Several years ago we would suspend physician privileges for not completing his/her charts, however, it was the hospital and the patient that was most affected because the physician would not be allowed to admit patients. This did not, at that time, impact them financially because they were employed, it really just gave them a night off call. The issue was presented to the medical staff for a more effective approach, which would get the results we all wanted, chart completion. The medical staff adopted a policy which involves a financial penalty. In summary, if the physician does not complete their medical records within the allotted time, which is 10 days post discharge, he/she are placed on the delinquent list. If this occurs three times in a 12 month period (not necessarily consecutive), they are then fined $500. This is due at the time they hit the threshold of 3 delinquencies. They are charged $5 per chart/day that they continue to be delinquent which is deducted from the $500. This money is kept in an account and at the end of the year if there are any dollars left, the physician receives those dollars back and starts a clean slate each January 1st. It has been an effective way to manage inpatient chart completion.

This is a very interesting approach to look at Joanne. As far as my hopsital is concerned, we adoted a strategy to stop the processing of any vacation leave for any doctor who has delinquent medical records on his shelves. Now I know that this is quite a loose situation, because it might take some doctors a long time to apply for a leave, yet, being in a hospital where about 90% of the doctors are expatriates, makes this strategy quite effective and it is working fairly well so far

A question for Joanne - What do you do with the money that you keep? How did the Phsyicians react to this process? Are you electronic or do the Physicians need to actually sign documents in Medical Records? What is the percentage of times that you are using this system? Has it improved your process and decreased the percentage of deliquencies?