CDI/MD Collaboration Lisa Didion, MD

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Presentation transcript:

CDI/MD Collaboration Lisa Didion, MD Section Chief - Pediatric Hospital Medicine Associate CMO – Children’s of Mississippi

Children’s of Mississippi By the numbers 8,300 inpatient admissions/year 8,500 surgeries/year 44,500 ER visits/year 112,000 clinic visits/year 30+ specialists 250+ faculty

Children’s of Mississippi 230 inpatient beds Batson Children’s Hospital Only children’s hospital in state 30 Critical Care beds 100 Med/Surg beds Wiser Hospital 100 bed NICU Only level 4 NICU in the state

CDI at Children’s Overall goal Improve documentation Consistently Accurately Improve Documentation Increase CMI Increase Reimbursement

Road to Towards the Goal Collaboration! Many providers don’t know whose looking at their documentation Providers don’t know all the “buzz words” Key players CDI Coding Providers Residents Nurse Practitioners Faculty

Collaboration at Children’s Clinical Documentation Excellence Teams Length of Stay Teams

Clinical Documentation Excellence Teams “Big Picture” Multidisciplinary CDI Coding Billing Providers Informatics

Clinical Documentation Excellence Teams Department of Pediatrics NICU specific Review: Professional billing Hospital billing Unspecified code usage Query response rate CMI Denials ICD-10 transition

Clinical Documentation Excellence Teams Keys to success Education, education, education Departmental Performance Improvement Conference Resident Orientation Departmental faculty meetings Divisional meetings One-on-one Tip cards – unspecified code usage Query process Within EHR Response rates

Query Response Rate

Improving Query Response Rates Education & Availability Data Departmental Division Provider

Unspecified Code Usage – Dept of Pediatrics

CMI – Children’s of Mississippi

LOS – Children’s of Mississippi

CMI - Hospitalist

Length of Stay Teams APR-DRG based Team Encounters LOS variance New pathways/guidelines Team Physician Champion CDI * Coding * Leadership

Length of Stay Teams Goals Education & data sharing Standardize care “My patients are much sicker than this” Standardize care Identify barriers to discharge Improve documentation

Length of Stay Teams Asthma (141) Bronchiolitis (138) Sickle Cell Pain Crisis (662) Diabetes (420) Childhood Behavioral Disorders (758) Appendectomy (225) NICU 500-749g (591), 750-999g (593), >2499 with major procedure (631)

Data Example– LOS Team Children's of Mississippi LOS Committee Diabetes Dashboard - APRDRG 420 - September 2015 Sep-15 Sep-14 # of Encounters Severity ALOS Expected LOS 2 1 2.36 2.61 2.07 8 1.81 2.75 9 2.54 3 0.00 4.27 3.56 4 9.35 Aug-15 Rolling 12 Months 5 2.22 46 2.04 10 2.79 116 2.69 19 2.91 4.26 8.87

CMI - Appendectomy

CMI - Bronchiolitis

CMI - Diabetes

CMI - Sickle Cell Pain Crisis

Lesson’s Learned Names and faces Education & Availability Data CDI team Physician Champions Education & Availability Data Feedback

Thank You Children’s CDI Team Shelia Bullock Laura Collins Maury Sherman