Crouse Hospital: Communication Central

Vol. 18 • Issue 22 • Page 12

Our 2008 HIM Team of the Year contest brought another round of impressive entries. This year was all about expanding and improving HIT, whether implementing EHR systems, bringing document imaging in-house or automating release of information.

Spanning from Connecticut all the way to the Philippines and ranging from an intimate group of four to a coordinated team of nearly 200, our 2008 Team of the Year applicants reflected many unique attributes, but they all share a common dedication to high quality documentation, processing and patient care.

Even tech-savvy staffers need time away from the computer screen, and ADVANCE was delighted to hear how HIM teams across the nation are making the workplace more fun. Appreciation days abound, and some teams are getting more creative with employee morale, such as hosting costume contests, organizing game nights and adopting team aliases like “Coders Gone Wild.” HIM staffs are also improving the lives of others through community service projects, charitable bake sales and collections for troops overseas.

Our 2008 judges, still beaming from last year’s recognition, were eager to take on the challenge of scoring this year’s entries. They evaluated each entry based on seven criteria: awards and recognition, initiative, adaptability, teamwork, above and beyond, knowledge and additional information. While scoring the entries undoubtedly came with some pressure, each judge expressed gratitude for being invited to participate in the process.

The contest was a close call, as many teams demonstrated exceptional work and continuing passion, but ADVANCE tallied the judges’ scores, and we are proud to introduce you to our 2008 Team of the Year. Remember, if you didn’t win this year, our 2009 contest kicks off in July!

The HIM department at Crouse Hospital in Syracuse, NY, has learned that the best return on investment comes from open communication and teamwork. Its 73-member team strives to maintain positive relationships not only within the department, but across all stretches of medical care.

“The hospital in general is going through a cultural change, and [we’re] really focusing on our patient satisfaction, customer satisfaction and employee satisfaction,” said HIM Director Carolyn Dupre, RHIT, who submitted the contest entry. “We’ve just made remarkable improvements,” she added.

Dupre said she is most proud of the department’s high level of employee satisfaction. “We’ve really come a long way in bringing the group together,” she explained.

Annual employee surveys help Dupre gauge how HIM is performing in comparison to other departments at Crouse. Dupre makes sure that HIM stays at the top of the list. She also asks for staff input and insists on implementing their suggestions. She said winning Team of the Year is proof that the system is working.

“It gives me a sense of satisfaction that we’re doing the right thing,” she glowed. “They work really hard; they’re here every day; and just recognizing their good efforts, it makes me proud.”

Whether attending administrative meetings or clarifying codes with physicians, Crouse Hospital’s HIM department has become a driving force behind the facility’s ongoing dedication to quality patient care.

“I have never [before] worked in an organization where when they talk about mission, vision and values, we truly live them here,” said Christina Cass, CPC, CMBS, HIM operations manager, who has been working at Crouse Hospital since April.

Among other accomplishments, the HIM department was recognized by the New York State Department of Health for congenital malformation registry and cancer registry reporting and came in third for Most Improved Customer Service at last year’s Crouse Choice Awards. Last year, the coding area improved reimbursement by $700,000, and the coding manager was recently recognized for winning two coding disputes that saved the hospital $13,000 in paybacks. Crouse Hospital is also embracing technology; the HIM staff uses NetAccess to reduce errors in patient demographics and just introduced electronic flow sheets.

Upholding the hospital’s standards hasn’t been without challenges. Spatial constraints dispersed the staff across two floors and five offices, and several MTs work from home. But thanks to monthly meetings, daily e-mails and an overall welcoming atmosphere, the HIM staff can scale any barrier.

“We work so closely together every day that the walls that divide do not matter,” Cass explained.

In addition to everyday contact, the staff has begun job shadowing all three shifts to further strengthen the lines of communication, while a bimonthly newsletter called “The Health Information Station” provides updates about employees’ personal lives, such as a wedding or birth in the family. Even the department’s refreshment table, with coffee to sip and photos to browse, invites comfort and conversation.

The team has also taken great strides to bridge the communication gap that often divides medical personnel and HIM.

“Sometimes we’re separated between the clinical and the business part of the medical field,” Cass said. “This [win] is huge for us because one of our goals this year was to bring HIM-our name-into the hospital and what we do and the importance of patient care.”

