1. Awards/Recognition:
Please list previous awards or recognition received by your HIM team.

Jennifer Watkins, Director of Quality Improvement at Crouse, gave HIM a "Simply The Best" recognition for being very helpful during an on-site visit from the New York State Department of Health. We went above and beyond to ensure she had everything she needed to ensure her compliance with the DOH was a success. We pulled her charts promptly, gave her a private workstation for her comfort and actually answered her pager so she was not interrupted. Two staff members in HIM, Amy & Erick, were awarded and recognized for calling a code and knowing the proper procedures. A man was down on the first floor and Erick and Amy called the code and stayed with the gentleman until help arrived. Transcription was nominated and came in 3rd for Most Improved Customer Service last year at the Crouse Choice Awards. Two of our medical transcriptionists (MTs) received well deserved recognition for going above and beyond what was expected of them. A while back there was a widespread internet problem, the MTs were not able to work remotely and were automatically paid downtime for this timeframe. In recognizing the need for patient care, the MTs could have chosen to simply enjoy this "opportunity" and take the day off with pay; but instead, two of the MTs drove to the office, and provided a service to our patients, physicians and employees by transcribing our STAT notes. That's dedication! Received recognition for the New York State Department of Health for Congenital Malformation Registry reporting as well as Cancer Registry reporting. The coding manager just recently was recognized by the Coding Disput Resolution as winning on two cases where she challenged the payers decision to change the DRG. She saved the hospital $13,000 in a possible payback amount (for just two accounts). Way to go!

2. Initiative: Provide examples of your team's initiative to improve the work environment/profession as a whole.

HIM has recently improved the department look with new decorations/ paint, etc. Acquired additional office space for coders and thorough cleaning of the department to help with any air quality/health issues New rug, fresh paint and A/C units. New PC's and office equipment and greatly appreciated by all as well. Created a "HIM Welcome Center" offering coffee and treats to our physicians and visitors daily (We want people to come into HIM feeling welcomed and know that we are there to assist them). Hung a new sign displayed as you first walk in, "Welcome to HIM- Committed to being "Simply the Best." Attach pictures of the office and sign. In efforts to "conserve our resources", HIM is working to decrease use of paper,toner and cutting down on fax confirmations by eliminatiion of printing and filing of certain reports as technology improved processes to access information online. This is the beginning of our electronic health record and want our processes to be in line with the exciting new technology. We are creating a HIM QI team to revamp processes. Along with these, we have begun job shadowing all 3 shifts to help to improve communication among shifts (within the department)and essential improve the work environment and profession as a whole. To improve report quality, we implemented a variety of on line tools that allows the remote MTs fingertip access to things such as a Procedure Guidelines Excel spreadsheet; this provides the MTs with frequently asked questions and answers, as well as our procedure guidelines; this is especially helpful to the staff who work after office hours. NetAccess, which provides them with patient information, such as visit date, and patient demographics, this helps reduce the amount of errors that can occur when the wrong patient demographics are downloaded onto the report. KRONOS, our electronic payroll system, provides the MTs, and the hospital, with an accurate working schedule. HIM has a Newsletter titled "The Health Information Station" that provides updates to the HIM staff with fun topics, new adventures, and new processes going on in each area of the HIM department. In our coding area, last year we were able to improve reimbursement of $700,000 by auditing coded charts prior to the bill being dropped. That allowed for the appropriate code changes to ensure proper billing.

3. Adaptability: How has your department shown that it is adaptable to the changes and "upheavals" currently going on in the HIM field and health care in general? What has your department done to support the future implementation of an electronic health record system?

HIM has stopped printing and filing ED and PromptCare transcribed reports, medical imaging reports for IP, ED and OP, and outpatient pathology reports. Access for this information is online. We just went live with the electronic nursing admission assessment and the electronic flow sheets. These reports will be accessed online. The HIM staffis very excitedabout the future changes with the electronic health record. We are in the beginning stages of implementing a document imaging solution, a vendor has been selected, beginning to gather document imaging needs from other departments within the organization. (And preparing for electronic forms as well) We adapt to the needs of our phyicians ( meeting them on the floors to explain coding clarifications) send letters of delinquencies, make weekly calls to communicate those charts over 30 days as a coutesy. Document imaging will allow the physicians to complete their charts online from home, their offices or within the organization. HIM realizes that some pbysicians may need extra help in accepting change as well as learning the new system. We are ready! We realize that change isn't accepted by all in the same way and we are prepared to coach employees and physicians through this exciting change in a very caring and charismatic way. HIM not only has all MT's working from home but a coder as well as the tumor registrar.

