The effect of performance incentives on resident documentation in an emergency medicine residency program.
We sought to improve resident chart documentation in an academic emergency department using an incentive. A stipend for educational expenses was offered to residents for documenting charts above specific threshold Evaluation & Management (E&M) levels. Comparisons were made with historical levels. Twenty-two residents participated over 4 months (70% received the stipend). Documentation levels increased significantly from 2.86 and 3.04 during historical controls to 3.31 during the study period (p < 0.05). Fifty-six percent of charts were documented at 99284 or 99285 during the study period compared to 39% and 23% in the control periods (p < 0.05). Three months after the plan (with no incentives), documentation continued to improve, with 59% documented at 99284 or 99285. Mean collection per patient was $48.05 for the study period and $42.36 and $35.86 for the historical periods (p < 0.05). Implementation of a resident incentive program to enhance chart documentation may considerably improve documentation and resident education in proper chart documentation.
Pines
Jesse M
JM
Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Reiser
Robert C
RC
Brady
William J
WJ
Braithwaite
Sabina A
SA
Ghaemmaghami
Chris A
CA
Cardella
Kathleen
K
Martin
Marcus L
ML
D004282:Documentation / Q000706:statistics & numerical data*; D004635:Emergency Medicine / Q000193:education*; D004650:Employee Performance Appraisal; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*