Capturing Misallocated Charges Departments 4PICU 4PEDS Project Team Mike McCormick Service Coordinator Kristi Milam RN Cindi Laporte Nurse Manager

Opportunity In 2005 misallocated charges to the Pediatrics and the Pediatric ICU floors totaled $88,000. These are costs that should be allocated by staff to particular patients yet have been charged to the unit. These costs directly reduce the units budget to purchase other items. Goal: To decrease the current year’s floor charges to 15% of the previous year’s.

January 2006 Floor Charges

Promoting Awareness Detailed posters were created to show the severity of the problem. Showing each staff members floor charge totals. Other posters were made to inform the staff of the necessity of charging individual patients for items. Signs were posted on omnicells to remind staff to avoid entering floor charges. Signs were created to show progress.

Pediatrics and Pediatric Intensive Care Unit Floor Charges Pediatrics and Pediatric Intensive Care Unit $12,000 $10,000 $8,000 Total Misallocated Charges $6,000 Changed how totals were calculated UCL = 4726 $4,000 $2,000 Target = $1,100 $0 Jan-05 Feb-05 Mar-05 Apr-05 May-05 Jun-05 Jul-05 Aug-05 Sep-05 Oct-05 Nov-05 Dec-05 Jan-06 Feb-06 Month

Results of Quality Initiative The average monthly floor charges since March 2006 have decreased to $612. This totals to a 92% decrease in total floor charges If these results were achieved hospital wide they could create 1.42 Million dollars per year in increased charges. (635 thousand not including ER) Or an approximate savings of $80,652 per year. This quality project has seen continuous improvement. There has been a noticeable downward trend in the monthly floor charges.

January 2007 Floor Charges

Next Steps Continue to have one on one in-service’s with the people who are responsible for misallocated charges. Email Floor charges to the staff member responsible for them. Work to maintain the reduction that we have currently achieved, as well as continue to reduce misallocated charges.