Case Study Challenge
To improve the accuracy of financial reimbursement and risk-adjusted performance metrics at Gateshead Health NHS Foundation Trust through improving the accuracy of the Trust’s coded data.
maxwell stanley have provided the Trust with valuable insights around the levels of accuracy of our Trust’s coded data and the impact that its quality has on both our performance profile and subsequent activity income.
maxwell stanley solution has enabled us to engage positively with our Clinicians and improve upon our performance data by way of informing coding data validation exercises. It has given Senior Managers within the Trust more confidence in the coded data they use to both analyse and plan activity.
Furthermore it has supported our work with Commissioners, allowing us to assess and agree upon the appropriate reimbursement path for clinical activity at Gateshead Health NHS Foundation Trust.
maxwell stanley solution and the accompanying consultancy services provided have informed and supported meaningful changes in our administrative functions, such as clinical coding, and have significantly contributed to the Trust’s recovery programme.
My personal experience is that the Team who visit our Trust each month have all worked for the NHS and their suggestions for improvements are all based on a real understanding and experience of how things work on the ground, as opposed to theoretical benchmarks. They are a pleasant team who integrate well with trust employees, simply because they all speak the same language!
Director of Finance and Informatics, Gateshead Health NHS Foundation Trust
Case Study Approach
The maxwell stanley solution was implemented at Gateshead Health NHS Foundation Trust, supported by our monthly Case Note Review service, to demonstrate that data quality improvements and financial benefits were achievable with immediate effect.
Once embedded, the maxwell stanley solution formed the Trust’s clinical coding quality assurance and income improvement process; feeding directly into Executive Board Cost Improvement Programmes (CIPS).
Whilst our standard ‘monthly’ methodology (typically reviewing c. 200 case notes per month) was proving successful, the maxwell stanley solution was continually identifying further opportunity should additional resource be employed. The Trust therefore, requested we provide a more intensive service delivery, more than doubling the case notes reviewed each month.
As clinicians’ awareness of the data quality improvements driven by the Clinical Coding department increased, their confidence in the quality of the data and staff increased, as did their engagement. This enabled us to begin addressing source documentation issues consistently identified by the maxwell stanley solution, and we initiated our Clinician Validation process; where clinicians validate the inclusion of chronic co-morbidities that have not been recorded in their most recent episode of care but have been recorded during previous patient episodes.
Case Study Outcomes
- £1.2 million increased annual revenue at Gateshead Health NHS Foundation Trust (based on reviewing c. 8.5% of case notes)
- Accurate reporting of performance metrics (Mortality Rates, LOS, and Complications Rates)