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Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
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Attempting to Define Clinical Productivity Metrics among Pediatric Palliative Care Services at Academic Children's

Daniel P Mahoney1, Ilanit Brook2, Mallory Fossa2

  • 1Texas Children's Hospital Pediatric Advanced Care Team (PACT), Houston, Texas.

Journal of Palliative Medicine
|August 13, 2019
PubMed

Insights

Pediatric palliative care (PPC) programs face complex workforce and billing challenges. Understanding these dynamics is crucial for the sustainability of PPC providers and to mitigate burnout in this vital field.

Area of Science:

  • Healthcare Management
  • Palliative Care Research
  • Pediatric Healthcare Services

Background:

  • Pediatric palliative care (PPC) programs have expanded significantly in US academic children's hospitals over two decades.
  • Limited understanding exists regarding the interplay of workforce staffing, billing/coding, clinical demands, and program sustainability in PPC.
  • High burnout rates among PPC providers necessitate a clearer definition of these operational relationships.

Purpose of the Study:

  • To investigate the relationships between workforce staffing, billing and coding practices, clinical service requirements, and program sustainability in academic PPC programs.
  • To gather data on billing provider full-time equivalent (FTE) staffing and productivity metrics within PPC programs.

Main Methods:

  • A convenience sample of 10 PPC program leaders from US academic children's hospitals was surveyed.
  • Information on billing provider FTE, billing/coding practices, and productivity metrics was collected for a three-month period (Jan-Mar 2017).
  • Evaluation and management data were analyzed from seven participating programs.

Main Results:

  • For the seven programs providing data, the estimated mean work Relative Value Unit (wRVU) production was 1626 per 1.0 FTE annually.
  • The estimated mean number of consultations was 15 per 1.0 FTE monthly.
  • The estimated mean total clinical encounters was 70 per 1.0 FTE monthly.

Conclusions:

  • The relationship between PPC billing provider productivity and clinical workload is intricate and highly variable across academic PPC programs.
  • Further research is needed to clearly define these relationships to enhance the sustainability of both billing and non-billing PPC providers.
  • Addressing these operational complexities is vital for supporting PPC workforce well-being and program longevity.

Keywords:
billing and codingclinical productivitypediatric palliative careprogram developmentsustainability

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