2007/8› Casemix pressure reignited› SSWAHS – Identified and supported need

for increased Clinical Coding workforce

Clinical Coder Trainee Program – Three to-date

Standardised SSWAHS Coding Auditing Program

SSWAHS Documentation Guidelines published on the intranet

Clinician Buy-In

Three programs run to-date› PROGRAM 1› Advertised internally – no experience

necessary› PROGRAM 2› Advertised internally only – working

towards qualifications› PROGRAM 3› Advertised internally and externally –

working towards qualifications

+VE Increased workforce Familiarisation to our practical coding Networking (trainers and trainees) Trainees able to fill vacant positions

-VE Loss of investment – trainees moved on Cost / Time - course / trainer’s time / non-productive

time The right fit – What makes a good coder??? Different learning styles – formal program didn’t fit Individual vs Group training No Area Trainer

Standardised program across all SSWAHS Facilities

› Designed to fit all facilities› Weekly / Monthly / Quarterly / Bi-Annual

Types of Audits› Individual Clinical Coder Audit› Random 5% of one months discharges› Error DRGs› Adjacent DRGs› Outliers

Coder Education› Clinicians presenting to coders› Coders watching procedures› Internet Access for self teaching

+VE Benchmarking across facilities Identification of training needs Identification of documentation issues Development of Documentation guidelines (specialty

cheat sheets in some facilities) Correction of errors – hopefully for gains in funding Coders Self Checking - mandatory highlighting of

patient’s LOS against ALOS/DRG

-VE Time restraints Staffing restraints Internet access

Published documentation per specialty on the intranet

Endorsed by SSWAHS Executive

Memo to GMs from CEO› Copies in JMOs offices on wards, › Laminated copy for bedside

Sent to Clinical Training Schools / Facility

+VE Standardised information across SSWAHS Education by Specialty Accessibility via intranet

-VE “Not one shoe fits all” “Cheat Sheets” or tick a diagnosis/procedure

– not always documented in the record as well as the cheat sheet – therefore can’t code = waste of time

Revved up education in past few years Heads of Department meetings Ward Rounds JMO Orientation Specialty meetings (Adopt a HIM or

Adopt a Clinician) Individual Clinician Patient Flow Casemix reports

+VE Education for Clinicians at all levels Education by Specialty Lifts the HIM’s and Coder’s profile

-VE Jaded Senior Clinicians Availability of HIM to educate Time consuming Lack of Casemix HIM specialists Coders – under the spotlight

Surgical Targets Introduction of Local Health Districts Workforce issues Education Maintaining HIM profile Driving Efficiency and Change