AUDITING MEDICAL RECORDS

PURPOSE:

A. The purpose of quantitative analysis is primarily to identify obvious and routine omissions that can be easily corrected.

B. The purpose of qualitative analysis is the identification of correctable deficiencies, patterns of poor documentation practices, and potentially compensable events.

DEFINITION:

Auditing refers to the quantitative and qualitative analysis of Medical Records.

A. "Quantitative analysis" is a review of prescribed areas of the medical record for identifying specific deficiencies in recording.

B. "Qualitative analysis" is a review of the content of medical record entries for inconsistencies and omissions, which may signify that the medical record is inaccurate or incomplete.

PROCEDURE:

The following list outlines the steps for auditing Medical Records by the Medical Records Technician based on quantitative and qualitative analysis. This procedure makes the medical record more complete for reference in continuing resident care; for protecting the legal interest of the resident, physician, and the facility; and meeting regulatory requirements.

A. A 10% random sample of all Medical Records shall be audited monthly.

B. A Monthly Chart Audit Checklist is maintained for every medical record. The Checklist is a criteria-based, monitoring tool used to ensure that a specific standard is always met. A check mark is placed next to item that meets the standard. A x (in red ink) is placed next to each item that does not meet the standard.

C. A list of deficiencies that need to be corrected is sent to the responsible department head within five days of the audit.

D. The date the deficiencies noted, it is to be recorded on the corresponding resident index card in the "Tickler File."
 


MEDICAL RECORDS  - 35-03-009

 

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