工作流程工作组影响急诊医师对点护理超声文件和计费的依从性。

IF 3.6 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Critical Ultrasound Journal Pub Date : 2016-12-01 Epub Date: 2016-05-20 DOI:10.1186/s13089-016-0041-0
Resa E Lewiss, Jessica Cook, Allison Sauler, Nicholas Avitabile, Nicole L Kaban, Jeffrey Rabrich, Turandot Saul, Sebastian D Siadecki, Dan Wiener
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引用次数: 17

摘要

背景:急诊点超声(POC u/s)是卫生信息技术的一个例子,它改善了病人的护理和正确诊断的时间。POC u/s检查应记录在案,因为它们是医生决策的一个组成部分。不完整的文件妨碍了超声引导程序和病人护理的编码、计费和医生团体补偿。我们的目的是评估定向教育和个人反馈的效果,通过一个工作组驱动的倡议,以增加急诊医师记录和转移给医疗编码员的POC u/s检查的数量。方法:在选定的上线日期前三个月,由科室领导、超声科和住院医师组成工作组。通过头脑风暴和电子邮件征集,确定了编制文档的障碍。在工作队干预前后,对执行并转移到医疗记录和医疗编码器的POC u/s检查的总数和特定应用程序进行了比较。采用卡方分析确定干预前后报告的POC u/s检查次数的差异。结果:研究期间共报告POC u/s检查1652例。向病人护理图表和医疗编码员成功报告的比例从工作队干预前的41%增加到干预后的63% (p值0.000)。3个月期间(干预前、干预后0-3个月、干预后3-6个月)进行的扫描次数相似(521次、594次和537次)。当通过具体应用进行分析时,大多数显示报告的检查百分比在统计上显着增加,包括对患者护理决策最关键的检查:EFAST(41%对64%),血管通路(26%对61%)和心脏(43%对72%);最常见的是胆道(44%对61%)和盆腔(60%对66%)。在编码并报告报销的POC u/s研究中,15.9%在干预前计费,32%在干预后计费(p值:0.000)。结论:在6个月的时间里,工作流程解决方案工作组的成立对急诊医生遵守POC u/s编码和计费文档产生了积极影响。进一步的调查应评估干预的长期效果,以及这是否转化为增加部门的收入。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A workflow task force affects emergency physician compliance for point-of-care ultrasound documentation and billing.

A workflow task force affects emergency physician compliance for point-of-care ultrasound documentation and billing.

A workflow task force affects emergency physician compliance for point-of-care ultrasound documentation and billing.

A workflow task force affects emergency physician compliance for point-of-care ultrasound documentation and billing.

Background: Emergency point-of-care ultrasound (POC u/s) is an example of a health information technology that improves patient care and time to correct diagnosis. POC u/s examinations should be documented, as they comprise an integral component of physician decision making. Incomplete documentation prevents coding, billing and physician group compensation for ultrasound-guided procedures and patient care. We aimed to assess the effect of directed education and personal feedback through a task force driven initiative to increase the number of POC u/s examinations documented and transferred to medical coders by emergency medicine physicians.

Methods: Three months before a chosen go-live date, departmental leadership, the ultrasound division, and residents formed a task force. Barriers to documentation were identified through brain storming and email solicitation. The total number and application-specific POC u/s examinations performed and transferred to the healthcare record and medical coders were compared for the pre- and post-task force intervention periods. Chi square analysis was used to determine the difference between the number of POC u/s examinations reported before and after the intervention.

Results: A total of 1652 POC u/s examinations were reported during the study period. Successful reporting to the patient care chart and medical coders increased from 41 % pre-task force intervention to 63 % post-intervention (p value 0.000). The number of scans performed during the 3-month periods (pre-intervetion, post-intervention 0-3 months, post-intervention 3-6 months) was similar (521, 594 and 537). When analyzed by specific application, the majority showed a statistically significant increase in the percentage of examinations reported, including those most critical for patient care decision making: (EFAST (41 vs. 64 %), vascular access (26 vs. 61 %), and cardiac (43 vs. 72 %); and those most commonly performed: biliary (44 vs. 61 %) and pelvic (60 vs. 66 %). Of the POC u/s studies coded and reported for reimbursement, 15.9 % were billed before intervention and 32 % were billed after intervention (p value: 0.000).

Conclusions: The formation of a workflow solution task force positively affected emergency physician compliance with POC u/s documentation for coding and billing over a 6-month period. Further investigation should assess the long-term effect of the intervention and whether this translates into increased revenue to the department.

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Critical Ultrasound Journal
Critical Ultrasound Journal RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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