Impact of a specialty trained billing team on an academic otolaryngology practice

Development of billing post competency evaluation index system for nurses in China: a Delphi study

AIM

This study developed a set of competency evaluation indicators for billing nurses in China.

BACKGROUND

In clinical practice, nurses often take up billing responsibilities that are accompanied by certain risks. However, the competency evaluation index system for billing nurses has not been established in China.

METHODS

This study consisted of two main phases of research design: the first phase included a literature review and semi-structured interviews. Individual semi-structured interviews were conducted with 12 nurses in billing departments and 15 nurse managers in related departments. Concepts distilled from the literature review were linked to the results of the semi-structured interviews; this phase produced the first draft of indicators for assessing the professional competence of nurses in billing departments. In the second phase, two rounds of correspondence were conducted with 20 Chinese nursing experts using the Delphi method to test and evaluate the content of the index. The consensus was defined in advance as a mean score of 4.0 or above, with at least 75% agreement among participants. In this way, the final indicator framework was determined.

RESULTS

Using the iceberg model as a theoretical foundation, the literature review identified four main dimensions and associated themes. The semi-structured interviews confirmed all of the themes from the literature review while generating new themes, both of which were incorporated into the first draft of the index. Then two rounds of the Delphi survey were conducted. The positive coefficients of experts in the two rounds were 100% and 95%, respectively, while the authority coefficients were 0.963 and 0.961, respectively. The coefficients of variation were 0.00-0.33 and 0.05-0.24, respectively. The competency evaluation index system for billing nurses consisted of 4 first-level indicators, 16 s-level indicators, and 53 third-level indicators.

CONCLUSION

The competency evaluation index system for billing nurses, which was developed on the basis of the iceberg model, was scientific and applicable.

IMPLICATIONS FOR NURSING MANAGEMENT

The competency assessment index system for billing nurses may provide an effective practical framework for nursing administration to evaluate, train, and assess the competency of billing nurses.

Maximizing the effectiveness of scribes in surgical practices

Surgeons are spending increasing amounts of time on non-patient facing responsibilities such as electronic health record (EHR) documentation, coding, and inter-office communication. The burden of documentation is a significant contributor to burnout, which adversely affects surgeons' work satisfaction, productivity, and personal wellness. Scribes can help reduce the clerical burden experienced by surgeons. Studies have shown that scribes increase work satisfaction, reduce EHR documentation time, improve provider productivity, and increase work relative value units (wRVUs). That being said, surgeons must learn how to work with scribes effectively in order to yield these benefits. We outline considerations and strategies for optimizing the role of scribes in a surgical practice. Scribes can be valuable members of the surgeon's healthcare team by 1) learning the language and pathologies specific to a surgical specialty, 2) efficiently documenting prior to, during, and after clinical encounters, and 3) assisting with coding and inter-office communication.