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Pocket change: a simple educational intervention increases hospitalist documentation of comorbidities and improves

Rachel Sparks1, Alex H Salskov, Anita S Chang

  • 1Department of Medicine, University of Washington, Seattle (Drs Sparks, Salskov, Chang, Gupta, Staiger, and Anawalt); and Division of Endocrinology, University of California at San Francisco (Dr Wentworth).

Quality Management in Health Care
|April 2, 2015
PubMed

Insights

A simple pocket card and education improved hospitalist documentation of patient comorbidities. This enhances clinical care and hospital quality measures.

Area of Science:

  • Medical Informatics
  • Healthcare Quality Improvement
  • Clinical Documentation

Background:

  • Accurate documentation of patient comorbidities is crucial for clinical care, reimbursement, and quality metrics.
  • Six common comorbidities include coagulation abnormalities, metastatic cancer, anemia, fluid/electrolyte issues, malnutrition, and obesity.

Purpose of the Study:

  • To assess the impact of a pocket card reminder and educational intervention on hospitalist documentation of common comorbidities.
  • To evaluate the effect on hospital quality measures and expected length of stay.

Main Methods:

  • An intervention group (hospitalists) received a pocket card and education (520 admissions).
  • A control group (non-hospitalists) did not receive the intervention (590 admissions).
  • Documentation levels, expected length of stay, and mortality were measured over 9 months.

Main Results:

  • The intervention significantly increased documentation of anemia, fluid/electrolyte abnormalities, malnutrition, and obesity.
  • Documentation improvements were noted compared to baseline and the control group.
  • Expected length of stay increased in the intervention group.

Conclusions:

  • A simple educational intervention and pocket card effectively improved comorbidity documentation by hospitalists.
  • This approach positively impacted hospital quality measures at an academic medical center.
Abstract

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