HB Workqueue Analysis and Best Practice

Advocate Aurora and Atrium Health underwent an organization merger, creating a vast hospital system between the Midwest and southern regions of the US, in 2022. Because of the mega merger, and how current it occurred, the, now combined, hospital system departments have differing procedures within departments. The Health Information Management (HIM) and Coding departments work together to ensure providers fill out correct patient visit documentation, via their electronic medical record systems. In the Midwest, both departments utilize Epic for their tasks, while the South utilizes Epic and 3M. This capstone project encapsulates the necessity to analyze the procedures for HB workqueues and determine best practice, ensuring timeliness of medical record completion, creating accountability of provider documentation, and increasing quarterly organizational revenue, by having a formal process and timeline for completing deficiencies.

Objectives:

• Identify pros and cons between use, or lack thereof, of 3M
  • Ensures cost of 3M is effective for system
  • Analysis of cost for Midwest sites if 3M is needed for coding
• Revise current strategies for assigning deficiencies
• Determine turn around time between both regions for specific queues
  • Comparison used for suspension process
• Identify all medical group policies/bylaws that could affect suspension process
  • Medical group bylaws cannot be changed, but analysis for change can occur
• Identify all spots for improvement in SE and MW work queue procedures
• Explore new guidelines for suspension process
  • Needs to be in-line with all medical group bylaws
• Explore idea of certain departments needing further explanation/training
  • Training will need to occur for either region’s teammates, dependent on the continue/end of 3M
• Assemble all findings to present to HIM administrators and head of providers to change current missing documentation procedures
  • As it has been determined as the greatest need, the findings need to be presented, with the hope of phase three being adoption and roll out of procedure