Case Study
AMC Clinical Documentation Improvement (CDI)
Situation
BRG professionals collaborated with Duke Health, an academic medical center (AMC) with over 36,000 staff members, $4.2 billion in net revenue, and 1,500 physicians. The healthcare system consists of more than 1,200 beds, three hospitals, university-affiliated physicians, and community private diagnostic clinics. At the time of the project, Duke Health treated over 60,000 inpatient admissions on average and encountered over 1.3 million outpatient visits yearly.
Organizational Background
The BRG team provided deep experience from working with a variety of AMCs and large teaching hospitals across the county to rebuild Clinical Documentation Improvement (CDI) programs from the ground up, focusing on opportunities to improve financial and organizational performance. During this engagement, the BRG CDI team implemented new, sustainable program models created from each organization’s unique data.
CDI improvement analysis and work included:
- Applied effective staffing ratios and hardwired step-by-step daily activities process to improve time management
- Improved education program for new hires and existing team members
- Redesigned daily processes to meet best practice standards, including physician rounding
- Established and implemented accurate reporting of performance metrics
- Optimized use of an automated CDI tool for workload management, accurate data entry, query management, and reporting
- Improved physician engagement through education and face-to-face interaction with physicians and mid-level
- Providers on patient units for case discussion and query follow-up
- Streamlined physician query format and process to enhance compliance
- Provided direct interim CDI management to oversee daily processes, including case review, physician query writing
and follow-up, and quantifying impact for the organization