1 / 19

Hospital & Health System Association of Pennsylvania Achievement Award 2006

Hospital & Health System Association of Pennsylvania Achievement Award 2006. MDS Coding: A Cultural Change. FCMC Mission & Vision . Mission To continuously improve the health of our community. Vision

JasminFlorian
Download Presentation

Hospital & Health System Association of Pennsylvania Achievement Award 2006

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Hospital & Health System Association of Pennsylvania Achievement Award 2006 MDS Coding: A Cultural Change

  2. FCMC Mission & Vision • Mission • To continuously improve the health of our community. • Vision • To become the Heath Care provider of choice in Fulton County by providing state of the art products and services to our community in a way that reflects our commitment, our competence and our compassion.

  3. Problems that were recognized • Recognized Supporting Documentation for Section G was not accurate • Incorrect Coding resulted in: • Inaccurate resident ADL assessments • Not obtaining the appropriate reimbursement rate • QM indicated a 33% decline in ADL function as reported by CMS for 4th Quarter 2003

  4. Data Collection • Base line needed to determine staff’s ability to accurately code Section G of the MDS • ADL Audit Tool Comparing the LPN documentation and the CNA’s verbal interpretation regarding Section G Results: Inconsistencies in capturing highest functional level of care

  5. Intervention • Interdisciplinary ADL training occurred on: • ADL Definitions • Proper Coding • Significance of accurate coding

  6. Question: Were we on the right track? • Second Audit was completed • Results • ADL coding accuracy was at 44%

  7. Further Findings • The LPNs were completing the ADL tracking forms. • The ADL Trackers were being completed after the change in shift thus not capturing direct caregivers input • There was a lack of understanding in regards to the coding definitions • Inconsistencies in interpreting ADL tracking form

  8. What next? • More education was needed: • LPNs were instructed on accurately completing the tracking form • Education on communicating with front line care givers on ADL functioning in regards to the residents • Reeducated on ADL definitions

  9. 3rd and final audit • Administered ADL coding quizzes to all of the LPNs • Results • 37% accuracy rate

  10. Assessment Findings • ADL trackers were completed by both LPNs and CNAs for a select group of residents • This determined that our most accurate data was obtained from the direct care staff • This made it evident that a cultural change was needed

  11. Implementation Process • Development of the “ADL Core Training Group”. • Incorporating CNAs from every shift • Those who completed the highest “clinical ladder” • This allowed for an individual to be available at all times for: • Clarification of definitions • Coding Instructions • Mentoring coworkers in accurate ADL Coding

  12. Intensive Training • This occurred over a two month period • This was conducted by: • The MDS Coordinator • Restorative Nursing Coordinator • As well as the complete support of the NHA and DON

  13. Objectives • Objectives for the training included: • Understanding the importance of accurate coding • Understanding the effects this has on the true level of care and reimbursement • Purpose and frequency of the MDS • Significance of interdisciplinary contribution • Coding and ADL definitions • Identifying resident ability • Identifying staff assistance required

  14. Development of a new ADL Tracker A new ADL tracker form was developed by and tailored for effective use by the CNAs PLEASE SEE HANDOUT

  15. Testing of ADL Core Group • ADL Core Group (total of ten individuals) was quizzed using the MDS manual to ensure their level of understanding • Results • 100% accuracy

  16. Ongoing Training • Education was provided to all CNAs • New Policy and Procedures were developed • Implementation of: • CNA completing ADL Tracker Form beginning January 1st 2005

  17. Summary • Our goal was to have 95% accuracy • We obtained a 98% accuracy and continue to maintain that rate • Our CMI increased from a 1.10 to a 1.20 • Our Quality Measure for ADL decline dropped from 33% to 12%

  18. How do we maintain Accurate ADL Coding • We perform ongoing education 4 times a year that is fun and entertaining • Jeopardy Games • Themed educational sessions (with quizzes) • ADL Newsletter • With quiz attached • Flow chart to assist with ADL coding (please see handout) • Continue Audits • 1:1 education as needed

  19. Credits • Quality Insights of PA • Nursing Staff • Jeff Thomas • Administration • MDS Coordinator • Restorative Nursing Coordinator • Therapies • HAP

More Related