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Quality documentation accurately reflects the quality of care that Lancaster General Health provides.
Are your patients really sicker? Prove it by learning about risk adjustment and the mortality index. LG Health uses the Vizient model to measure mortality with an observed over expected ratio.

The chart above shows Lancaster General Hospital’s mortality index when compared to peer hospitals.

Vizient’s 10 most common variables document the severity of your patient’s illness.

Chief Clinical Officer Michael R. Ripchinski, M.D., said that in order to achieve the most accurate mortality index, provider documentation must reflect patients’ true severity of illness. The Vizient tool aids these efforts by identifying potential areas for documentation improvement.
“LG Health cares for very sick patients,” he said. “Our mortality index should reflect that. A lower index means that more patients survived than were expected due to the severity of their illnesses.”
Ideally, a hospital’s mortality index will be less than 1, or better than expected. LG Health’s current mortality index falls within Vizient’s top quartile. Our goal is to reach the top decile compared to our peer hospitals in the country.
Director of Health Information Management Charlotte Walton-Sweeney said mortality index data also contributes to publicly available quality data and ratings, including U.S. News & World Report, HealthGrades and CMS’s Hospital Compare.
“It is very important to public reporting, quality and reimbursement that all secondary diagnoses make it in the medical record with a clear present on admission status,” she said. “This ensures that our providers get credit for the work they do.”
Pat Ducey, Retrospective Mortality Reviewer, said LG Health providers will see an increased number of queries as clinical documentation improvement specialists and professional coders attempt to make the record as accurate as possible. The CDI team is currently working closely with individual specialties.
“Thorough documentation that accurately reflects the severity of illness in your patients will reduce the number of queries you receive,” she said. “When you receive a query, it’s important that you answer with as much specificity as possible.” 
LG Health Physicians Cardiothoracic Surgery Managing Physician Jeffrey T. Cope, M.D., said all providers in the group made a conscious commitment to improving Vizient scores. Their work included daily one-on-one rounding with Ducey to help clarify documentation expectations. Present on admission diagnoses were clearly documented within the H&P/consult or noted within the first day of hospital stay.
“Quickly we developed a smart phrase within Epic that contained our most common variables (diagnoses) for our particular DRG’s,” Dr. Cope said. “With buy-in from everyone, we soon realized the need to have these diagnoses addressed each and every day for all of our patients.”
The dot phrase helps to ensure that CTSL’s providers do not inadvertently miss documenting any common variables, Ducey said. It also prevents follow-up queries, improving efficiency for providers and staff.
“Quality documentation is key, and maintenance is essential,” Dr. Cope said. “We were able to go from the bottom quartile of Vizient scores to the top tercile.”

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