New CDI Service: Remote CDI coverage for peds/NICU cases on a per chart cost....contact PRG for details.
What PRG Clients Say...
PRG improved our CDI program’s financial impact by over 4 million dollars in the first year alone. Their pediatric expertise was invaluable to our hospital.
Marcos Mestre, MD, MBA
Chief Medical Officer
Nicklaus Children’s Hospital
Pediatric Resource Group was instrumental in providing physician training to our new physician advisor program and establishing best practices to better support the utilization review process. Their expertise in this space led to an improved secondary review process by our hospitalist physicians which led to us canceling the need for a third-party vendor and its associated costs. The final result was much better denial prevention on the front end.
Bianca Barraza, MHA, BSN, RN, CPN
Vice President, Utilization Management
Dallas Children’s Hospital
The pediatric CDI educational series by PRG really fills a big gap that has existed in the CDI space. There is nothing like it available anywhere and every HIM and CDI leader needs to consider this for their team.
Ruth Hauser
Director, Health Information Management
Children’s Hospital Los Angeles
Unmatched Pediatric Expertise From Around the Country
The culture, patient care and reimbursement model of pediatrics is different from adults. Why do most hospitals use a consultant that isn't focused solely on pediatrics? Because they had no options, until now….
PRG consulting associates are physicians & nurses who live and breathe pediatrics and understand the operational challenges in this space. No other consulting firm has the collective pediatric expertise of PRG. We are experts in healthcare delivery within all aspects of inpatient pediatric care and we continue to care for patients, participate in research, and educate trainees.
We don’t just consult on it…we still live it daily in our clinical and administrative roles at our own children’s hospitals.
PEDIATRIC RESOURCE GROUP WILL USE ITS EXPERIENCE AND EXPERTISE IN THE FOLLOWING AREAS TO HELP YOU DEVELOP AND OPTIMIZE THESE PROGRAMS AT YOUR HOSPITAL
Clinical Documentation Improvement (CDI) Programs
PRG has years of experience in starting and leading successful pediatric CDI programs at children’s hospitals and pediatric units around the country. Accurate documentation of the patient’s care is important for the sharing of information amongst the clinical team to provide the best care possible. In addition, complete documentation also ensures that the appropriate acuity of the patient is reflected in the chart, which drives the severity-adjustment for quality and operational metrics and can also significantly impact hospital reimbursement.
Utilization Management
An increase in the hospital observation rate is affecting many adult and pediatric facilities. This is a national trend that has significant impact on hospital reimbursement. In this environment, it’s important for hospitals to have an effective utilization management (UM) program that evaluates the medical necessity of admissions in a timely manner, ensures the patient is placed in the appropriate status (inpatient, outpatient, observation services), interfaces with payers throughout the stay with peer-to-peer contact, and also provides for a strong written appeals program if a formal denial is received. Our physician UM leaders can work with your UM team on systems (i.e. InterQual™ or MCG (Milliman™)) and processes that can create a streamlined and effective UM program to ensure your hospital is optimizing its processes and progressing towards best practice in status determination.
Physician Advisor Programs
A physician advisor is an administrative role that has been growing in popularity over the years, especially in pediatric organizations. The physician leader acting in this role works with care coordinators/UM nurses and the care team to triage patients to the appropriate level of care, manages length of stay, facilitates patient flow, educates providers on documentation issues, and acts as a liaison between their physician peers, hospital administration, and payers. The consulting associates at PRG have been at the forefront of the pediatric physician advisor movement and can help your organization design and implement a program that best serves your strategic priorities.
Inpatient Pediatric Care Assessment & Optimization
The physicians of PRG have a wealth of clinical and administrative experience in the care of hospitalized children and are leaders in the Pediatric Hospitalist movement. PRG can assess and optimize all aspects of inpatient care from the admission process, coverage models, staffing, scheduling, and co-management guidelines as well as a comprehensive review of your Pediatric Hospital Medicine program.
Pediatric Emergency Care Optimization
PRG can perform a comprehensive assessment of the current state for pediatric emergency care at your organization, recommend best practice interventions, and partner with your team to implement changes. The people, systems, and setting of pediatric emergency care can be evaluated with the end goal of pediatric emergency care optimization. The consulting associates of PRG have decades of experience in pediatric emergency medicine and continue to practice as pediatric emergency medicine physicians and pediatric hospitalists.
Inpatient Access
The safe and efficient intake and placement of admission requests is a critical function for all hospitals. We can implement or redesign your inpatient access center to minimize missed admissions due to inefficient processes, improve the timeliness of transferring patients to your organization, enhance communication to and from referring providers, and create tracking systems to ensure the improvements are sustained.
Patient Flow - Throughput
Moving patients forward in their plan of care in an efficient manner without delays is beneficial to patients, families, and the hospital. To tackle this chronic issue that exists at almost every hospital, we’ll partner with our data scientists to analyze your severity-adjusted length-of-stay (LOS) data, compare it to pediatric specific expected LOS benchmarks, identify where the opportunities for improvement may be, process map suspected inefficient services in your hospital, and then use all of that information to implement interventions that can work within your hospital’s priorities, processes, and culture.
