Increase in case mix versus prior year
Additional reimbursement in the 12 months after physician education
When it came to clinical documentation improvement (CDI), physicians at Baptist Beaumont Hospital, a 325-bed community hospital in Beaumont, Texas, had turned a deaf ear. And with limited support for their efforts, the hospital’s CDI staff had become unmotivated.
Twelve months later, Baptist Beaumont was telling a different story. Here’s how it happened.
How Baptist Beaumont engaged the right physicians
Troubled by physicians' indifference to documentation, leaders at Baptist Beaumont engaged our Physician Documentation Initiative team to help.
Physician documentation experts from the Advisory Board worked with the leaders from the 325-bed hospital in Beaumont, TX, to identify the hospital’s biggest documentation opportunities through a three-step process.
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Step 1: Identify physicians to target with one-on-one training
Our documentation experts analyzed financial and quality data to find opportunities for documentation improvement. We emerged with a focus on simple pneumonia and pleurisy, joints, nutrition diagnoses, cardiogenic shock, peptic ulcers, and encephalopathy.
For each opportunity, we pinpointed the physicians who had the most potential to affect performance by improving their documentation.
Leaders at Baptist Beaumont then edited this initial list of target physicians to remove physicians who were no longer practicing at the hospital and to add a new physician who was likely to admit a large volume of patients in the future. The final list for one-on-one education included 13 physicians, physician assistants, nutritionists, and the coding team.
Step 2: Educate physicians individually using personalized materials
Our team reviewed charts for the targeted physicians to identify specific opportunities to improve their documentation and prepared materials for each physicians.
These custom materials included examples, hospital- and specialty-specific documentation performance, and evidence demonstrating why the physicians should pay attention to what they write down.
Then, it was time to have some conversations. We started our physician education in March 2013. Our documentation experts sat down individually with each target physician to review his or her performance and recommend specific actions to improve their documentation.
A transformative financial and cultural impact
The results? In the 12 months after the one-on-one education sessions with physicians, enthusiasm for documentation improvement among physicians, coders, and CDI staff grew dramatically.
“[Physicians] do not generally come to you and say, ‘hey, how am I doing?’ That had not been our experience prior to this, but it is what we're seeing now….Dr. Joe and Donna [the Advisory Board’s documentation experts] put them at ease.”
—Sarah Horner, Director of Case Management
In 11 out of 12 months, CMI was significantly higher than those months the prior year, even when variations in high-acuity cases were taken into account.
Overall, Baptist Beaumont saw an 8% increase in case mix index and $8.2 million in additional revenue in the first 12 months.
The individual education sessions also had a marked impact on the perception of the CDI program throughout the hospital. Because physicians better understood the effect of what they wrote down, they came to see the CDI team as allies to help them improve their quality scores. Consequently, the physicians’ support has motivated the clinical documentation specialists and coders in their own work.
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