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Using Data to Guide Education and Tell Your Story
Melissa Maguire, BSN, RN Clinical Documentation Improvement Educator
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Objectives Define data Review the benefits of using data
How to display data
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Penn State Health Milton S. Hershey Medical Center
551-bed Academic/Quaternary Care Medical Center 28,654 hospital admissions Physicians and other providers 900 Clinical Residents and Fellows 551
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Clinical Documentation Improvement (CDI) Program
13 CDI Specialists Two Physician Advisors Manager Educator Review all inpatient service lines Adult Pediatric Obstetric Service line based Review all payors Report to the Director of Quality Systems Improvement
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Data Facts and statistics collected together for reference or analysis. Data is limitless and present everywhere in the universe. Reference:
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Florence Nightingale Used her passion for statistics to save lives of soldiers during the Crimean war Worked at the British military hospital in 1856 The mortality rate was high, and the hospital was chaotic Established order and method within the hospital’s statistical records and collected new data Outcome: Poor sanitary practices were the main culprit of high mortality in hospitals Reference:
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Data-Information-Knowledge-Wisdom
Temp 37.5, HR 128, RR 32, SBP 185 DBP 109 Information Vital Signs BP 185/109 Knowledge Tachycardia Tachypnea HTN Wisdom CDI Hypertensive crisis Respiratory failure PE Reference: Picture:
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How can a CDI Educator use Data?
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CDI Specialist CDI Department Service Line Hospital
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The CDI Specialist
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New Hire Ready to Move into Production?
Productivity Number of initial reviews Number of charts per day Time in chart Average time for initial reviews Service line Don’t forget about quality
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New Hire Example Don’t let quantity get in the way of quality
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Data Display Providing a Visual Picture
Is there a problem? Review time (minutes in chart) is greater than goal Develop your education plan Mark interventions Is the intervention working? Is the CDI specialist ready to move to production?
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Root Cause Clinical Issue Documents Reviewed Coding Issue Shadow
Queries
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CDI Department
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Make Data Fun and Meaningful
Share fun facts What is your data telling you? What do you want the audience to do with the knowledge? Photo:
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Query Data Example Staff meeting
Shared July 2017 through September 2017 query data with fun facts Staff engaged Turn the corner What is the data telling us? What should you do with the information?
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Query Data Example Making it fun Total number of queries Top query
Top 10 queries Provider who received the most queries Response rate How many CDI queries this provider Query with the highest no response rate Most queries on one patient
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Query Data Example What is your data telling you?
Our top 10 queries made up 53% of all queries Asked “What triggers your decision to query?” Is clinical support needed? Indicators present but missing diagnosis? Lack of specificity? Conflicting documentation?
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Query Data Example What do you want the audience to do with the knowledge? Provider education opportunity Tip cards Resident education Rounds Learn from each other Reinforce clinical indicators Tips to get providers to respond to a query Opportunity to ask questions
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Service Line Data
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Poll Question Do you share data with your providers? Yes No
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Sharing Service Line Data
Data is the hook We are part of the team Trust and collaboration CDI dedicated agenda time during division meetings Picture Source
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Service Line Data Top DRGs Top queries Case Mix Index
Review definitions prior to presenting data
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Top 10 DRGs July, August & September 2017 Discharges
Data display does not always need to be a graph Top 10 DRGs July, August & September 2017 Discharges Discharges 871 Septicemia or severe sepsis w/o mv >96 hours w mcc 136 189 Pulmonary edema & respiratory failure 61 392 Esophagitis, gastroent & misc digest disorders w/o mcc 53 291 Heart failure & shock w mcc 51 872 Septicemia or severe sepsis w/o mv >96 hours w/o mcc 47 683 Renal failure w cc 45 378 G.I. hemorrhage w cc 43 603 Cellulitis w/o mcc 690 Kidney & urinary tract infections w/o mcc 37 897 Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o mcc 31
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Top Queries Total number of queries: Query response rate: Top queries:
Share percentage of total queries Include case scenarios for review Often generates conversation to ensure providers are responding to queries Increased engagement with real scenarios Use real case examples
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Case Mix Index Know your data and your display
Is there a lot of variation? Vertical axis display
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Hospital Data
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Pressure Injuries Example
Organization goal Numbers did not seem right Findings Provider documentation opportunities CDI query opportunities Coding opportunities Education action plan Providers CDI specialist Coders
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Pressure Injury Action Plan
Providers Documentation tip card CDI Share data Level of care Hospital day Devices Coding guidelines Coders Organization goal Where to find the documentation
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Data Display What Chart Should I Use?
Display data in a way that is easy to comprehend.
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Compare Values Column Bar Line
Vertical display Bar Horizontal display Line Example: Comparing number of queries pre and post intervention
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Show the Composition Pie Stacked bar, stacked column
Example: Pie chart to display queries
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Analyze Trends Line Example: CMI over the past 12 months
Number of data points Trend line Example: CMI over the past 12 months
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Additional Considerations
Know your data and data source Use of color Number of data points Labels
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How do you use Data to Guide Education and Tell Your Story?
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Questions?
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