Area of good practice
Promoting the achievement of the Accredited Clinical Coder Qualification (ACC) within a specialist trust.
Background
Royal Brompton and Harefield is a specialist trust focusing on cardiopulmonary activity. Therefore the majority of coders at the trust don’t have experience in coding multiple specialities.
Objective
To encourage all the coders within the department to gain experience in multiple specialties and motivate them to complete the ACC and attend other relevant courses. Departmental support clerks are also encouraged to obtain coding skills via courses such as AMSPAR and ECDL. As coding vacancies arise for trainees they and the department will be in a good position to step in to fill them.
Outline
The clinical coding manger joined the Trust in 2009 and introduced a bespoke study timetable for each individual based on their strengths and weaknesses. For example, starting with anatomy physiology on one chapter, studying the related ICD10, then related OPCS, finally revising all the coding clinic updates relating to the same topic and updating the books.
The following all encourage and promote coder training and development:
- A deadline is set for each chapter followed by a departmental test which is marked and feedback given to the coders. Originals are given to the coder and copies are kept in the progression file for individuals.
- Quick fire question sessions in all specialties – coders enjoy this session which is done as a group and with individuals around two to three times per week. Coders were using the medicode drop down menu which is not good practice. Since they started doing the regular internal tests, they use the books rather than the drop down menu.
- The Trust has a good study leave policy. Seven days would be awarded as study leave, and a further three study leave days can be awarded by the appropriate director. The coders are also allowed an hour study time each morning for three months prior to the exam.
- Coders are encouraged to attend all the specialty workshops (even though not every specialty exists at the Trust).
- Coders’ achievements are published in the hospital news with their photos.
- The service development director personally calls them to congratulate them and show appreciation for their hard work (a coder who achieved a distinction was awarded with a prize.
- The coders are encouraged to attend the award ceremony and the expenses are paid by the Trust.
- Seeing their colleagues’ achievements, all the other coders are motivated and have more enthusiasm to study. The Trust currently has five ACC coders (two distinctions) and five more staff will be sitting the exam within the next 12 months.
- Once the coders complete the ACC, they are encouraged to do other courses on topics such as management and audit.
- Departmental support clerks are encouraged to do AMSPAR (The Association of Medical Secretaries, Practice Managers, Administrators and Receptionists) and ECDL (The European Computer Driving Licence) courses. Two clerks will be completing their AMSPAR in May 2010. Another two are also preparing to take the course. Those clerks with an AMSPAR education also get small training sessions on clinical coding regularly and they will get an opportunity in coding when the vacancies arise.
Impact
The clinical coding manager noticed immediate improvements in coding performance. Since the coders started to revise they read the inclusion and exclusion notes and apply the coding rules more thoroughly. Their achievements have created a confident and happier environment and their concentration has improved tremendously; most importantly everyone wants to attempt the ACC exam.
The Trust’s information team have noticed improved adherence to deadlines with no undefined HRGs noted and clinicians noticed improvements during the validation of coding.
Source: Royal Brompton and Harefield NHS Foundation Trust