Good practice from 2009/10 PbR inpatient audit
Area of good practice
Back to basics training for clinical coders.
Background:
The Trust has the following structure:
- Trainee coders - When they join the team they undertake the Foundation Training Course, rotate through several specialties, are allocated a mentor from the senior coders and attend other courses as are available. After about 12 months in post, they are audited to assess their coding skills and given an interview to assess their communication, interaction and people skills, and so on. If they pass then they are upgraded to clinical coder.
- Clinical coders - Most of these staff will embark on their coding exam training within a few months of becoming a clinical coder. However, the Trust also has a good few staff who do not feel they want to sit the national exams. These staff undertake various specialty workshops and refresher courses every three years and rotate through some of the more complex specialties. The Trust decided to offer them a back to basics course which is, in effect, the examination training but without the worry or pressure of sitting the exam at the end. This training has been very well received and ensures the coders' books are fully up to date.
- Senior coders - These staff have attained their Accredited Clinical Coder qualification and code the most complex specialties as well as mentoring trainee staff and attending specialty meetings. Some have also undertaken the coding auditor course and are able to carry out small internal audits on request.
Objective
To ensure all staff, even those who did not want to take the Accredited Clinical Coder exam, could maintain and improve coding quality. Taking the back to basics course may also have the benefit of encouraging coders to go on to sit the national exams.
Outline
Many coders at the Trust were experienced but did not want to obtain the Accredited Clinical Coder qualification. Therefore, a new back to basics training was introduced for coders who wanted to update their coding skills but did not want to sit the national exams. The training course is in effect the examination training without the perceived stress and worry of sitting exams.
Impact
Intended impact
To ensure the continued attainment of high-quality coding and ensure that staff are given every opportunity to improve their standard of work.
Actual impact
The coding manager reported that coders now have more confidence and this in itself improves coding quality. Also, from a training point of view, knowing the coders have all the relevant updates in their books means that management has more confidence in their coding.
The coding manager found that of the group of five they have going through this training at the moment, at least two have expressed a tentative interest in sitting the exam in the future. The others are close to retirement.
This has been the first group to receive the back to basics training. However, the coding manager has noticed that the exam candidates (who go through similar training) are coding in greater depth and accuracy and are confident enough to question more. The Trust can now feel confident to send its coders as well as its senior coders out to meet with consultants and medical groups to discuss coding.
Source: D&A Consultancy and Leeds Teaching Hospitals NHS Trust