INNOVATORS Gold Award - New Orleans City Business

MEDICAL
PHOTO BY FRANK AYMAMI
Members of East Jefferson General Hospital’s TDI team include, from left, Raquel Joubert, Lindy Sells, Royceann Fugler, Stacy Collins and Melissa Mayer.
TDI Team
East Jefferson General Hospital
Key innovation: establishing the Teaming for
Documentation Integrity Program to ensure thorough
and accurate documentation
Where they’re based: Metairie
Top executive: Stacy Collins, director of health information
management
Year introduced: November 2007
AN IMPORTANT BUT overlooked aspect of running a
hospital is appropriate documentation of a patient’s treatment.
This benefits not just the patient, but also the hospital
because flawed documentation means revenue lost.
To improve the accuracy of documentation, East
Jefferson has created the Teaming for Documentation
Integrity, or TDI Team.
In the past, a patient would receive care for whatever he
or she needed right away, but documentation would be completed
much later. With TDI, the documentation takes place
immediately.
“Instead of waiting to do it on the back end, we’re
doing a concurrent review,” said Royceanne Fugler, a registered
nurse and clinical documentation specialist.
Documentation used to be done by coders, people
without the medical expertise of nurses. All of the TDI
members — Fugler, Lindy Sells and Melissa Mayer — are
RNs and clinical documentation specialists.
“The nurses can make clinical judgments, whereas
coders could not. … Nurses can make clinical decisions
on what to ask the physician,” said Stacy Collins, director
of health information management at East Jefferson.
“If we see oversights in the medical records, we can point
those out. We’re an objective eye,” Mayer said.
Why is this so important To be reimbursed for
Medicare costs, the hospital must list every aspect of
diagnosis and treatment. In the past, if a patient was
treated for an injury as the primary ailment, but simultaneously
for an infection as a secondary ailment, the
injury would be listed but not the infection. As a result,
the hospital would be reimbursed only for treating the
injury.
Even though the program has been in place for less
than a year, East Jefferson has increased reimbursement
for its Medicare population by $1.1 million since
December. The more accurate documentation also helps
physicians from being audited.
If the documentation is wrong and a doctor said he
treated two things but the hospital was only reimbursed
for one, then that doctor is susceptible to an
audit. The TDI Team aims to eliminate that hassle for
doctors.
While the hospital said the program has already been
successful, East Jefferson plans to add more nurses to the
program and roll it out to other insurance companies that
pay by Diagnostic Related Group.•
— Fritz Esker
New Orleans CityBusiness 41A