Stroke Clinical Coding and Documentation Education Program

This will be a cluster randomised controlled trial, using the stepped wedge design, with the allocated states/country as the clustering unit. This approach will involve the pre-intervention and intervention periods being staggered across clusters, thereby ensuring that the intervention is available to all participants. The intervention modules will be implemented monthly across the 4 intervention periods 1) Victoria/Tasmania; 2) New South Wales/Queensland; 3) Western Australia/South Australia/ Northern Territory; 4) New Zealand. The education program will comprise eight modules, including those focusing on: 1) rationale for coding 2) understanding the brain and stroke 3) management of stroke 4) Australian coding standards for stroke 5) good coding practices 6) coding trees 7) good clinical documentation 8) scenarios. These modules will be aimed at improving the knowledge of clinical documentation for stroke and coding of stroke. Coders will complete all modules, while clinicians will complete four modules (1,4,5,6 modules). The education workshop has been scheduled to be delivered via teleconference to registrants in all states in Australia (3 workshops) and in New Zealand (1 workshop). The mode of training includes lecture + power point slides and interactive activities (e.g. pre and post surveys as well as polls for the scenarios). The one day education workshop is targeted for coders and clinicians and will take 60-90 minutes. The education program will be delivered virtually by A/Prof Monique Kilkenny (an academic, with more than 20 years experience as a health information management expert and epidemiologist), Ailie Sanders (more than 3 years as a health information manager/clinical coder) and Dr Lauren Sanders (an academic and clinical neurologist), and will be updated regularly as it evolves. Therefore, the modules will be structured such that they can accommodate future changes or updates in coding. The Admissions coded datasets in all states in Australia and New Zealand will be monitored regularly (each quarter) to determine whether there has been a decrease in the coding of I64 (Unspecified Stroke). The validation study comparing the Australian Stroke Clinical Registry clinical diagnosis and the admissions coded data will be repeated to monitor the coding of stroke (see Ryan et al. Stroke & Cerebrovascular Diseases 2020).