Goals measurement for a successful CDI program
I was wondering how you measure the success of the CDI program?
Is it base on the CMI and the improvement? I was reading an article about Success Measurement in CDI.
It had a list of measurements: ROM/SOI scores pre and post CDI review. Percentage of CC/MCC changes, records with Principal dx change. Do you work with your HAC/RAC department?
I know that our query responses have improved so there is an increase in the % of response. We have some postive in the capture of revenue.
As the doctors improve their documentation do you try to capture the providers that are using the correct diagnosis?
We do have a report that shows the physician: how many queries, response, capture and potential capture cost. We run this monthly and quarterly. We also do this by provider groups such as Oncology, Surgical, Hospitalist, etc.
Just wondering how other facilities are reporting their progress. And does the measurement show the need for the CDI program?
Let me know.
Toni
Is it base on the CMI and the improvement? I was reading an article about Success Measurement in CDI.
It had a list of measurements: ROM/SOI scores pre and post CDI review. Percentage of CC/MCC changes, records with Principal dx change. Do you work with your HAC/RAC department?
I know that our query responses have improved so there is an increase in the % of response. We have some postive in the capture of revenue.
As the doctors improve their documentation do you try to capture the providers that are using the correct diagnosis?
We do have a report that shows the physician: how many queries, response, capture and potential capture cost. We run this monthly and quarterly. We also do this by provider groups such as Oncology, Surgical, Hospitalist, etc.
Just wondering how other facilities are reporting their progress. And does the measurement show the need for the CDI program?
Let me know.
Toni
Comments
About your last question -- yes, our metrics do demonstrate our success and value to the organization. They also illustrate areas where we need to improve (otherwise why would we track and use the metrics??).
First, would love to know the reference article (always looking for perspectives & information).
Second, generally measures depend on the focus of the organization & the CDI program.
Programs range from strictly financial impact all the way over to complete and accurate documentation where the CDI staff (& program) do not directly measure any financial or ROM/SOI results. Most are somewhere inbetween, though there does seem to be to broad groupings -- those programs that are largely financial focused & those that are more focused on ROM/SOI.
If you look at the most recent ACDIS Query Benchmarking survey (http://www.hcpro.com/acdis/details.cfm?topic=WS_ACD_JNL&content_id=265437), you can get a good idea of what people are measuring.
There are 2 contributions I've made recently that might also be helpful -- a white paper on auditing (http://www.hcpro.com/acdis/details.cfm?topic=WS_ACD_JNL&content_id=268350) as well as a blog post discussing what might constitute failed CDI programs, however if you turn that around and look at it from the perspective of areas to grow and improve.... (http://blogs.hcpro.com/acdis/2011/06/finding-a-defination-for-failed-cdi-programs/)
I also had a blog post on Metrics ideas & thoughts: http://blogs.hcpro.com/acdis/2010/12/metrics-ideas-and-thoughts/
Additionally, the AHIMA papers on Query standards & on CDI program guidelines would be good references. Both strongly recommend specific things that should be monitored as well as things that should be audited.
All of the items you've mentioned are good potential measures. The key I would suggest is to know firmly what the goals and focus of your program are, then identify metrics that tell the big picture and demonstrate progress towards your specific organization's focus. The standards to strive for can be gathered from the survey results, discussion here, consultant suggestions, and also very importantly your own organization trends and analysis.
Of course, one of the limitations for your metrics is the data sources you have access to. I can not directly demonstrate ROM/SOI gains because we do not have the 3M APR-DRG grouper. I can however trend LOS & Mortality index for the larger picture.
There is a Chapter in the second edition of The Clinical Documentation Improvement Specialist's Handbook on Monitoring the CDI Program. The CCDS Exam Study guide also has a section on metrics.
Another, but different topic is data collection and analysis to identify trends -- needed Medical Staff &/or CDS education topics or reinforcement, effectiveness of same (such as the trends among specific query topics -- for example increase in query for HCAP specificity or for urosepsis...)
Some programs do use things like awarding certificates of appreciation or outstanding documentation awards, as well as letters to Department Chairs (think there are samples in the Forms & Tools library).
Comments:
Nice drill down on physician collaboration (specialty group as well as individual) -- do you share that back with those groups?? as well as some measure of the success of their collaboration (suggest avoid financial though)?
Questions (because these are not necessarily consistent everywhere):
How do you calculate increased revenue due to CDI activity?
How do you calculate query rate?
Feel free to email me if you wish.
Don
Donald A. Butler, RN, BSN
Manager, Clinical Documentation
PCMH, Greenville NC
dbutler@pcmh.com