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Tip: Narrow the focus of your physician education

Case Management Weekly, June 4, 2008

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When determining where to focus your physician education efforts, ask the following questions:

• What is our volume of symptom diagnosis-related groups (DRGs)? One goal should be to move these DRGs off your top 15 DRGs list. If your top 15 list includes them, take small and realistic steps toward removing them. For example, set quarterly goals to achieve your ultimate goal. Remember that Rome was not built in a day.
• Do physicians continue to write symptom diagnoses after they discover more specified etiological factors? For example, does the physician document “chest pain” when he or she suspects gastroesophageal reflux disease?
• Does physician documentation outline why quality measures are not met? For example, one goal of the Surgical Care Improvement Project (SCIP) is to encourage physicians to discontinue antibiotics within a specified period depending on the specific surgical procedure. However, there are many clinically valid reasons as to why this may not be the most appropriate course of treatment. When this is the case, the physician must clearly document the reasons for continuing therapy.

(The above tip was excerpted from The Clinical Documentation Improvement Specialist’s Handbook, written by Colleen Garry, RN, BS, and published by HCPro, Inc., 2008. Learn more about this book).

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