Question

Case Study 5.9 Delinquent Medical Records: When you came on board as a HIM director, an issue needing immediate attention was the high delinquency rate of medical record completion. In fact, as the last The Joint Commission survey, the organization received a zero for insufficient compliance with this standard. The organizations current practice is that a letter is send to physicians once charts have become delinquent at 30 days post-discharge. Follow-up letters continue weekly and if charts weren't completed, the previous director would call the physician office. Strategize solutions to the high delinquency rate. 1. Recommend a minimum of four options that could be implemented easily and have a positive impact on the record completion process. 2. Note three options that will take longer to implement and assess the pros and cons of implementing those options.

Answer 1

1. Recommend a minimum of four options that could be implemented easily and have a positive impact on the record completion process.

• The follow-up letters should be sent quite frequently and with lesser time for example in every weeks time, or after a period of 2 weeks and so on.
• Before 30 days, calls must be made to the physicians along with the letter sent to her.
• Facilitate the various reasons so that their records can be furnished as soon as possible for example, the reasons can be communicated about the importance of patient care.
• Having a regular and consistent plan in the implementation and execution of the policy. Ensure the proper training of the staff and they are aware of the policies.

2. Note three options that will take longer to implement and assess the pros and cons of implementing those options

• The record clerk should call and write a letter in every 7-12 days of the period on the basis of the policy of the hospital. Despite that there is an incomplete record, no new patient can be admitted in the hospital till the completion of the record is not done. The main advantage of this will be that this will force the physician to complete the required records at the earliest rather than waiting for the last moment. The demerit o this is that there will be a lot of responsibility on the record clerk.
• Serious punishments must be given at earliest. The main benefit of this plan will be that there will be a lot of accountability of the physician and thus she will take the lesser time to fulfill the records. The demerit of this plan is that it will require some time to establish the guidelines for the plan, provide information to the physicians and others who must be informed about the possible modifications and at last executing the plan.
• There can be a chance that the reward and punishment plan can provide us the desired results. If all the records are completed by the physician without any mistake, then some kind of rewards can be provided to them. On the other hand, some serious punishment can be provided to those who do not fulfill the required record within the deadline. This will force them to complete the records on time and there can be a good competitive feeling among the physicians.

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