Reference no: EM132223217

You are the assistant director for the health information department in a 350-bed hospital and the coding section is one of your major responsibilities. The department is open 24 hours a day, but the coders work on the day shift. The section has positions for four coders. Until four months ago, these positions have been filled by Kathy, Karen, Nora, and Ginny. At that time, Kathy had her baby and went on maternity leave. Within three weeks she resigned, stating she wanted to stay home with her baby full time.

After posting the job and advertising, Sara was hired and started on her probationary period. Sara had experience in coding gained at a smaller hospital. She was a congenial person but was unable to maintain the accuracy and productivity requirements of the department. Several measures were tried to help her achieve these but were unsuccessful. Therefore, she was asked to leave before the end of the probationary period.

While searching for a new coder, Kathy was asked to fill in on a temporary basis. She did this and began to ask about coming back full time. At this point, it was recognized that when Kathy returned, conflict and tension were evident among the coders. This often resulted in arguments, sarcastic remarks, and wasting of time resolving these problems. On reflection, this had been the “normal” state of affairs prior to her maternity leave.

An attempt was made to analyze the situation and the following facts emerged:

Much of the conflict seems to revolve around the different attitudes toward education and formal coding training. Kathy and Karen had been in school together where they received formal coding training and they have two years coding experience in this department. Some non-coder employees voiced their perception that Kathy was the “leader” in the coding section even though she had no formalized title. Nora has a high school education and learned coding on the job. She often asserts that this is the only way to be a truly good coder. She is an excellent coder with seven years’ experience, four in this department. Ginny is an LVN, has formal training in coding and five years’ experience, three in this department. Ginny has little interaction with the other coders. She simply goes to her cubicle, codes all day and leaves. Her breaks are spent with friends from another department where she worked previously.

An experienced coder from a small hospital has also applied for this position.

Often, there are not enough records assembled and analyzed in the morning so coders sometimes wait for records to code.

1. What is your analysis of this situation and what are some actions that could be taken to resolve it? What is your rationale for these actions?