Dupre said her staff educates other departments and physicians about HIM to ensure they understand the processes needed to maintain standards. “Teaching the doctors what it truly means, coding vs. documentation, they’re more apt to work with us and basically respect what we’re all about,” Dupre said.

Every year, the HIM staff hosts an open house and invites all other hospital personnel to explore the department and learn more about documentation and coding. This year’s theme is “Footprints,” and Dupre plans to place a path of footprints meandering through the hallways, “just so they can see the trail of the information and how it flows from the units through the HIM department,” she said.

This alternative approach to education is just one example of how Crouse’s HIM team makes the workplace more fun. Department meetings are held outside the office; employees snack on pizza and soda while playing games that promote teamwork, such as a rousing round of “Family Feud.” The department is also funding its own Christmas party, so staff members-including the remote MTs-are organizing fundraisers and bake sales.

“It’s a huge team builder because we all come together with different ideas and we get to know each other,” Cass said.

Their teamwork is also benefiting the community; staffers created “Crouse HIM: Hope in Miracles,” a breast cancer awareness group, and they also received rave reviews after coordinating with a summer program that brought young volunteers into the department and taught them about HIM’s role in patient care.

The well-established lines of communication both within and beyond the department walls will prove valuable as Crouse Hospital looks toward the future. In addition to working with vendors to implement document imaging-a project Dupre said she hopes to have up and running by next fall-the hospital’s IT department is simultaneously developing the means to establish an EHR. “That’s a huge undertaking,” Dupre attested.

The HIM department will also undergo major renovations as it moves from a paper-based to an electronic environment, including plans to make telecommuting available to coders. Currently, the team is developing a clinical documentation improvement program that will further educate physicians about coding needs.

With so many ambitious projects ahead, the HIM staff at Crouse Hospital is happy to be recognized for what they’ve already accomplished. They plan to wrap up HIT week and celebrate their win on Nov. 7 with a “Night on the Town” celebration sponsored by ADVANCE. They’ll also receive individual certificates, a department plaque and a package of goodies from ADVANCE’s Healthcare Shop.

“Our celebrating has begun today and it probably won’t end until next year,” Cass beamed.


Saint Luke’s Health System

Kansas City, MO

Teamwork and Technology

This year’s recognition has been 7 years in the making at Saint Luke’s Health System in Kansas City, MO; since 2001, the HIM department has been working to unite 11 segregated medical records departments into a single, cohesive group under the leadership of senior corporate director of HIM and decision support, Randy House, MBA. The transition continued this year, as computer applications at two facilities were updated and integrated into the health system. Only two of the 11 departments have yet to be upgraded.

“Bringing on new facilities into the organization and onto the computer system, we were able to really work as a team and figure out why we do certain things,” said Sharon Korzdorfer, MPA, RHIT, HIM director.

Bringing all 11 facilities together, with some separated by as little as 5 minutes or as much as an hour and a half drive, not only helps to centralize the system but also encourages each hospital to re-evaluate its documentation and management practices.

“Without that mandate of moving from one system to another, [each facility] would have probably continued doing its same process,” Korzdorfer noted.

Re-evaluation is paying off, as Saint Luke’s has made vast improvements, particularly to its relations with medical personnel. Beginning in late 2004, HIM managers set out to improve deficiencies in physician reporting. They noted that 60 percent of the deficiencies came from residents, so managers worked with educational staff members at the teaching hospitals to ensure that residents received proper instruction for completing charts. Residents who were continuous offenders would not receive credit for that semester of residency. “We really put some teeth into the policies,” Korzdorfer said.

The initial delinquency rate was more than 40 percent. Now, it’s down to 6.65 percent.

Korzdorfer said the improvement she is most proud of, however, is the success of the health system’s Physician Portal, which provides a convenient, centralized location where physicians can access all applications. “They don’t have to wait for us to tell them [a record is] delinquent,” Korzdorfer explained. “They can actually complete that signature or dictation while the patient’s in-house.”

Korzdorfer attributes Saint Luke’s success to the HIM team’s strong connections with the IT department. While HIM departments at other facilities often struggle to have a say in IT decision-making, Saint Luke’s prides itself on cooperation; the HIM team includes functional analysts that work with IT, while a project manager ensures that systems are up-to-date and user-friendly.

