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Developing Education and Training …….

It’s Not a Crap Shoot

HCCA Compliance Institute

April 2006

Georgette Gustin, CPC, CCS-P, CHCDirector, Healthcare Industries

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Today’s Discussion

Discuss how to identify and prioritize learning objectivesProvide strategies on how to develop curriculumReview common obstacles and mistakesQuestions/Answers

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Establish a Game Plan Don’t be afraid of change

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Tailoring Message to Audience

Who are the participants?

Medical StudentsResidentsPhysiciansAncillary StaffCoders/BillersHIM ProfessionalsBusiness OfficeAdministrationManagement

What’s in it for ME?

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Understanding the Message

What do you hope to accomplish with the training?Inform and create awarenessChange behavior

Why is it important?How should the sessions be structured?What will the organization achieve?

Group education versus individualized training:Classroom (didactic) One-on-one sessionsShadowing physicians

Computer Based Learning (CBL) modules

“Seek first to understand before you can be understood”—Stephen Covey

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

5

Establishing Learning Objectives

What do you want the participants to walk away with?Reference MaterialsTools/Pocket CardsKnowledge & Confidence

Develop learning objectives that are measurable

Provide an awareness of ….Understand policy/procedure…..Become proficient in………..Recall the documentation requirements…Select the appropriate CPT code(s)…………………..

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Developing Training Curriculum

Determine what is most helpful to the participantSolicit input from participantsCopy of Presentation MaterialTools or Pocket CardsCase example DiscussionStudy group exercisesOther

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Developing Training Curriculum

Create an outline of information to be includedEstablish session duration (45 minutes, 1 hour)Review outline – scale back information to allotted timeModify flow and content to tie back to learning objectivesIncorporate tools:

Case examples, job aides, forms, policies/procedures, exercises, etc.

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Use Case Examples

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Use Your Tools - CMS 1500 Claim Form

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Tools – Sample Medicare Bell Curve Analysis

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

99241 99242 99243 99244 99245

Medicare Dr. A Dr. B Dr. C Dr. D

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Source: CMS Website (www.cms.hhs.gov)CPT ® Copyright American Medical Association

Tools - CMS Top 200 Level I (HCPCS/CPT Codes) Physician/Supplier Data Calendar Year 2002

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Tools - Medicare Fee Schedule 2004

2004 National Physician Fee Schedule Relative Value File CPT codes and descriptions only are copyright 2003 American M edical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Dental codes (D codes) are copyright 2002 American Dental Association. All Rights Reserved.REVISED 1/14/2004

FULLY FULLYIMPLEMENTED IMPLEMENTED

STATUS NON-FACILITY FACILITY GLOB PRE INTRA POST MULT BILAT ASST CO- TEAMHCPCS MOD DESCRIPTION CODE TOTAL TOTAL DAYS OP OP OP PROC SURG SURG SURG SURG11100 Biopsy, skin lesion A 2.12 1.23 000 0.00 0.00 0.00 2 0 1 0 019101 Biopsy of breast, open A 8.11 5.10 010 0.10 0.80 0.10 2 1 1 0 044320 Colostomy A 26.86 26.86 090 0.09 0.81 0.10 2 0 2 1 046260 Hemorrhoidectomy A 10.44 10.44 090 0.09 0.81 0.10 2 0 1 0 047605 Removal of gallbladder A 22.73 22.73 090 0.09 0.81 0.10 2 0 2 1 048152 Pancreatectomy A 66.94 66.94 090 0.09 0.81 0.10 2 0 2 1 050240 Partial removal of kidney A 34.11 34.11 090 0.08 0.83 0.09 2 0 2 1 052000 Cystoscopy A 5.53 2.91 000 0.00 0.00 0.00 2 0 1 0 068100 Biopsy of eyelid lining A 6.43 2.03 000 0.00 0.00 0.00 2 0 1 0 093975 26 Vascular study A 2.53 2.53 XXX 0.00 0.00 0.00 0 0 0 0 099203 Office/outpatient visit, new A 2.57 1.92 XXX 0.00 0.00 0.00 0 0 0 0 099213 Office/outpatient visit, est A 1.41 0.95 XXX 0.00 0.00 0.00 0 0 0 0 099223 Initial hospital care A 4.15 4.15 XXX 0.00 0.00 0.00 0 0 0 0 099233 Subsequent hospital care A 2.09 2.09 XXX 0.00 0.00 0.00 0 0 0 0 099238 Hospital discharge day A 1.87 1.87 XXX 0.00 0.00 0.00 0 0 0 0 099243 Office consultation A 3.23 2.47 XXX 0.00 0.00 0.00 0 0 0 0 099253 Initial inpatient consult A 2.61 2.61 XXX 0.00 0.00 0.00 0 0 0 0 0

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Tools - Sample Outpatient Encounter Form

Provides a mechanism to sequenceup to 4 diagnosis codes

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Common Obstacles/Mistakes

Using either an unqualified and/or inexperienced instructorNot “teeing” the session up appropriately at the get-go

Need to set expectations, address materials, question/answer format, etc.

