View June's Board Pack - Royal Bournemouth Hospital

Board of Directors – Part I10 th June 2011Results of the 2010/11 PbR Assurance Coding Audit,by the Audit Commission1. IntroductionEach year an audit of our PbR coding is undertaken by the Audit Commission, paid forby our host PCT. The full results are attached. This paper summarises the:• Key findings and messages• Updates against the proposed action plan.• Provides context as to impact of the action plan.The audit methodology is based upon a risk assessment of outlier codes and localknowledge from the PCT. This is then used to select areas for attention. 200 casenotes are then audited and used for these results.2. Key findings and messages2.1 Headline messages are that:• Coding accuracy has significantly improved.• There was a 0% financial impact of any inaccuracies.• Changes required in one aspect of cardiac coding will be a feature of the 2012/13contract.2.2 HRG error rateThis is 9.9% versus the national average of 9.1%. However, within this the two mainareas driving the number can easily be rectified (skin site of surgery coding andcoding of cardiac catheters). As a result the underlying accuracy is now much morerobust. This is also a massive improvement from the 24% error rate, which was drivenby our move to HRG4, which was hampered by being in a minority of trusts in our useof READ methodology.2.3 Procedure and diagnosis error rateThese have also massively improved, as the charts on Page 3 of the reportdemonstrate and the report which “commends” the efforts and improvements atnumerous points. These are both better than the known national average. Again theareas for improvement are relatively clearly identified and actionable, and thus havealready been applied.2.4 Key messagesThe really difficult aspects of coding improvement are:1) Widespread clinical engagement.2) Electronic notes including eIDF (Immediate Discharge Form).3) Tackling multiple consultant transfers of emergency inpatients on the system.Results of the 2010/11 PbR Assurance Clinical Coding Audit Page 1 of 3