Technology also helps the 199-member team stay in constant communication. Weekly e-mails called “Friday Update” keep staffers informed about individual facility changes as well as system-wide news. Online communication boards keep remote MTs and coders in the know, while “mid-week huddles,” which go out on Wednesdays via e-mail, give employees an idea of where they are with accounts receivable and where they need to be by that Friday.

As Saint Luke’s transitions into the digital age, HIM’s role in IT is even more crucial, Korzdorfer said. “Any enhancements to make our jobs better and more efficient-whether it be speech recognition enhancements with our electronic medical record (EMR)-those types of things we’ve got to be a part of,” she asserted.

And Saint Luke’s certainly has some projects in mind. Nine out of the 11 facilities use an EMR, so Korzdorfer would like to see the remaining two make the switch. The HIM team found success with speech recognition technology, and now they’re eyeing computer-assisted coding to improve efficiency.

While directors and managers help streamline processes, Korzdorfer said, “it’s the staff who really do the day-to-day job and make us the team that we are.”


Methodist Medical Center

Peoria, IL

A FISH Story

When confronted with the often intimidating shift from paper to EHR, the health information services (HIS) staff at Methodist Medical Center in Peoria, IL, rose to the challenge. With many employees holding double-digit tenures at Methodist, the team was admittedly “old-school,” according to MT Amy Diggle, who sent in the contest entry. But that made their transition to a functioning electronic system all the more impressive.

“The success of our department this year has been a team effort,” Diggle said. “We pride ourselves on how well we work together because we’ve worked together so long.”

All 39 members of HIS are housed under one roof, so the department has become a second family over the years. Face-to-face communication is common, and employees are comfortable addressing any issues.

Diggle described the staff as “patient-driven, responsible, real, responsive and ready” and said they are dedicated to the facility’s ongoing mission to deliver superior health care. Managers and employees alike uphold high standards, as the organization strives to be in the top 5 percent of anything it does, whether it’s employee satisfaction or patient outcomes. Most recently, the MT department scored highest in the facility’s physician satisfaction survey.

Staff camaraderie became essential when HIS faced the high expectations and negative connotations accompanying EHR implementation. Diggle said they heard other facilities voice frustration about the switch to an electronic environment. “To weather that and to have successfully, so far, implemented the EHR, I think that’s something that we’re most proud of,” she said.

Taking a cue from Fortune 500 companies, Methodist Medical Center instituted a departmental initiative to facilitate the transition to the EHR. The FISH! philosophy, inspired by dedicated fishmongers from the Pike Place fish market, emphasizes four leadership principles: be there for co-workers, play, make someone’s day and choose your attitude about work. Employees spent 2 days a month getting oriented to the EHR, which Diggle said helped to settle nerves and “got everyone on board” for the transition. The department also carried the FISH! philosophy over to annual events: HIS week had an aquatic-themed potluck, games and prizes. At the department Christmas party, the office manager gave live fish as gifts.

Diggle hopes the recognition from ADVANCE will help the department garner more visibility. The nursing staff at Methodist Medical Center has been drawing attention as employees pursue Magnet recertification, so Diggle wants to add HIS to the hospital chatter. “It’s nice to put our department on the map,” she said.

HIS Director and President-elect of the Illinois Health Information Management Association, Jean Ward, BS, RHIA, agreed and said she was proud that Diggle took the initiative to nominate the staff. “To be recognized for the behind-the-scenes work that we do is very rewarding,” she affirmed.

While the switch to an electronic environment has been a success, the HIS team is far from done. Document capture technicians are honing techniques for scanning documents into the EHR, while MTs not only use speech recognition technology, but have also learned a Word-based application that improves productivity. Diggle said they hope to expand speech recognition even further and are now looking to improve chart turnaround time.

“We’re meeting goals, we’re improving,” Diggle said. “That’s all we can ask for at the end of the day.”

Cheryl McEvoy is an editorial assistant with ADVANCE.

Meet the judges

Evelyn Bickley, RHIA, is the HIM director at Mary Washington Hospital, Fredericksburg, VA, the winner of our 2007 Team of the Year contest.

Kim Jackson, RHIT, CHP, is the district director of health information services at Palomar Pomerado Health System, San Diego, a runner-up in our 2007 contest.

Candy Uhlhorn, RHIA, is the director of HIM and medical staff services at Select Specialty Hospital-Memphis in Memphis, TN, also a 2007 runner-up.