Sands said that medical workers used a marker to correctly label the side of the patient that should have been operated on but that, somehow, the surgeon failed to notice the marking. “I think he began prepping without looking for the mark and, for whatever reason, he believed he was on the correct side,” Sands said. Perhaps most crucially, the team of medical workers hovering in the operating room neglected to conduct what’s known as a “time out” before the surgeon first placed his scalpel on the patient. Time outs are safety procedures that require the operating team to verbally call out, “Right patient, right procedure, right location.

I embarked on a mission several years ago to stream line our billing and coding process. Data is knowledge. And knowledge is power. The power to improve the process. This was no easy task. For an entire year I kept intricate details of my billing practices for every single patient I saw for an entire year. About 2500 encounters. I created a spread sheet program full of fancy formulas and incredibly useful information for our group. From what type of shift it was long shift, short shift, night shift . What hospital, what the billing code was the CPT code , how many daily encounters for every shift, how many new admissions and consults for all the different shifts, total numbers of RVUs for all different shifts worked, numbers of shifts, numbers of procedures, daily RVUs, monthly RVUs. I developed numerous calculations. I developed my own efficiency ratio the total number of follow-up codes/total number of admission codes where as we could evaluate the practicing characteristics of all 17 of our hospitalists. Because shift work hospitalists don t own a patient from start to finish, it is often hard to tell who hangs on to patients longer and who is efficient with discharges. In most hospitalist programs across the country, salary combines with productivity based models of care. These characteristics can become important when dissecting out those partners that see more new encounters from those that simply see more patient encounters. A form of length of stay equalizer.