Taking coding out on to the wards to improve accuracy and visibility of the coding team

Case study: Papworth Hospital NHS Foundation Trust

Clinical coding and data quality have an essential role to play in ensuring appropriate patient care and the correct financial reimbursement from commissioners. Winner of the 2016 CHKS data quality award (specialist trusts) was Papworth Hospital. Claire Tripp, interim chief executive, says the trust places a great emphasis on helping staff and clinicians to understand why it is important that data accurately reflects what they do and that the trust cannot optimise income without accurate records. “We engage with our clinicians to explain what accurate coding entails and why we expect them to detail what has happened to a patient accurately.”
NHS coders may be employed by the trust, but they are independent from the individual directorates and they have to apply national tariffs. So when there is a new tariff, or submission of reference costs we meet with clinicians to help them understand the impact.”
Claire believes that coders are so fundamental to the organisation and the success is only possible when your clinicians understand the importance of accurate data.  “Once data is a accurate it can be used to inform the finance report and various performance committees who can be confident that the decisions they make are based on a true representation of the patient journey.”
Peer challenge is encouraged throughout the trust and it is an important part of the improvement journey. Tripp describes a culture where it is considered reasonable to ask questions of each other. This is also true of the coding team where anyone in the coding team can ask a question of someone else.
Linda Kenny is a senior clinical coder within the coding team. She says that as a specialist hospital the team works hard to ensure that anyone new to the team has the knowledge they need. Coders from other parts of the NHS will have to learn how to code procedures that are only carried out at Papworth, such as Pulmonary endarterectomy (PEA).  

As for engagement with clinicians, the team makes this a priority and holds regular workshops, but also makes sure coders are visible throughout the hospital. Coders also attend business unit team meetings on a regular basis. As for coding itself, most of this is done on the wards because they have found there are fewer uncoded episodes if the data is captured quickly.
“There is a definite recognition amongst hospital staff that accuracy of coding is a good thing. Once they know what is involved, they appreciate the coding team a lot more,” she says.

For advice and further information email info@chks.co.uk.

“We engage with our clinicians to explain what accurate coding entails and why we expect them to detail what has happened to a patient accurately.” Claire Tripp, Interim Chief Executive, Papworth Hospital NHS Foundation Trust