Decision algorithm for when to use the ICD-11 3-part model for healthcare harms

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Abstract

Accurate data collection of healthcare-related adverse events provides a foundation for quality and health system improvement. The International Classification of Diseases for Mortality and Morbidity Statistics, 11th revision (ICD-11 MMS) includes new codes to identify harm or injury and the events or actions leading to the adverse events. However, it is difficult to choose the correct codes without in-depth understanding of which event may be classified as an injury or harm. A 3-part model will be available in the ICD-11 MMS to cluster the codes for the harm or injury that occurred, the causal factors, and the mode (mechanism) involved. While field testing coding of adverse events, our team developed a decision tree (algorithm), which guides when to use the 3-part model. The decision tree now resides in the ICD-11 Reference Guide. This paper is part of a special ICD-11 paper series and outlines the steps used in the decision-tree (algorithm) and provides examples to help understand the process.

While it may take coders some time to gain experience to use the 3-part model and decision-tree, the ICD-11 Reference Guide and this paper can be helpful resources to help clarify the process.

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ICD-11 for quality and safety: overview of the WHO Quality and Safety Topic Advisory Group.

S Brien, Brigitta Spaeth-Rublee, T Ustün … (2013)

This paper outlines the approach that the WHO's Family of International Classifications (WHO-FIC) network is undertaking to create ICD-11. We also outline the more focused work of the Quality and Safety Topic Advisory Group, whose activities include the following: (i) cataloguing existing ICD-9 and ICD-10 quality and safety indicators; (ii) reviewing ICD morbidity coding rules for main condition, diagnosis timing, numbers of diagnosis fields and diagnosis clustering; (iii) substantial restructuring of the health-care related injury concepts coded in the ICD-10 chapters 19/20, (iv) mapping of ICD-11 quality and safety concepts to the information model of the WHO's International Classification for Patient Safety and the AHRQ Common Formats; (v) the review of vertical chapter content in all chapters of the ICD-11 beta version and (vi) downstream field testing of ICD-11 prior to its official 2015 release. The transition from ICD-10 to ICD-11 promises to produce an enhanced classification that will have better potential to capture important concepts relevant to measuring health system safety and quality-an important use case for the classification.

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Training and experience of coding with the World Health Organization’s International Classification of Diseases, Eleventh Revision

Cathy A Eastwood, Danielle A Southern, Chelsea Doktorchik … (2021)

Background: The new International Classification of Diseases, Eleventh Revision for Mortality and Morbidity Statistics (ICD-11) was developed and released by the World Health Organization (WHO) in June 2018. Because ICD-11 incorporates new codes and features, training materials for coding with ICD-11 are urgently needed prior to its implementation. Objective: This study outlines the development of ICD-11 training materials, training processes and experiences of clinical coders while learning to code using ICD-11. Method: Six certified clinical coders were recruited to code inpatient charts using ICD-11. Training materials were developed with input from experts from the Canadian Institute for Health Information and the WHO, and the clinical coders were trained to use the new classification. Monthly team meetings were conducted to enable discussions on coding issues and to select the correct ICD-11 codes. The training experience was evaluated using qualitative interviews, a questionnaire and a coding quiz. Results: total of 3011 charts were coded using ICD-11. In general, clinical coders provided positive feedback regarding the training program. The average score for the coding quiz (multiple choice, True/False) was 84%, suggesting that the training program was effective. Feedback from the coders enabled the ICD-11 code content, electronic tooling and terminologies to be updated. Conclusion: This study provides a detailed account of the processes involved with training clinical coders to use ICD-11. Important findings from the interviews were reported at the annual WHO conferences, and these findings helped improve the ICD-11 browser and reference guide.

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Author and article information

Contributors

Cathy A. Eastwood:

ORCID: http://orcid.org/0000-0002-4569-8014

caeastwo@ucalgary.ca

Journal

Journal ID (nlm-ta): BMC Med Inform Decis Mak

Journal ID (iso-abbrev): BMC Med Inform Decis Mak

Title: BMC Medical Informatics and Decision Making

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6947

Publication date (Electronic): 7 June 2022

Publication date PMC-release: 7 June 2022

Publication date Collection: 2021

Volume: 21

Issue : Suppl 6 Issue sponsor : Work for the series of articles has been undertaken by the WHO-fic (World Health Organization Family of International Classifications) Network. Funding from the Canadian Institutes for Health Research (CIHR) and the Agency for Healthcare Research and Quality (grant number 5R13HS020543-02) supported aspects of this work and activities of several of the authors. The articles have undergone the journal's standard peer review process for supplements. The Supplement Editors declare that they have no competing interests.

Electronic Location Identifier: 380

Affiliations

[1 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Centre for Health Informatics, Cumming School of Medicine, , University of Calgary, ; 3280 Hospital Drive NW, TRW 5E06, Calgary, AB T2N 4Z6 Canada

[2 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Department of Community Health Sciences, Cumming School of Medicine, , University of Calgary, ; Calgary, Canada

Author information

Cathy A. Eastwood http://orcid.org/0000-0002-4569-8014

Article

Publisher ID: 1887

DOI: 10.1186/s12911-022-01887-6

PMC ID: 9171926

PubMed ID: 33388057

SO-VID: 16f8d1ba-5fb3-4f96-b009-0115e4b01b04

License:

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