Maxwell Stanley has worked with South Tees Hospitals NHS Foundation Trust to help them to ensure high standards of clinical documentation and coding accuracy in order to improve the Trust’s financial position and morbidity data.
Summary
South Tees Hospitals NHS Foundation Trust provides healthcare services to more than 1.5 million people across the Tees Valley, North Yorkshire and beyond.
They approached Maxwell Stanley for assistance with the quality of their coding data, as they felt that the complexity of activity within the Trust was not being accurately captured. This would have a detrimental impact for the accuracy of future financial contract baselines and in-year negotiations.
Under their mission of ‘safety and quality first’, South Tees Hospitals NHS Foundation Trust also wanted to understand why their Summary Hospital- level Mortality Indicator (SHMI) score was ‘higher than expected’ and if poor data quality was the cause of this.
Project Objectives
- Increase activity complexity accuracy, equivalent to £100k national tariff increase per month (£1.2m p/a), with a proportion directly related to Elective Recovery Fund
- Short-term: reduce SHMI score to below 1.1
- Long-term: achieve “as expected” SHMI score Improve accuracy of coded data to ensure financial baseline payments for activity are based on true complexity of activity
- Improve overall clinical coding depth (average number of secondary diagnoses coded per episode)
- Education to Clinical Coders and Clinicians as to importance of accurate comorbidity recording and coding for mortality rate data
Solution
Using the Maxwell Stanley solution, a comprehensive suite of mortality rate specific rules were auto-applied to the Trust’s activity data, focusing on inconsistent recording of patients medical history, particularly any missing long-term or chronic Charlson comorbidities. The solution analysed the Trust’s coded activity data to facilitate a weekly, targeted review of those prioritised admissions identified in which the clinical coding and source documentation had been flagged.
Results
- Increased accuracy of the complexity of the activity data, equivalent to a national tariff increase of more than £1.5m over 12 months (of which £300k is Elective)
- Both short- and long-term objectives achieved: SHMI mortality rate moved from 1.17 to 1.06 and the current SHMI score “as expected
- Identification of the source of coding and documentation inaccuracies, allowing South Tees to start to improve data quality accuracy from the start
What South Tees Said
“We asked Maxwell Stanley to help us identify whether they could help us to improve our financial position, to ensure we are able to recover the correct income for the treatments and care that our clinicians provide. They really delivered – we have seen measurable increases in case value and they’re providing us with regular reporting, which we use to educate our coding teams and clinicians to reduce documentation and coding errors in future. Our SHMI score improved significantly, and this has been sustained." Deputy Director, Strategy and Planning.
