There are many measurements that contribute to the successful management of a CDI program. Productivity may be the single most important measurement for any function. Productivity is important to the individual, the department, and the entire organization. How you manage productivity must be understandable, straight forward, and consistent. When individual reviewers are comparing their weekly, monthly or quarterly accomplishments, they must know that Mary is measuring her record review numbers in the same way as Kathy and vice versa. Here are some common questions that you must define the answers to, and document those definitions, if you want your measurement efforts to produce meaningful data. In otherwords, are you sure you are comparing apples to apples and oranges to oranges:
1. Record review - does this refer to the number of records reviewed or the number of reviews in each record? By not defining this clearly, you can have data that compares one indivual's review of an entire record (with possibly multiple reviews per record) to another individual who recorded each review in the same record separately. The outcome is data that is not meaninful.
2. Query rate - does your query rate reflect the number of records queried, or the number of total queries? If one record contains 3 or 4 queries, but is only counted as one query (because it is one record), again, your data is not reliable or meaninful.
3. Review rate - when calculating your overall review rate, you need to clearly define the patient population that is "eligible" for review. For example, if you have exlcluded newborns and one day stays in your eligible population, you want to make sure that those cases are deducted from the denominator when you calculate the review rate - if not, your review rate will appear much lower than it is.
All of these issues can be resovled by thinking through every measurement, defining each measurement, and documenting the definitions in places that are easily accessible to program staff: on forms or computer screens that are used daily. In addition, inlcuding measurements (to the extent practical) on the CDI Dashboard Report (or whatever you call your regular CDI summary to senior leadership and medical staff) provides clarity and transparency for all readers.
