Author(s)
Keven S.Y. Ji BA
Melissa A. Pressley BS
Russel R. Kahmke MD
Charles R. Woodard MD
Howard W. Francis MD
David W. Jang MD
Affiliation(s)
Duke University School of Medicine
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand that a one time resident educational program at a tertiary care institution was able to significantly improve documentation of inpatient comorbidities in otolaryngology-head and neck surgery patients. Objectives: Accurate documentation of patient comorbidities is critical in value based healthcare. In academic institutions, documentation of patient complexity often depends on the house staff's knowledge and attention to this issue. We aimed to assess the impact of an educational intervention for residents to improve inpatient documentation. Study Design: Otolaryngology residents at a tertiary care institution underwent a one time training program on accurate and thorough documentation of comorbidities for adult inpatients. Methods: Severity of illness (SOI) scores as calculated by Vizient (Irving, TX) were compared for inpatients in the two year periods before and after the intervention. Results: 881 patients were included: 418 pre-intervention and 463 post-intervention. The mean [SD] age at admission was 59.7 [16.5] years for pre-intervention vs. 59.6 [15.7] years for post-intervention patients. 52.6% of pre-intervention patients vs. 49.5% of post-intervention patients had a primary diagnosis of squamous cell or basal cell carcinoma of the head and neck. A greater proportion of post-intervention patients (30.5%) had a SOI score of 3 or 4 compared to pre-intervention patients (25.1%), although this did not reach statistical significance (p=0.058). Mean pre-intervention SOI was significantly lower than mean post-intervention SOI (1.97 vs. 2.11, p=0.01). Conclusions: A one time resident educational program was able to significantly improve documentation of inpatient comorbidities. Such a program may help to produce more accurate outcomes in an era of value based healthcare. Further study involving a larger patient cohort consisting of multiple specialties may help to validate the impact of this intervention.