| OCR Text |
Show Diagnostic Tracking and Data Collection in Rural Clinics Kylee levine, BSN, RN; Kate Jagla, Executive Director; Larry Curtis Garrett, PhD, MPH, RN Key Take Away An evaluation and subsequent redesign of the workflow at a rural health clinic improved the accuracy of diagnostic coding (ICD-10) and enhanced data reporting capabilities Background Results • Rates of all codes ICD-10 codes included: increased after implementation from 54% (n=92) to 93% (n=98) • Lack of patient population and diagnostic data presents challenges with tracking finances, applying for grants, and patient safety (Bowman, 2013) • Rates of dictation summary used: increased from 8% (n=8) to 100% (n=105) • Rates of problem list updated: increased 17% (n=29) to 75% (n=79) • Clinic data allows for outcome tracking and improved health outcomes (Tran et al., 2022) • Saved encounter: increased 8% (n=13) to 83% (n=88) • Usability: 100% (n=1) of clinic nurses reported a reference guide would be more helpful in inputting ICD 10 codes • Feasibility: 100% (n=1) of clinic nurses reported the new workflow to be “reasonable” • Satisfaction: pre-to post-test showed that the nurse was more satisfied with the post-implementation • Barriers: Provider by in. One of the nurses did not fill out their exit surveys before resigning • Facilitators: The executive director was key in getting nursing and staff buy-in. • Many rural clinics struggle to utilize their clinical data (Bekemeier et al., 2019) • The Clinic encountered workflow challenges with data entry, which resulted in incomplete patient data when generating reports on patient diagnoses Purpose This DNP project aimed to enhance a clinic’s data capture by targeting patient-specific and medical encounter diagnoses using ICD-10 codes, improving the quality of electronic health record data through redesigned workflows and identification of appropriate codes. Methods • An initial assessment revealed a need for a quality improvement project to facilitate the initiation of ICD-10 codes and workflows in a rural clinic • A workflow algorithm was designed based on feedback from the clinic educator, clinic executive director, nurses, and other office staff, as well as scholarly evidence-based articles Conclusions • Implementing workflows to standardize EHR usage surrounding ICD-10 codes resulted in improved data tracking and staff satisfaction, usability, and feasibility • This project presents an opportunity for sustainability, as it has established the necessary resources to train future employees. • The revised workflow's usability, feasibility, and satisfaction were assessed. • The ICD-10 code compilation is expected to expand as new codes are added • Chart Reviews were completed pre and post-implementation to assess the use of ICD-10 codes and the implementation of workflow interventions. • EHR reports will be more accurate and useful moving forward • This project has improved the quality of the clinic’s data and will support future projects that require accurate clinical data @uofunursing @utnurseresearch |
