of the CDS productivity?  Please share which type of reviews are used to calculate the follow up review rate. 

If your department has a benchmark for new (initial) and follow up reviews could you please share that as well?  Do you have difference benchmarks for level of CDS experience?  

If possible can you also share if your EMR is fully electronic/hybrid etc and if your team is onsite or remote?  I'm trying to determine what impact these variables have on productivity.  

Thank you, Shawn
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  • Shawn,  our team has an expectation of performing 20-22 cases per day as a benchmark.  The team functions very autonomously and they are required to use their clinical judgment and CDI knowledge to assign when a new case needs to be re-reviewed.  We use 3M 360, so productivity is easy to track.  The team does not normally put a finding in on a case that they are being asked to look at retrospectively by a coder unless that case is consuming a significant chunk of time and/or requires a retro query or several notifications back and forth between coding and CDI.  Performing reconciliation on their queried cases is a monthly expectation and occurs outside of their reviews that are expected for the day.  They also have expectations around sharing education with peers and providers.  Hope this helps.  Janie
  • Hi Janie - thank you for the information!  It was very helpful.  Have a great day.  Shawn
  • HI I would also like to know how other smaller programs review as well. We have 500+ beds with 3.5 FTE. How do you stream line your reviews?

    Thanks,


    Steph

  • smidgen21 said:
    Hello - we are researching best practice CDS productivity standards (we have done a review of the literature including the ACDIS White Paper). I'm curious what others are counting as a "follow up" review.  Do you count only concurrent follow up reviews done while the patient is in house - or do you include DRG reconciliation, mortality reviews, etc as part of the CDS productivity?  Please share which type of reviews are used to calculate the follow up review rate. 

    If your department has a benchmark for new (initial) and follow up reviews could you please share that as well?  Do you have difference benchmarks for level of CDS experience?  

    If possible can you also share if your EMR is fully electronic/hybrid etc and if your team is onsite or remote?  I'm trying to determine what impact these variables have on productivity.  

    Thank you, Shawn

    For CDI productivity, I calculate mine based on actual time spent in an open encounter.  We utilize Optum's CDI and CAC modules.  I am able to base productivity on time spend in an active review (not just clocked in time). 

    When calculating, I use their total time in a case in Optum and calculate a cases reviewed/hour.  Our internal benchmark is 5 cases/hour and this includes new reviews, subsequent reviews, and retrospective reviews.  The reporting Optum provides allows me to easily see what type of reviews each CDI is doing.  I count all reviews (initial, subsequent, and retrospective) in their hourly productivity numbers.  I do not have any different benchmarks for new vs. experienced staff, however a learning curve is natural with a new hire and wouldn't expect them to be at 5 cases/hour right away. 

  • I do suggest you separate follow-up concurrent reviews, and retrospective reviews. Reason being- that time spent performing reviews after discharge (such as mortality, PSI reviews, discharges w/o CDI review etc) removes a CDI from performing concurrent reviews. Which creates an ever growing problem, because the number of records not reviewed concurrently likely lends to increasing numbers of records to review on backside. If you separate out the number of retrospective reviews performed it might allow you support for addition of a new position to perform these reviews - allowing for your concurrent team to capture more thoroughly complete reviews prior to discharge. 
  • We count all reviews in our productivity. If a CDI is spending time reviewing notes, maybe placing a query, following up on queries, retrospective reviews, or working with coding or physicians then that time needs to be counted.
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