Ask the expert: Where should drafting an attribution policy start?
Credentialing Resource Center Connection, December 16, 2011
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Case attribution for inpatient care is not always a clear-cut process. Patients may see a number of physicians in certain medical situations and primary responsibility may not be well defined. Proactive research is needed before creating a new plan. Form a small task force that includes medical staff leaders, physicians, coding/medical personnel and IT/clinical informatics personnel. This task force should first attempt to understand the current condition of the attribution problem by asking key questions. Each task force should ask the following questions: · Does your organization have an attribution policy already in place? Determine if it spells out specifically the correct attending, consulting and procedural practitioners, and if updates are necessary. · Does the medical records department recognize that abstracting for the quality improvement program is part of their responsibility? The role, in support of the program, must be established. · Do the coders have the training to ensure adherence to these policy? Interview multiple coders to get their perspective on the formal attribution process. · How accurate are your attribution rates? The best way to gauge this is to audit a sampling of cases across several months for medical and surgical cases separately. This week’s question and answer are from The Complete Guide to OPPE: Strategies for Medical Staff Professionals, Physician Leaders, and Quality Directors, by Evalynn Buczkowski, RN, BSN, MS; Valerie Handunge, MA; and Wendy Crimp, BSN, MBA, CPHQ.
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