Not allowing adequate time between sessionsScheduling too many sessions in one dayToo much information to be covered in allotted timeInformation basic or to complexNot addressing each style of learning

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Relating to the Adult Learner

Keep in mind that people learn differentlyAudio, Visual, Kinetic

Include graphs, tables, exercises, group discussions, skits, etc.

Don’t include so much in your agenda that you loose your message and the participants attention

Provide the information in “sound bytes”

Check for remediation

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Selecting the Instructor

Who can portray the message in a clear, concise and confident manner?

Technical experience– Generalist or Specialist

Teaching experiencePublic speaking experience– Small groups/department meetings– Large groups– Formal sessions

Critique past evaluations, audio and videotapes

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Scheduling and Logistical Considerations

Schedule sessions at times that will be the less disruptive to the physicians clinical schedule

Schedule multiple sessions of the same type (e.g., Internal Medicine) at different times/days

Utilize department standing meeting times

Schedule the room for more time than the actual session

Do not overbook the instructor

Check the room set-up in advance

Arrange for audiovisual equipment and technical support

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Evaluating Performance and Comprehension

Instructor PerformanceDid the instructor relay the information in a clear and concise manner?Were the materials effective in illustrating key learning objectives?Did the attendee gain confidence in the subject?

Attendee ComprehensionCan the participant apply what they learned?Was a pre and post session assessment used?Did post education testing occur?

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Sample Evaluation Form

Select one answer for each of the following questions

ΟΟΟ

ΟΟΟ

1. Was the session length adequate?2. Were your expectations met?3. Did you attend an introductory session prior to this

training?

NoYes

ΟΟ

ΟΟ

ΟΟ

ΟΟ

1. Please rate the usefulness of the following:• Case Study Workbook• Pocket Guide

ΟΟΟΟ

ΟΟΟΟ

ΟΟΟΟ

ΟΟΟΟ

1. Please rate the following:• Overall Presentation• Flow of Presentation• Speaker’s Effectiveness• Quality of Handout Material

PoorFair GoodExcellent

ΟΟΟΟΟ

ΟΟΟΟΟ

ΟΟΟΟΟ

ΟΟΟΟΟ

1. Please rate your understanding of the following:• Diagnosis Coding Concepts• E&M Coding Concepts• Use of Medical Decision Making Tool• Use of Progress Note• Use of Pocket Card

Need additional

help

Some under-

standingUnderstandProficient

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Analyzing Evaluation Data/Results

78.0%

20.9%

1.1%

75.8%

23.2%

1.0%

79.2%

19.7%

1.1%

80.6%

17.3%

2.0%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

OverallPresentation

Flow ofPresentation

Speaker'sEffectiveness

Quality of HandoutMaterial

Excellent-Good Fair-Poor No response

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Analyzing Evaluation Data –Determining Next Steps

38.6%32.6%

57.5%

64.8%

3.9% 2.6%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

E&M Coding

Yes 38.6% 57.5% 3.9%No 32.6% 64.8% 2.6%

Proficient-Understand Some understanding-Need additional help

No response

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Conduct Post-Education Assessments

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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Keys to Success

Planning

Perseverance

Dedication

Compassion

Enthusiasm

Commitment

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In Conclusion

Gain internal supportIdentify and involve key stakeholdersDefine learning objectives Allow adequate time for up-front planningPrepare meaningful materials Provide reference toolsConduct post-education reviews

“I am always ready to learn although I do not always like to be taught”

—Winston Churchill

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

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“Never let them see you SWEAT”

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References

DiResta, Diana. Knockout Presentations, How to Deliver Your Message with Power, Punch and Pizzazz.Dunaway, Tray, M. “Health care language translation errors.” Compliance Today, Health Care Compliance Association, December 2002.Gustin, Georgette. “Tips to Presenting Technical Information to a Nontechnical Audience.” Journal of Health Care Compliance, October 2001.Hart, Kathy, Paul Magalian. “Audit, Individualized Training Dramatically Increase Physician Compliance.” Journal of Health Care Compliance,March-April 2001.http:www.oig.gov.hhshttp:www.presentersuniversity.comJeary, Tony. Inspire Any Audience.Knapp, Daniel. “Eight Time-Proven Presentation Tips.” Program Manager, Jan/Feb 99.Moffatt, Lauren. “Seven Steps for Using Scarce Resources to Deliver Education Sessions.” Journal of Health Care Compliance, July-August 2002.

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HCCA Compliance InstituteDeveloping Education and Training ……. It’s Not a Crap Shoot

Georgette Gustin, CPC, CCS-P, CHC©PricewaterhouseCoopers

georgette.gustin@us.pwc.com

Questions and Answers

For More Information contact:

Georgette Gustin, CPC, CCS-P, CHCDirector

PricewaterhouseCoopers300 N. Meridian Street, Suite 1700

Indianapolis, IN 46204(317) 860-2131

E-mail: georgette.gustin@us.pwc.com

© 2006 PricewaterhouseCoopers. PricewaterhouseCoopers refers to the U.S. firm of PricewaterhouseCoopers LLP and other members of the worldwide PricewaterhouseCoopers organization. All rights reserved.

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