TOPIC: Choose scientific samples for ongoing records review
HIM Connection, November 19, 2003
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JCAHO requires a sample size of 30 records or 5% of your average monthly discharges (whichever is greater) for a record review. When conducting your own ongoing record reviews (ORR), scientific sampling is strongly recommended because it makes the validity of your conclusions much more certain.
Scientific sampling requires that you select the records at random. The easiest way to do this correctly is to make a list of all the records that can be potentially selected and then draw 30 of them using random numbers. Computers can do this for you quickly. Once the record numbers are selected, you can pull the records, place them on your cart, and take them to the record review committee meeting.
The population of records from which you draw the sample will vary for each meeting. We suggest you draw the record sample as follows:
* CLOSED RECORD REVIEW. Draw a sample of records from among those that were completed since the last review meeting.
* FOCUSED REVIEW. Make a list of records with a certain property. For example, in the case of a focused surgical review, you would draw records from all surgical cases during the last month or quarter.
* OPEN RECORD REVIEW. Draw your sample from among all the patients currently in-house as inpatients or short-stay/same-day surgery patients, or select charts from a certain department to perform a focused review on open records, if desired.
Before setting the record review committee members loose on the records, it is a good idea to review the items they should focus upon because the focus will change with almost every meeting, reflecting the ongoing nature of the ORR process. It is also helpful to remind the members of the committee where to look in the record for each item they should focus on.
This week's HIM Connection was adapted from the book, Automating Ongoing Records Review: New strategies for JCAHO success, by Raymond S. Pinder, MS, RHIA, and Frank H. Osborn, Ph.D. Click here for more information or to order now and save $17.80 off the regular price.
Check out the Editor's Choice section below for solutions to your records completion problems.
Sincerely,
Kate Alvarez Editorial Assistant kalvarez@hcpro.com mailto:kalvarez@hcpro.com
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