Health Information Management

Get tough with physicians to lower the delinquency rate

HIM Connection, February 3, 2004

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IF you are having trouble getting physicians in your hospital to complete
their charts, it may be time to get tough. Don't let physicians get away
with tepid warnings and an endless flow of reminder letters. Let them know that if they don't complete their charts within a certain period of time, they will be suspended--without exception.

This policy has been effective at Missouri Baptist Medical Center, a 494-bed facility in St. Louis. "Records must be completed within 21 days of
discharge," says Terri Eichelmann, RHIA, MBA, director of medical records at Missouri Baptist. "If they aren't complete, physicians are suspended. Right now we have about a 6% delinquency rate."

Support, Eichelmann believes, is the key to the success of this policy-the
Missouri Baptist administration is fully behind the policy. It's also
important to garner support from physicians.

Once you have support and you establish your policy, it's important to be
firm-but help physicians as much as you reasonably can. At Missouri Baptist, the medical records department sends reminder letters to physicians every Tuesday. Suspensions might occur on Wednesdays, so the Monday and Tuesday before a physician might be suspended, the medical records department makes every effort to contact the physicians and let them know that he or she is about to lose admitting privileges, unless he or she finishes the delinquent chart.

The policy doesn't stop with suspension. A suspension lasts until the
physician completes his or her records, and most physicians do so pretty
quickly after they are suspended. If they don't, however, they face more
trouble. According to the Missouri Baptist policy, if a physician has been
suspended for a period in excess of 90 consecutive days, his or her
department chief shall provide notification by registered mail, return
receipt requested.

If a physician fails to complete all delinquent records within 14 days of
receiving notification, that constitutes an automatic resignation of medical
staff membership and clinical privileges. The possibility of losing
privileges permanently works if nothing else does. Eichelmann says very few physicians have ever let records lapse that long, and the ones who do are usually physicians who have admitted one or two patients and are not
planning to admit patients in the future.

This week's excerpt is from the book, "Mastering Records Completion 2: More strategies from Medical Records Briefing." For more information or to order, see below or go to http://www.hcmarketplace.com/Prod.cfm?id=1923&s=EHIMC.

Check out the Editor's Choice section below for solutions to your records
completion problems.

Kate Alvarez
Editorial Assistant
kalvarez@hcpro.com



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