4. Teamwork: Provide examples of how your team has worked together to accomplish certain goals.

The HIM team is commitment to working overtime to cover vacations, vacancies and in times when volume has increased. We currently hold a 100% turn around time for releasing all requests for information in 10 business days. Our staff is dedicated to working together to get records coded, analyzed and completed in a timely fashion. Our current delinquency rate is under 7%. We have 15 people from HIM who formed the "Crouse HIM - "Hope in Miracles" who will walk to help raise awareness to breast cancer in October; teamwork outside the walls of Crouse. We believe in bringing HIM and the importance of our profession into the clinical areas of the hospital. For HIM Week will are having an Open House- we will have hospital staff follows the steps through a chart( Coding, Transcription, Assembly, Analysis, Physician completion and chart filing. WE are hoping with awareness to the details of a complete records, compliancy and quality of the chart will improve. We have had Strategic Planning meetings with all HIM employees to come up with our own ideas - to incorporate into the hospital's strategic plan to meet the mission, vision and values. Since we have a large team, we hold department meetings outside the office with food and drink to show them how much their hard work and dedication is appreciated. We play games at the meetings where all members have a chance to get to know one another in a more relaxed environment. We pride ourselves by having "fun" at work.

5. Above and Beyond: Provide exemplary instances of how your team has gone "above and beyond" to make a difference in your facility.

Coding took on the challenge of properly assigning patient status- known to be a huge area of concern. We took the initiative to get the patient status task force up and moving. Coding is where the status changes initiate. Trying to do everything we can to get this problem fixed. Utilizing SMART, a coding flagging software, HIM is trying to maintain that portion of the DNFB at zero. We often stay late to get it at zero- therefore leaving a cushion for other line items on the DNFB. Clinical Documentation Improvement- HIM has implemented CDI for the Hospitalists and ICU critical care physicians, used as a way to educate the physicians on their documentation. HIM attended daily Hospitalists and critical care meetings to convey any documentation/coding concerns. HIM taught our coding guidelines and why they were receiving coding queries from us. Helped with Physician satisfaction to understand why we needed to query. HIM currently review every single physician query that is on bill hold to verify the validity and to make sure the query was written appropriately- no leading. It's a big part of physician satisfaction. HIM has an ED coder helping to to educate the ED docs on documentation- have seen an increase in assignment of our ED E&M levels. Junior Volunteer Program- HIM had 10 JV's for the summer months. All JV's worked in all areas of HIM, learning the functions of the department, and the role HIM plays in the hospital. We believe the for lack of a better term "Children are our future" we took advantage of the Junior Volunteer experience to show the kids what we do in the hospital and how what we do impacts patient care. We had an appreciation Ice Cream Social for the volunteers, where we presented them with a Framed Certificate of Appreciation and "Back to School" Gift bags.

6. Knowledge: Provide examples regarding how your team has shown the ability to learn new technologies (software applications, etc.).

Training and using NetAccess (hospital information system). It saves on printing all patient reports, user friendly program, functions better than old system, working with IT to advance towards assisting HIM's needs and desires. Scanning records to be viewed by insurance companies and our billing department. We strive to stay on top with Coding Compliance, HIPAA Regulations, JACHO Regulations, CMS regulations and the NYSDOH. HIM just recentlyupdatedthe encoder, Quantim. All coders adapted well to the changes and the training did not impact the DNFB. Transcription went live with the Dictaphone Enterprise Workstation, including editing of speechrecognition reports.

7. Additional Information: Why else does your team deserve to be recognized as the 2008 HIM Team of the Year?

We love what we do and always do our best to make things happen, no matter how hard or long the struggle. We are very proud of our profession. Longevity of our staff, several members of our HIM Team have brought a wealth of information to the department (clinical, billing, admitting, etc). We understand the need of other departments and assist them to the best of our ability. We at Crouse Hospital HIM- genuinely support our hospitals Mission, Vision and Values. They aren't just words to us- we live by them everyday. We strive to offer our patients, employees and physicians quality and efficiency.