The AHIMA international team recently completed an exciting long-term project in coding and auditing with an organization in Southeast Asia. AHIMA International’s Kathy Giannangelo, MA, RHIA, CCS, FAHIMA, Cari Greenwood, RHIA, CCS, CICA, CPC, and Gina Sanvik MS, RHIA, CCS, CCS-P, developed workshops, completed two train-the-trainer programs, curriculum review and co-development of an audit and process tool.  We sat down with Kathy Giannangelo to learn more. 

Kathy, can you share an overview of the project and the outcomes?

This was a multifaceted project completed over a 10-month period. First, we developed a one-week train-the-trainer program. Materials created for the training included an agenda, PowerPoint slide deck, handouts, exercises, and 15 case studies. We also provided a pre- and post-training tests to validate participant learning and understanding. We provided two (2) training programs. The in-person trainings were conducted from March 20-31 using an interpreter. Each group was very engaged and eager to learn. At the conclusion of each week, attendees were awarded an AHIMA certificate stating completion of the AHIMA International Train-the-Trainer Program and recognition as an AHIMA International Coding Trainer in ICD-10 and ICD-9-CM.

Next, the client’s current clinical coding curriculum, training, and assessment materials were reviewed. Our findings showed that the curriculum included appropriate baseline courses to meet the goals of the training. We did suggest courses to expand and add for a more comprehensive, best practice, training program. 

The final step was co-development of an outline and protocol for a clinical coding audit and assessment. Deliverables included an audit protocol and checklist based on international best practices, an example of an audit report applying the protocol and checklist, and an audit data collection and reporting tool. The client tested the tool by conducting a coding audit and found it to be easy to apply.

When AHIMA provides train–the–trainer programs, what is involved in this process? How is feedback provided to the trainees?

Initially we work with the client to define the scope of work. Several planning calls are needed to discuss the purpose, training, and scheduling, and to come to agreement regarding what the training will and will not include. The agenda for the training should be agreed upon by both parties. Managing client expectations can be tricky and scope creep can happen if you are not careful. To manage expectations, we create PowerPoint slide decks, handouts, exercises, and pre- and post-test assessments.

We clearly articulate the objectives of the train-the-trainer program as follows:

• Apply facilitative skills to promote learner engagement, reflective practice, and skill acquisition
• Display understanding of solutions for the most misunderstood issues related to training
• Employ common training strategies such as brainstorming, interactive presentations, processing/process checks, and practice sessions.
• Identify intervention options for difficult training situations

Thus, the exercises are designed to strengthen the participant's facilitation skills. A key portion of the train-the-trainer program is the participant teach-back demonstration. This is where a participant presents for 10-15 minutes to the AHIMA facilitator and other attendees. Standard evaluation elements are used by the AHIMA facilitator when providing feedback after each presentation. Other attendees are also asked to comment on the presentation.

What are the next steps for this organization to continue refining their coding and auditing?

Those trained as AHIMA International Coding Trainers will conduct coding workshops to expand the clinical coder workforce for the country. They will use the AHIMA-developed PowerPoint slide deck, handouts, exercises, and 15 case studies for the workshop.

Selected individuals from the organization will conduct coding audits and assessments to ensure there is coding accuracy and consistency across hospitals. AHIMA created a protocol and checklist to facilitate the auditing of coded clinical data to measure compliance with their coding standards. We also provided essential data-collection and reporting tools for the client to incorporate into the audit processes.

What other types of train-the-trainer programs does AHIMA offer? How can readers learn more?

AHIMA can provide a train-the-trainer program for multiple health information (HI) topics. The training topic or workshop can be customized for a specific organization or it can be based upon current workshops that AHIMA offers. If your organization is interested in building staff capacity, AHIMA can provide this type of training for a select group of staff to become trainers on a specific HI topic. If you are interested in learning more, please contact Lori Shanahan at lori.shanahan@ahima.org.

Kathy Giannangelo, MA, RHIA, CCS, FAHIMA