improving the quality of clinical coding and discharge ... · improving the quality of clinical...
TRANSCRIPT
The Health Roundtable
Improving the Quality of Clinical Coding
and Discharge Summaries with the Mobile
Clinical Application
Dr Samuel Chan, Dr Andrew P Maurice, Associate Professor W Clifford
Pollard, Dr Helen E Ward and Professor Darren L Walters
The Prince Charles Hospital, Brisbane, Queensland, Australia.
Poster Session
HRT11420 –Innovation Awards
November 2014 Melbourne
The Health Roundtable
Background
Mobile Clinical Application
The Health Roundtable
Problem 1
Reimbursement of hospital: depends on documentation
Documentation is generally poor
Cholelithiasis with cholecystitis –
laparoscopic cholecystectomy performed
$8,382
(Av. LOS: 1.7)
Cholelithiasis with cholecystitis – laparoscopic
cholecystectomy performed with electrolyte
imbalance (e.g. Hypokalaemia)
$14,169
(Av. LOS 3.5)
Chest Pain $1,242
Acute Myocardial Infarction $3,800
The Health Roundtable
Problem 2
Discharge summaries: handover of critical information
The Health Roundtable
Innovation Developed
Mobile Clinical Application
The Health Roundtable
The Health Roundtable
The Health Roundtable
The Health Roundtable
Patient 1
Patient 2
Patient 3
Patient 4
Patient 5
Patient 6
Patient 7
Patient 8
Patient 9
The Health Roundtable
The Health Roundtable
The Health Roundtable
The Health Roundtable
The Health Roundtable
The Health Roundtable
The Health Roundtable
TRANSFER TO DISCHARGE SUMMARY
The Health Roundtable
The Health Roundtable
The Health Roundtable
Results
Mobile Clinical Application
The Health Roundtable
IMPROVEMENTS IN FUNDING
Two months after implementation, the proportion of
admissions classed in the "A" category increased by
6.1%. The proportion of admissions in the "B" category
dropped by 1.4%.
Given that there were approximately 900 patients
admitted in each of the two months that DCPC was on
trial for, this equates to an average increase in revenue
per patient by $200 and thus $180,000 in total.
The Health Roundtable
Frequency of Overall Quality Score Pre and Post
Intervention
0
1
2
3
4
5
6
7
1 2 3 4 5
Score (out of 5)
Fre
qu
ency
Pre Intervention
Post Intervention
The Health Roundtable
Pre-
Intervention
Post-
Intervention
P-value
Mean hours spent completing
discharge summaries per week
10.5 ± 3.5 7.2 ± 2.2 p<0.05
Mean actual overtime (hours) 8.5 ± 4.4 5.7 ± 2.7 p<0.05
Mean overtime claimed (hours) 5.3 ± 5.4 3.5 ± 3.2 p<0.05
Overtime cost per resident $290 $175 p<0.05
The Health Roundtable
The Health Roundtable
Additional Benefits: Three-fold reduction in duplicated work
The Health Roundtable
Discussion
Mobile Clinical Application
The Health Roundtable
WILL THIS INNOVATION HELP YOU?
Completed patient lists
Faster ward round notes
More rapid completion of discharge summary
Improved quality of discharge summary completion
Improved clinical coding
Improved clinical reimbursement
Improved legibility of medical notes
Upgrade further innovations in the future
The Health Roundtable
CONTACTS
Dr Samuel Chan
Dr Andrew P Maurice
Associate Professor Clifford W Pollard
Dr Helen E Ward
Professor Darren L Walters
Email contacts