Assumptions:
All sites:
⚫EHR available with access to all necessary applications by the coders. It is not known whether all applications will function remotely as they do in house; however, corporate IT services are strong, and the relationship between IT and HIM Services is excellent.
It is a requirement that all coders be credentialed: RHIA, RHIT, CCS or CCS-P are the accepted credentials.
⚫ Mandatory monthly coding education programs are provided for all coders with the site rotating between the three facilities.
Coding backlogs are handled by a combination of overtime (OT) and contract coding at all three sites. Combined costs for OT and outsourcing were $418,000 during the last fiscal year.
Facility #1: Pine Valley-South
750 inpatient (IP)
beds
Urban teaching hospital, OB services, Level III nursery, Level I trauma, full outpatient (OP) services including 3 OP clinics and associated physician office practices.
17 FTEs perform all coding functions, but not abstracting (core measures, registry data, etc.). Coders are cross trained and can perform IP and OP coding as needed for all hospital services including clinics, but not physician offices.
Coding productivity and quality standards have been in place for many years. Coding accuracy rate: 98% High turnover rate in coders: longevity ranges from 2 weeks to 9 years. There are currently four open coding positions in the department that have been open for over 3 months. Most coders drive at least 25 minutes to work and pay for monthly parking. The hospital is in a less-desirable area of town. The coding supervisor is confident that coders would work well with minimal supervision.
Facility #2: Pine Valley-North 350 inpatient beds Urban teaching hospital, OB services, Level II nursery, full OP services including 2 OP clinics and associated physician
office practices. This hospital was the one that was "merged." The "other"
HIM director did not get the corporate position but elected to stay on as a manager of all HIM services except for coding and transcription.
12 FTEs perform all coding functions, but not abstracting (core measures, registry data, etc.). Coders have begun to be cross-trained, but the process is still new. They provide coding for all hospital services including clinics, but not physician office practices.
Coding productivity and quality standards have been in place only since the merger occurred. Coding accuracy rate: 90%
Moderate turnover rate in coders: longevity ranges from 3 months to 23 years. There is currently one open coding position in the department that has been open for over 2 months. Most coders drive at least 20 minutes to work and pay for monthly parking. The hospital is in a more desirable area of town but is still considered to be a "downtown" location. The coding supervisor is not at all confident that coders would work well with minimal supervision.
Facility #3: Pine Valley-West 250 beds
Suburban non-teaching hospital, no OB services. OP services consist of ER, Same Day Surgery, Pain Clinic and OP testing.
This was a sister hospital to Pine Valley-South but located in a suburban setting where medical staff physicians treat their own patients so there are no residents or associated physician office practices.
9 FTEs perform all coding functions including abstracting (core measures, registry data, etc.). Coders have not been cross-trained; there are IP and OP coders. Coding productivity and quality standards have been in
place for many years. Coding accuracy rate: 93% Low turnover rate in coders: longevity ranges from 4 years to 27 years. All coding positions are currently filled. Most coders drive no more than 15 minutes to work and do not pay to park. The coding supervisor is somewhat confident that all coders would work well with minimal supervision.
Deliverables:
1. SWOT analysis in an acceptable format. The SWOT analysis must cover the entire health system, do not submit a separate SWOT for each site. Do not download the case study into your answer.
