SOI question

dogdog
in CDI Talk Archive
Following up on our previous thread where SOI/ROM was discussed, I have been able to make generalizations about the effectiveness of the CDS program based on the SOI numbers I can get from corporate. I can see a consistent rise from 26% SOI 3/4 prior to the program up to 47-52% now.

However, by design, our nephrology group has started funneling a significant number of ESRD patients with medical issues to our hospital, where they would have gone elsewhere in the past. Clearly the SOI is going to go up without me doing anything to cause it; how do I pull those diagnoses out of the mix so I am measuring CDS impact as purely as possible? I have no APR-DRG grouping software, just raw numbers in a report.

Thanks,
Renee

Linda Renee Brown, RN, CCRN, CCDS
Clinical Documentation Specialist
Arizona Heart Hospital

Comments

  • dallend@einstein.edudallend@einstein.edu
    edited May 2016

    We have IS remove cases with certain diagnosis from our reports. Perhaps your IS dept can do the same.


  • bea.smithbea.smith
    edited May 2016
    What "numbers" do you use for this analysis?




  • stacy.vaughnstacy.vaughn
    edited May 2016
    how did you show the improvement? Just by trending






  • dogdog
    The reports show the APR-DRG and the number in each SOI category, and total percentage of SOI 3 and 4. I can select any dates I want. Yesterday I pulled up the numbers, and there really is a large increase in our severity 3 and 4 since I started doing CDS. I can't take all the credit, of course, but it is interesting. But if our patient demographic changes, it's going to be hard to connect continued high SOI or improved SOI to my work.

    Renee

    Linda Renee Brown, RN, CCRN, CCDS
    Clinical Documentation Specialist
    Arizona Heart Hospital
  • bea.smithbea.smith
    edited May 2016
    Can anyone share with me the breakdown of your coding dept? How many
    beds does your facility have? How many inpatient coders? How many
    discharges do they code per day? Do they do any concurrent reviews or is
    that strictly left up to the CDIS? We are currently looking for ways of
    being more efficient and I am curious how other hospitals have their
    departments set up. Thanks in advance for your answers.

    Bea Smith, RHIT
    Cullman Regional Medical Center


  • nbrunson84nbrunson84
    edited May 2016
    We have 4 dedicated inpatient Coders and one Lead Inpt. Coder. They are
    responsible for 25 Inpatient charts a day.

    CDI is responsible for initiating the coding on the floors. We update
    diagnoses when Queries are answered and add surgeries as we have time.

    We are around 300 beds.


    N. Brunson, RHIA
    Clinical Documentation Specialist
    Bay Medical Center


  • bea.smithbea.smith
    edited May 2016
    Not to sound crazy here, but 25 charts each per day, correct?


  • mannb1mannb1
    edited May 2016
    Our coders' productivity standard is 3 charts per hour, so in an 8 hour day, that breaks out to ~ 24 charts. Unless they have a "high dollar/long stay" chart, and that falls into a special equation they use to calculate how many hours it took them to code the chart.



  • mannb1mannb1
    edited May 2016
    One of my coders clarified that previous post - they are expected to do 3 charts per hour for a 6.5 hour day - as there is consideration of their breaks, getting charts, faxing to MD offices, etc., so that is about 19.5 charts per day.



  • stacy.vaughnstacy.vaughn
    edited May 2016

    3 charts per hour is a standard we have set. The charts will balance with
    the longer LOS chart/complex with the healthy newborns, etc. I also do
    consulting work 3 per hour is the rate.

    Stacy Vaughn, RHIT, CCS
    Clinical documentation Specialist






  • nbrunson84nbrunson84
    edited May 2016
    For the High Dollar charts if the LOS is greater than 10 days - it
    counts as two charts.


    N. Brunson, RHIA
    Clinical Documentation Specialist
    Bay Medical Center

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