Reward for documentation increases compliance
Reward for documentation increases compliance
An inexpensive acknowledgment of a job well done
Documentation of patient education often is a struggle at many health care facilities. While patient education managers are certain education takes place, they know that there must be a record of teaching in order to prove it.
To improve documentation on the multidisciplinary education record at Southwest Washing-ton Medical Center in Vancouver, WA, Mary Paeth, MBA, RD, patient/community education coordinator, initiated an award system for good documentation. The plan was set in place with the approval of the patient education committee in preparation for a survey from the Joint Commission on Accredita-tion of Healthcare Organizations based in Oak-brook Terrace, IL, and to improve use of the new documentation form.
The awards pushed documentation of patient education up by about 20% housewide over a five-month period, and patient education received good marks from the Joint Commission.
"There are several reasons why the awards program helped," says Paeth. "It was quick to implement and efforts at documentation were swiftly recognized. Also, it acknowledged the actual person who documented. So often we reward the whole group, and there may have only been 10% that made the effort."
It was easy to implement because the details had been laid out at a poster session at a national conference Paeth attended and she followed them, although her system was less formal than that used at the Florida hospital where the original awards program was created.
Paeth rewarded units as a whole one month, and individuals the next beginning in September 2001 and ending in January 2002 when the Joint Commission surveyed the health care facility.
To determine if units as a whole were documenting patient education, she assigned one employee to conduct closed chart audits. To keep the project manageable and provide quick feedback, the designated employee did two to five chart audits per unit. "Our point was to give staff a frequent summary," she explains.
In September, two units were named winners of the "Patient Ed" Award because they had the highest percentage of charts showing that education was completed and documented on the multidisciplinary education record. "Patient Ed" is a bookworm toy that Paeth found at a local toy store and uses as a mascot to represent learning and education.
Winning units displayed the mascot and received a certificate that explained the reason they were receiving the award. Employees were given individual rewards. The first month apples for the teachers were delivered and after that employees were given packages of gummy worms. The individual rewards had stickers on them that read: "In recognition of your documentation on the patient education form." A copy of the information about the award also was printed in the medical center’s clinical newsletter.
In November, the criterion for judging units was most improved documentation in the medical record and multidisciplinary education record. In January, the Patient Ed Award was given to two units that had maintained their record during the time of the competition.
"I was fortunate enough to find two little mascots and bought them at the same time in case that happened. Because I only had two, each time I looked for something that separated two units from the others, and that became the reason they were awarded," says Paeth.
In the months of October and December, individuals were rewarded for their documentation efforts. To identify them, Paeth went to various units with a basketful of candy and looked at open charts. She made a list of all the signatures on the multidisciplinary education record. If the staff members were at work, she handed them a package of the candy and personally thanked them for their documentation of patient education.
"They were usually very surprised to receive a reward for doing something that was their job," says Paeth. If they weren’t working, she put the reward in the person’s employee box or folder. She delivered the rewards to all disciplines that had documented and that included physical therapy, nutrition, social work, and pharmacy, as well as the nursing staff.
The awards program was very inexpensive. Paeth bought the packages of candy through the hospital gift shop at cost for about $200. The apples she gave as the reward the first month were purchased from the food service department. She switched to the candy because it stored for a longer period of time and took less space than the apples.
The patient education committee decided to continue the Patient Ed Awards program following the Joint Commission survey to support documentation. The medical center is considering expanding the program systemwide, giving awards for all documentation efforts rather than singling out patient education.
"Realizing their work was noticed always catches people off guard and makes them more diligent in doing their work," says Paeth.
Source
For more information about the Patient Ed Awards program for better documentation, contact:
• Mary Paeth, MBA, RD, Patient/Community Education Coordinator, Southwest Washington Medical Center, P.O. Box 1600, Vancouver, WA 98668. Telephone: (360) 514-6788. E-mail: [email protected].
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