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Case study: CDI program elevated with prioritization at leading academic health care system

Real results

  • A bar chart trending downwards

    Total cases reviewed declined by 9.3 percent, freeing up time for coders to spend on critical cases.

  • A clipboard with a checkmark in front of it

    After several months, this academic health system has already seen pre-discharge queries increase by 4.2 percent and post-discharge queries decrease by 13.6 percent. It drastically improved documentation capture prior to discharge.

  • A dollar sign with an up arrow in front of it

    Overall complication or comorbidity/major complication or comorbidity capture rate increased by 3.8 percent and case mix increased by 8.6 percent, boosting the organization’s revenue.

  • Academic health system profile

    As a Level 1 trauma center, this organization delivers clinical innovation and quality care for every patient.
     

    • Location: Western United States
    • Beds: 600+

    3M product used: 3M™ 360 Encompass™ System for clinical documentation integrity (CDI)
     

  • Prioritization? Not a chance

    In 2018, this academic health system took its clinical documentation integrity (CDI) program to the next level with 3M™ 360 Encompass™ System. After learning about 3M’s new prioritization feature during implementation meetings, the group was interested, but hesitant to introduce a new feature to its already overwhelmed staff.

    Fast forward to April 2020 - the height of the COVID-19 crisis. The clinical team was juggling the coronavirus outbreak with limited staff and countless hours of work. A 3M performance advisor encouraged the health system CDI manager to reconsider using prioritization, to help better manage workloads and reduce administrative burdens. After reluctantly agreeing, the team implemented the advanced features to see how it would enhance their work.
     

  • Technology that makes a difference

    Prioritization uses advanced natural language understanding (NLU) and artificial intelligence (AI) technology to find cases with documentation gaps. The prioritized worklists update in real time with new patient information or team actions.

    This customizable tool embedded in 3M 360 Encompass saves CDI teams hours of painstaking manual review by locating the highest opportunity cases, based on the organization’s priority worklists and delivers convenient queries. 3M’s algorithm flags cases for review based on diagnosis related groups (DRGs), quality indicators, financial opportunity and more. It has never been easier to identify documentation improvement opportunities and increase efficiency – with one tool.
     

  • Guide to successful implementation

    Launching priority worklists may seem like a daunting task, but this organization didn’t have to start from scratch.

    Using the 3M default settings, this academic health system created an invaluable group of super users. These early adopters quickly became experts on the prioritization feature in 3M 360 Encompass. After just one month of training, the academic health system’s super users ensured the implementation was a success.

Decorative background

The ability to prioritize your work is an ever-changing demand.

  • Cultivate a mindset shift

    It’s no secret that health care is undergoing a drastic transformation that values quality over quantity. In the past, CDI departments could show an impact on a case-by-case basis. How should today’s CDI programs define success?

    It depends on the goal of an organization’s CDI program. Does the organization want to be able to show the value and impact of the queries or stay with the traditional efforts of looking at the number of cases reviewed? For example, this academic health system cultivated a mindset shift to trust the technology to alleviate the workload.

    By prioritizing the worklist, the tool removed the guesswork and improved cross-team collaboration. Which didn’t just help the organization’s CDI team but showed how it helped people outside the department. The mindset shift allowed the team to go beyond those traditional efforts and transform the quality of the CDI program.
     

  • Now is the time to rethink value

    With a new priority workflow structure in place, this academic health system can zero-in on the CDI cases with the highest impact. AI-powered prioritization has expanded its CDI program – without expanding the need for more staff. With one tool, this health system increased efficiency with flexibility and customization.

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Academic health system profile

  • A hospital
    • Location: Western United States
    • Beds: 600+
    • Operating rooms: 70+
    • Annual emergency room visits: 77,000+
    • Annual discharges: 27,000+

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