Aligning Patient Safety with Healthcare Revenue Cycle Goals

HealthWare Systems Blog

Aligning Patient Safety with Healthcare Revenue Cycle Goals

Posted on Fri, Jan 23, 2015

Is your hospital equipped to address The Joint Commission’s National Patient Safety Goals for 2015?  Do your teams have the necessary tools in place to improve staff communication, to integrate all forms of patient information, and to avoid surgery-related mistakes?

Preventable errors aren’t hard to anticipate (the same general categories have defined NPSGs for more than ten years). But planning and implementing an effective strategy to combat these core problems can be daunting— especially in light of all the different players (administrators, nurses, physicians, patients and their families) and all their varying perspectives.

There’s another issue at play, too. Financial challenges (declining reimbursements, bad debt, funding cuts) have ranked as hospital leaders’ number one concern for the past ten years, according to the ACHE. CEOs are feeling the pressure to address revenue cycle management (RCM) ahead of healthcare reform, government mandates, and yes, even ahead of patient safety, in order to keep their institutions afloat.

Luckily, there are ways in which patient safety and revenue cycle goals overlap. In fact, the National Patient Safety Foundation’s Lucian Leape Institute just released a report of sweeping recommendations on this topic.  With the right dynamics in place, solving for better outcomes actually supports better metrics on the financial side, too. Here are some examples:

Improved Communication throughout the Clinical Encounter

Handoff communication is a key patient safety issue. According to The Joint Commission, handoff communication has been a leading cause of malpractice lawsuits since the organization began collecting data in the mid-1990’s.

But improved communication isn’t just about those specific patient care transitions that occur when a nurse’s shift ends or when a unit transfer takes place. Information transfer happens throughout the patient encounter. It requires accuracy, comprehensiveness, and double checks, as early as the pre-arrival stage.

Poor handoff communication is representative of a much larger issue in most hospitals, which has to do with incentivizing and rewarding individual performance versus team performance—in this case, a team’s collective safety goals. Health systems that invest in a strong patient safety culture are those that prioritize structured teamwork across the board—from registration to discharge.

Their message to peers: don’t just create handoff communication protocols; start with patient access. Cross-train and measure communication performance that extends from scheduling and registration, to accounts receivable and customer service. In this way, you can begin to make patients safer and create a healthier front-to-back revenue cycle.

Preventing Mistakes in Surgery

A cancelled surgery costs  your facility between $2,000 and $6,000, depending on the specialty involved. Since many cancelations are avoidable—e.g. cases postponed due to incomplete patient charts or misplaced test results/physician orders—you should be doing everything you can to simplify documentation.

For example, our solution for perioperative workflows and surgery center management converts all faxed forms and orders (from referring physicians, PCPs, or third-party test centers) into electronic documents. The digitized files are then incorporated into custom workflows, to ensure completion of all pre-encounter activities.  This all but eliminates the problem of missed revenue opportunity owed to cancelled surgeries.

There’s another upside to smarter perioperative workflows. You guessed it: increased patient safety.

A 2013 study estimated that more than 4,000 surgical “never” events occur annually in the US, totaling more than $1.3 billion in malpractice payments over the past 20 years. Never events include totally preventable surgery-related mistakes, like wrong-site or wrong-patient procedures. A tool for surgical documentation can’t prevent all adverse surgical events, but a tool that helps perioperative teams streamline and standardize their processes is certainly a big step in the right direction.

 Next Steps in Patient Safety and RCM

This year, Patient Safety Awareness Week will occur March 8-14, 2015. And the overarching themes are teamwork and enhanced communication. The NPSF has developed educational materials specifically designed to rethink communication channels among patients, providers, and medical peers.  As their website explains, “enhanced communication begins with an informed and engaged patient and helps to lead to safer care.”

So whether you’re in the process of vetting a new HIT solution for registration accuracy, or financial assistance screening, or unstructured patient information, remember that everyone in your organization plays a role in RCM, and everyone plays a role in patient safety. Insist on a culture that prioritizes both, by working together and communicating.