Query Rate
We have a large quaternary facility with several ICUs. Our program has been in existence for almost 12 years. We review all charts, all payers and we have done extensive physician education over the years. I am wondering if anyone has a similar situation. Our vendor is reporting that our query rate should be 35-40% but we are finding that impossible to achieve. Our strategy has always been quality; not quantity. But its difficult to convince the C-suite. Any thoughts?
Comments
This is the link to the 2017 Physician Query Survey .
CDI benchmarks and program accountability "As far as query metrics, the percentages of respondents in 2017 who have a set query quota and those who do not were nearly the same, with "yes" garnering 47.22% and "no" garnering 46.91%. Of those who do have a quota, the expected percentages of charts queried was quite varied—although the norm seemed to be a quota of around 21%–25% of charts reviewed. ""These expectations appear well founded, as 28.09% of respondents say that 21%–30% of their chart reviews result in a query. ""These expectations appear well founded, as 28.09% of respondents say that 21%–30% of their chart reviews result in a query. "I would expect a lower query rate for an established program that has low physician turnover and that has provided extensive physician education. I think query rates are an easy metric for your C-suite to monitor. It can be difficult to quantify the impact of CDI programs so query rates, number of reviews etc are used as they are easy as compared to assessing the impact of CDI on denials prevention, PSI/HAC prevention and other quality areas.Cynthia Mead RN CCDSCynthia.mead@nahealth.com
Pair this information with the provider response rate- a high response rate indicates provider engagement.
I have always been concerned when a query quota is enforced- as this might lead to queries being asked for no other point then to meet the quota. If the queries are not quality in nature, this would likely lead to decreased engagement.
I agree with Laurie. We all know that we could query on almost every chart that we touch but is that a good use of our time and our Providers time? If you have a mature program then perhaps the C-suite should consider that you've actually improved Provider documentation by being engaged, providing education, etc. I've always seen the consultant's query quotas but have not actually seen them applied to the charts of that organization. Definitely a retrospective review as Laurie said should get some attention if you have a low rate of missed opportunities. It's sad that we tend to get punished or scolded when "we" are actually engaged with our Providers and out talking with them, doing presentations, etc.. I am thankful to work for an organization that has not been brainwashed by the "query quota".
Jeff
Thank you to everyone for your response. Very helpful!