Improving the quality of clinical coding and payments through student doctor–coder collaboration in a tertiary haematology department

Improving the quality of clinical coding and payments through student doctor–coder collaboration in a tertiary haematology department

Hospitals within the UK are paid for services provided by ‘Payment-by-Results’. In a system that rewards productivity, effective collaboration between coders and clinicians is crucial. However, clinical coding is frequently error prone and has been shown to impact negatively on departmental revenue....

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Bibliographic Details
Published in:BMJ open quality Vol. 9; no. 1; p. e000723
Main Authors: Abdulla, Suha, Simon, Natalie, Woodhams, Kelvin, Hayman, Carla, Oumar, Mohamed, Howroyd, Lucy Rose, Sethi, Gulshan Cindy
Format: Journal Article
Language:English
Published: England British Medical Journal Publishing Group 01-03-2020
BMJ Publishing Group LTD
BMJ Publishing Group
Subjects:
Accuracy
Collaboration
cost-effectiveness
Data collection
Health administration
Hematology
Hospitals
Intervention
medical education
Medical personnel
Medical students
Patients
PDSA
Physicians
Professionals
quality improvement
Quality Improvement Programme
Sickle cell anemia
Tariffs
teamwork
cost-effectiveness
medical education
teamwork
quality improvement
PDSA
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Summary:Hospitals within the UK are paid for services provided by ‘Payment-by-Results’. In a system that rewards productivity, effective collaboration between coders and clinicians is crucial. However, clinical coding is frequently error prone and has been shown to impact negatively on departmental revenue. Our aim was to increase the median number of diagnostic codes per sickle cell inpatient admission at Guy’s Hospital by 3. Three interventions were implemented using the Plan, Do, Study, Act structure. This consisted of student doctors searching for diagnoses along with comorbidities that clinical coders had missed, distributing laminated cards with common clinical codes and implementing discharge pro formas. Through auditing, student doctors generated a total of £58 813 over 16 weeks. We observed an increase in the median number of codes by ≥2 additional codes. We improved coding accuracy where we identified errors in an average of 32.5% of admissions each month, improving the quality of patient documentation. We have demonstrated student doctor involvement in clinical coding as a potentially sustainable means of achieving accurate payment for services provided; increasing departmental revenue. We are the first to report the efficacy of student–coder collaboration in improving the accuracy of clinical coding.
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ISSN:2399-6641
2399-6641
DOI:10.1136/bmjoq-2019-000723