Best Practice at your facility?

Unknown
edited May 2016 in CDI Talk Archive
The hospital I work for is an academic teaching facility with many
residents. We have a lot of unanswered queries. I am enlisting the
help of the case managers to get our queries answered and am planning a
presentation for them now. How do your case managers help you with your
CDI program?

Stacey Forgensi, RN, CCRN, CCDS
Clinical Documentation Specialist
Pager 642-1011




Comments

  • dsmith12h@aol.comdsmith12h@aol.com
    edited May 2016
    CDI fall within the case management department here. We are also a teaching hospital. We have 2 CDIS and the case managers have no part in what we do, they are very busy and would not have the time to help. We have good success relative to having our queries answered, not great only good.

    Debbie Smith








  • nbrunson84nbrunson84
    edited May 2016
    I agree - our case managers have so much to do with Discharge
    Planning/Social Issues - and I'm very leery of depending on other people
    for getting my information.





    N. Brunson, RHIA

    Clinical Documentation Specialist

    Bay Medical Center


  • Unknown
    edited May 2016
    Regarding my question from earlier:

    The hospital I work for is an academic teaching facility with many
    residents. We have a lot of unanswered queries. I am enlisting the
    help of the case managers to get our queries answered and am planning a
    presentation for them now. How do your case managers help you with your
    CDI program?

    I'm just looking at having them be a liaison between the CDS and the MD
    - they round with them everyday with the charts. I thought that was a
    great opportunity to have them remind the MD to answer the query when
    they see one. I'm not looking to have them do actual CDS work, just
    tell them to answer a query when they see one.



    Stacey Forgensi, RN, CCRN, CCDS
    Clinical Documentation Specialist
    Pager 642-1011




  • lspryszaklspryszak
    Your idea certainly seems like a logical "second approach' to getting your queries answered. I think it would be worth your time to bring this to administration and see if you can include this "communication of information" as part of your formal written program process (assuming you have one). Better documentation will often support an increased length of stay so you're helping the case managers, too.

    This is an example of how we're not trying to step on another's toes, but collaborate for the best outcomes. If you look at it from an overall perspective, why wouldn't a facility encourage this type of collaboration?

    Or...what is the potential for YOU to round with the resident/attending at least once a week on each of your units? This is a perfect opportunity to get clarification as they're discussing the case. Even if your teaching facility first rounds on the computer you can sit in and ask how they documented something and suggest changes.

    I've seen this in action and it's very effective.
  • stacy.vaughnstacy.vaughn
    edited May 2016

    I was just thinking about the feasibility of CDI on the rounding
    perspective. Wondering how beneficial it would be. Seems like a great
    idea, but time consuming.

    Question: Do you page the physician to get answers to your queries? I
    know everyone has different routes depending on the physician and their
    approach, but I wonder if paging should be saved for direct patient care
    purposes?

    Stacy Vaughn, RHIT, CCS
    Data Support Specialist/DRG Assurance
    Aurora Baycare Medical Center
    2845 Greenbrier Rd
    Green Bay, WI 54311
    Phone: (920) 288-8655
    Fax: (920) 288-3052




  • nbrunson84nbrunson84
    edited May 2016
    I have called physicians to talk with them about queries. Sometimes it
    has been beneficial and sometimes not. I really try to talk with them
    on the floor.





    N. Brunson, RHIA

    Clinical Documentation Specialist

    Bay Medical Center


  • digardskdigardsk
    edited May 2016
    We only page / call if there has not been a response to our written methods, and if we think the question warrants it. (for money, an mcc...) Otherwise, we do try not to be intrusive with pages.

    Kim


  • dogdog
    I'm lucky if the case managers let me know when they've converted someone from OP to IP. Actually, I'm usually telling them when I find a problem with the orders.

    As for rounding, each doctor has his/her own routine and it is never the same from day to day. We have no idea who is going to be anywhere at any time. It's always been a source of frustration for nurses, patients, and families.


    Renee

    Linda Renee Brown, RN, CCRN, CCDS
    Clinical Documentation Specialist
    Arizona Heart Hospital
    (602) 532-1117 (desk); (602) 532-1918 (mobile)
  • dallend@einstein.edudallend@einstein.edu
    edited May 2016

    I just wanted to something to this discussion - we do page our physicians at our facility and that seems to work well. We tried rounding with them but it was way too time consuming.


  • tiffany_susantiffany_susan
    edited May 2016

    They are not involved with our program at all. Unfortunately, I feel we
    could help each other out greatly.

    Thank You,
    Susan Tiffany RN CDS
    Supervisor Clinical Documentation Program
    Guthrie Healthcare System
    phone: 570-882-6094
    fax: 570-882-6768
    email: tiffany_susan@guthrie.org

    "Twenty years from now you will be more disappointed by the things you
    didn't do than by the ones you did do. So throw off the bowlines. Sail
    away from safe harbor.Catch the trade winds in your sails. Explore. Dream.
    Discover." Mark Twain







  • robert.hodges2robert.hodges2
    edited May 2016
    My providers here told me to page them if I couldn't catch them by
    phone. Of course they know that patient care comes first and I don't
    expect an immediate response to their page.



    Robert



    Robert S. Hodges, BSN, MSN, RN

    Clinical Documentation Improvement Specialist

    Aleda E. Lutz VAMC

    Mail Code 136

    1500 Weiss Street

    Saginaw MI 48602



    P: 989-497-2500 x13101

    F: 989-321-4912

    E: Robert.Hodges2@va.gov



    "Anyone who has never made a mistake has never tried anything new."
    -Albert Einstein




  • Unknown
    edited May 2016
    We take an interdisciplinary approach to things and work well with the
    other departments. Our CDI program is also involved with LOS as we are
    under the Case Management Department. I provide a list to the CRC's and
    Social Workers of the Working DRG with GMLOS and the actual LOS. It
    gives them an idea of where they stand for D/C planning etc. As we only
    review DRG payors we also assist as needed with other payors and
    selfpays to achieve better documentation resulting in less denials. I
    also work collaboratively with the Evidence Based Measure RN here to get
    the documentation we both need. Additionally I attend interdisciplinary
    rounds in ICU daily.



    As for queries-we try to talk to the MD's personally to get an answer to
    a written query or verbally query whenever we can. One to one seems to
    get a much better response.

    .

    Virginia Bailey RN CDS

    Clinical Documentation Specialist

    Morton Plant Northbay Hospital

    727-859-4880 or ext 74880 from within system




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