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Weekly UpdatesTITLE. Knowledge Sharing Networks Related to Hospital Quality Measurement and Reporting
AUTHOR. Pavani Rangachari, PhD, assistant professor, Healthcare Management and Informatics, Medical College of Georgia, Augusta
GOAL. This study explores the relationship between the organizational knowledge-sharing network and hospital coding performance related to quality measurement. It seeks to identify strategies for effective knowledge exchange and communication related to quality measurement and reporting within healthcare organizations during times of rapid environmental changes.
METHODS. This study used an exploratory and comparative research design. The sample comprised four hospitals, of which two showed "good coding" performance and two showed "poor coding" performance. Interviews and surveys were conducted with administrators and staff in three subgroups in each facility: (1) quality assurance, (2) medical staff (physicians), and (3) coding (health information management). Survey data were subjected to social network analysis to examine knowledge-sharing network structures, while interview data were subjected to qualitative analyses using grounded theory methods.
PRINCIPAL FINDINGS. The study finds that good coding performance (related to quality measurement) is systematically associated with a knowledge-sharing network rich in brokerage and hierarchy, where quality administrators connect different professional subgroups (i.e., physicians and coders) to each other and to the external environment, rather than in density, where physicians and coders directly connect to each other. Other organizational variables associated with good coding performance include senior leadership involvement in quality improvement; structural integration between the quality department and hospital administration; and facility-level investment in conceptual education related to medical record documentation, coding, and quality report cards.
APPLICATIONS TO PRACTICE. From a healthcare management perspective, the study suggests that to improve coding performance related to quality measurement and reporting, senior hospital administrators must undertake proactive and unceasing efforts to coordinate knowledge exchange across physician and coding subgroups and to connect these subgroups with the changing external environment. Hospital administrators must also be proactive in developing cognitive linkages among day-to-day medical record documentation; coding; and organizational results in report cards, including the potential impact on financial reimbursement and quality ratings.
CONTACT. Pavani Rangachari at prangachari@mcg.edu.
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