Using a Visual Management System to Reduce Variation in Chart Availability

Group Health, based in Seattle, Washington, using focus groups held in 2010 confirmed that both payers and patients expected to receive timely, accurate and understandable statements of accounts. This was not happening routinely. As a key contributor to timely billing, Health Information Management (HIM) Operations coding was identified as an obstacle to generating timely billing statements. Analysis verified that documentation needed for complete coding was not always available to coders in a timely way, making discharge document processing a candidate for improvement.;HIM Operations staff members involved in processing after-visit documents for scanning into the electronic health record (EHR) worked as a team to evaluate every aspect of the process. Using LEAN methodologies, the team studied every step in their processes. Results of process mapping, procedure reviews, skills assessments and daily activity tracking were displayed visually in the work area, clearly linked upward to the customer's expectations. Team members agreed to adopt standard work based on each updated procedure. Review of updated procedures also informed staff training (or retraining where appropriate) for each staff member to ensure that work is consistently done the same way.;Many methods of displaying progress toward the goal of consistently have documentation available for coders within 3 days of date of service or hospital discharge were investigated. In the end, measuring and tracking the number of patient charts received and processed each day proved to a simple and understandable way to display the data. Staff members were engaged in every step of the process improvements and are proud to know that five months later they routinely comply with the goals sought at the outset of the engagement.