Assess whether to escalate a case to peer review (c1ae8c)

SITUATION A unit that is an outlier after risk adjustment put unexpected mortality case series in front of clinical documentation integrity manager in a multi-hospital system comparing length of stay. This Healthcare / Models and Documentation close is to escalate a case to peer review from unexpected mortality case series, and the live options are Proceed under protocol, Pause the pathway, Escalate safety review.

DECISION Clinical documentation integrity manager in a multi-hospital system comparing length of stay must choose Proceed under protocol / Pause the pathway / Escalate safety review / Hold using unexpected mortality case series after a unit that is an outlier after risk adjustment.

HYPOTHESES TO TEST 1. Clinical documentation integrity manager can defend Proceed under protocol from unexpected mortality case series after a unit that is an outlier after risk adjustment in a Healthcare challenge. 2. Clinical documentation integrity manager cannot defend Proceed under protocol from unexpected mortality case series; Pause the pathway is what the extract actually supports after a unit that is an outlier after risk adjustment. 3. A unit that is an outlier after risk adjustment never reached the population in unexpected mortality case series — reopen intake, do not close to escalate a case to peer review. 4. Two facts in unexpected mortality case series after a unit that is an outlier after risk adjustment conflict for clinical documentation integrity manager; hold this Models and Documentation file.

ANALYSIS REQUIRED 1. Trace access logs and outputs to the rule clinical documentation integrity manager must apply. 2. Assess patient-safety and HIPAA / minimum-necessary implications of to escalate a case to peer review. 3. Quantify who is harmed if unexpected mortality case series is wrong. 4. For this Healthcare Models and Documentation file, read unexpected mortality case series against a unit that is an outlier after risk adjustment and write the one fact that would move to escalate a case to peer review for clinical documentation integrity manager.

RECOMMENDATION Choose Proceed under protocol / Pause the pathway / Escalate safety review / Hold on this Healthcare / Models and Documentation packet (unexpected mortality case series after a unit that is an outlier after risk adjustment). Lead with the Healthcare option unexpected mortality case series can support after a unit that is an outlier after risk adjustment, then the two facts that force it, then the Monday action for clinical documentation integrity manager in a multi-hospital system comparing length of stay.

COMMAND RETURNS - Bottom-line Healthcare option on to escalate a case to peer review, then the evidence in unexpected mortality case series, then the action for clinical documentation integrity manager - Hypothesis scorecard against unexpected mortality case series: supported / rejected / untestable - Models and Documentation finding in unexpected mortality case series that a second reviewer can re-perform - Missing page in unexpected mortality case series after a unit that is an outlier after risk adjustment, if any