apply 6

CHAPTER SIX

Introduction

Chapter six will endeavor to identify and correlate the issue of proficient and consistent medical documentation with the “FIT4” principles the form the policy base for the Central Christian Health Care organization. These principles, along with professionalism will determine the patient experience. They will also dictate the CCC caregiver’s expected attitudes and approaches. These principles are as follows: Fit Soul, Fit Body, Fit Mind and Fit Heart, dealing respectively with the spirit, the social, competency and implementation aspects of the job.

Integration, Fit Soul

The Fit Soul principle finds its meaning in integrity. Judy Bielby, (2013) offers the following advice for data handlers:

“The importance of accurate, complete, and consistent coded data continues to increase. Coders who focus solely on coding for reimbursement can lose sight of the fact that coded data are also used for monitoring other aspects of care provided by hospitals and care providers. If coders allow reimbursement to incorrectly influence code assignment it could result in a very negative impact for the hospital or care provider beyond the threat of audits and fines. This negative impact extends to the measurement of a healthcare provider’s quality and safety, which could result in negative publicity and missed quality measures. The best way to prevent this is to be mindful that the data are used for a variety of purposes. It is best to focus on adherence to applicable code set and abstraction conventions, rules, and guidelines.” Bielby, J. (2013, para.6)

Integration, Fit Soul (continued)

The element of choice in the process is brought to the fore by G. Bryant (2017) para.6 in a recent article for ICD-10 Monitor:

"With encounter data now being submitted by providers and captured for payment analysis and determination, coded data is at the core of payment models and future payment models. It’s at the core of quality reporting and future quality reporting. It’s at the core of research and outcomes. If we choose not to code something that is codable and reportable due to time constraints and other challenges, then we are not being compliant nor true with data submission, and therefore not achieving data integrity. Ultimately, this type of practice affects decisions being made on healthcare for the future on many levels."

Integration, Fit Heart

The heart in this context refers not only the emotional element of an individual, but also to the relational and social environment into which that individual contributes. Learning a new documentary program such as ICD-10 can be difficult enough, but strong leadership to avoid morale loss is critical during any transition. D. McCafferty (2011) wrote:

"Many organizations struggle to develop a winning company culture. In fact, 87 percent of HR and business leaders acknowledged that a lack of employee engagement has emerged as their No.1 issue, according to research from Deloitte. Only 12 percent said they have a program in place to define and build a strong culture, and just 7 percent rate themselves as "excellent" in measuring, driving and

Integration, Fit Heart (continued)

improving engagement and retention. Given the findings, it's safe to conclude that many organizations are facing employee morale issues." McCafferty, D. (para.1)

Not everyone learns at the same rate and the seeming inequities of a group of employees who struggle, against others who adjust easily is likely to cause hard feelings and divisions among the staff and even between the outsource team and staff. To get out in front of such a possibility, Kinley McFadden (2013, para.7), suggested teamwork:

"People like working in teams. Statistics show that people are at their most efficient when they work in teams – a phenomena called synergy, which states that the combined output of a team is more than the output of each individual added together. Or in other words, 2+2=5! Thus, it is very important to form teams, put employees in teams that will get the best out of them, form ‘support groups’, and promote and nurture unity. Make people in your organization feel valued. When people work in teams, they see themselves as a group that works towards the attainment of a common goal, rather than just bunch of individuals competing against each other."

Integration, Fit Mind

In this model the mind, in addition to performing as the center of intellect, is also held to be the source of relationships. Lateral relationships with co-workers and chain of command relationships above and below. Regarding coworker relations, Nicole Liloia (2014), writing for Forbes advises the following when communicating:

“It’s important to remain non-judgmental and non-confrontational when speaking with your colleagues. This will create an environment where employees are encouraged to talk to each other about any issues that come up so that they can be handled quickly and efficiently, without anyone feel uncomfortable addressing these things.” Liloia, N. para.3

The nation today is tensely divided. Communication and self-discipline in such an environment may be, for some, a challenge. Implementing a gentle and humble mannerism will engender a calm and productive workplace environment. Amanda Haddaway (2016), offers the following tips to remember:

"Understand that people are unique and dwell on their positive qualities, not their negative qualities. It’s acceptable to not be friends with everyone but try to at least be professional and cordial in your interactions. Rise above office gossip. No one wants to earn the reputation of being the office busybody. Communicate, communicate, communicate! Your co-workers are not mind readers, so make sure you’re communicating with them and your manager on a regular basis." (Para.4)

Integration, Fit Body

The body is the vehicle through which people interact with the world. Each of the preceding “FIT” elements require active implementation in order to be effective. ICD-10 went into effect in 2015. Today healthcare practitioners must continue to implement and integrate with the new coding paradigm. With this in mind, Mark Jahn, (2014) admonished organizations to be ready for action and to actively prepare in specificity for the (then future) launch of ICD-10 and all its attendant changes. He wrote:

Integration, Fit Body (continued)

"Because of the uniqueness of ICD-10, you will likely need to outsource at least part of your ICD-10 training to an external organization and/or purchase ICD-10 training solutions. Your coders will need to start earlier than other roles in your hospital, learning anatomy and physiology first (to comply with these key requirements in ICD-10), and then moving to more advanced ICD-10 training topics, specific to their assigned areas. Physicians also will need to be trained; there are several technology-based training solutions enabling physicians to learn on their smartphones and other mobile devices in small snippets of time, as opposed to being required to sit through multi-hour presentations. All departments impacted by ICD-10 will need some level of ICD-10 training and education." (Jahn, M. para.8)

Similarly, Gary Lucas (2018) observes that human nature may lead to less productive behaviors:

"Providers still need training on clinical documentation and coding related to ICD-10-CM. Too much reliance on coding software tools and leaning too heavily on "favorites" lists can prevent clinics from accurately reporting diagnoses to patients, payers, public health and

beyond." Lucas, G. (para.1)

Conclusion

The integration of these Christian principles and practices has proven to benefit all who relied on them in the past. The Fit Soul has engendered integrity. The Fit Heart, a strong social character. The Fit mind has rendered its wielders competency and the Fit Body provided the vehicle for implementation.