HIT 205: Performance Improvement Case Analysis

Purpose: To allow students to analyze key points in the performance improvement process.

Instructions:

For each of the following scenarios, categorize each part of the HIM process being described.

In each scenario, identify:

• Process
• External benchmark (not found in every case)
• Internal benchmark (not found in every case)
• Process measure
• Outcome measure (may be a datum point)

Scenario 1: The coding supervisor at Louisville General Hospital has a problem. Her Discharged Not Final Billed (DNFB) report is staying over the limit that upper management desires. She needs to determine what needs to be done to bring her DNFB down and still maintain coding quality. The information in the table below describes some of the data available for this process. Your task is to use the data/information in the table to identify all the categories listed above.

Current DNFB	$1.2 million
Desired DNFB	$600,000
Age of DNFB	1-3 days old	35%
	4-10 days old	20%
	11-21 days old	15%
	22-30 days old	15%
	>30 days old	15%

Scenario 2: HIPAA requires that record requests be met and released within thirty (30) days of receipt of a valid authorization. Currently, the Release of Information (ROI) department at Jefferson Clinic has a backlog of greater than ninety-two (92) days. The Compliance Officer has asked that an effort be put in place to reduce this backlog to at least sixty (60) days. Within a month, the ROI department has brought its performance down to fifty (50) days to respond to requests.

Scenario 3: According to accreditation standards, operative reports are to be completed as soon as possible after a surgery has occurred. Kentuckiana Surgery Center states in its physician bylaws that operative reports should be complete within forty-eight (48) hours of the service. The transcription department consistently transcribes operative reports within twenty-four (24) hours of service. However, the number of operative reports that remain delinquent past forty-eight (48) hours remains at 53%. The Transcription Coordinator does not believe that the delinquency rate is a result of transcriptionist turnaround time (TAT), but of physician failure to dictate the reports. She plans to study the average TAT for operative reports to show that her department is doing their part in meeting the accreditation and bylaw standards. She also plans to record the TAT between the end of surgery and when physicians dictate their reports.

Students may present their analysis findings in a table, Excel spreadsheet or similar method. Be sure to include your name on the submission.