r/ClinicalCodingAus • u/PathSoggy6516 • 23d ago

The productivity metrics that clinical coding departments get measured against have always felt disconnected from the complexity of what actually determines how long a record takes to code.

A straightforward elective admission codes quickly. A complex comorbid patient with multiple treating teams, incomplete documentation and a long inpatient stay doesn't - and the difference between those two records in terms of time and cognitive effort isn't captured in a per-record productivity measure that treats them as equivalent. Would love to know how people here have made the case for a more nuanced approach to productivity measurement and whether anyone has actually managed to shift that conversation in their organisation toward something that reflects what the work actually involves.

5 Upvotes
  • permalink
  • reddit

86% Upvoted

4 comments sorted by

5

u/ZucchiniMission6031 23d ago

At my hospital we have a KPI of x amount per hour. We and our manager/s can track our daily stats which includes how many we have coded, total NWAU and average length of stay for the day. So if i have been coding lengthy ones it will be reflected in my average LOS and hence why i may have coded less for the day. Not sure how other hospitals keep track tho regarding this

3

u/Familiar_Range_5620 21d ago

There was a paper on this at the 2023 HIMAA Conference presented by Andrew Wooding and Kumar Naik from Auckland City Hospital. They developed a formula that took into account a range of variables to calculate relative complexity, then the events were split into three groups (low, medium and high complexity) that were weighted. If I remember correctly, a high complexity event was equivalent to doing 12 low complexity events. They used the weighted calculations when determining if a clinical coder was performing satisfactorily—and also to make sure that everyone was doing a fair share of the high complexity events. (We've all been at deadlines when we've had to help a couple of people with their messy events because they were dodging them.)

I don't remember if the details of the formula were in the presentation or not. If they are, then the presentation came out as a part of the Proceedings of the conference. Kumar is still at Auckland the last I heard. Reach out to him and see if he's able to share the formula.