Team Building

cynthia.a.goeweycynthia.a.goewey
in CDI Talk Archive
Hi...We were just told today that our coding department is moving off site. We have 5 CDS RN's and we have always worked in the same office (our 5th is starting in a month). With this move 3 of us will be off site and 2 of us on site, rotating between the two areas. We feel this will be detrimental to our team, hindering learning, communication and support for each other. We have an all electronic medical record so don't spend much time on the floors (a whole other topic altogether). Two of our nurses have been a CDS for less than 1 year and our 5th is starting in 4 weeks. I am wondering how many programs spend some time together in the same area/office together everyday and how many work independently and don't communicate much with their peers face-to-face? Has anyone worked together as a team and then been split up and if so how did it impact the program?
Thanks for your feedback,
Cindy Goewey RN, BSN
Clinical Documentation Specialist
DHMC

Comments

  • lsipos@monument.healthlsipos@monument.health
    edited May 2016
    Cindy
    Wow...sounds like a cluster. I know for myself and the 2 other CDI's it is imperative for us to be "united" on all fronts for education, learning, and especially working. I think it is imperative (especially with a fairly new CDS in our office), for us to be in the same location. We "bounce" things off one another all day long....questions, verbiage for a query, and "what do you thinks"......sorry to hear you will be transposed. That stinks! I think it can only hinder long term goals and communication between everyone! Hope it changes for you!

    Juli Bovard RC CCDS
    Rapid City Regional Hospital
    jbovard@regionalhealth.com
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    Well, I just moved cross-country in May and my employer decided to allow me to keep my position. It DOES have impact. Prior to my move my other CDS (there is just one more and we are in the process of hiring) and I sat basically back-to-back. We routinely asked questioned and talked issues out. Of course that is less likely to happen in this scenario. The larger issue is that I am unavailable to other staff. I have many other duties that are strictly chart reviews and I am no longer available for face-to-face meetings and such.

    To combat these issues, I have done a few things:
    * Downloaded an instant messenger so that I can easily contact coworkers (coding, CDS, quality, etc)
    * Set up Monday morning quick phone meetings with my boss
    * Schedule quick morning call-in with coworker
    * go out of my way to be available for conference calls and such
    * Phone call-in with the coding manager several times a week.

    On-the-other-hand, I am very happy my employer went for my remote proposal. There are many advantages. I am MORE productive at home and I love the flexibility (I am dealing with a 3 hr time difference so my hours are not set, I can basically work when I want). It also can be really beneficial to the hospital to "hold on to talent". I know that in my case, this is a big reason they accepted my proposal. My employers invested lot of time and money into my training. Prior to me taking this role 18mo ago, the position went unfilled for over a year. My hospital is 3 hours from a major city and because CDI is relatively new, they have to "grow" their own staff into these kind of roles. In the case of CDI, this is often time consuming. So, for them, they felt it was in their best interest to keep me.

    That being said, I only spend half my time on concurrent reviews and I can see more shifting of my role coming in the future.

    I was moving during the ACDIS conference but I believe that there was a talk on remote CDI from a hospital that was 100% remote.

    Good luck!

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404
  • cynthia.a.goeweycynthia.a.goewey
    edited May 2016
    I just have been more clear when I said off site- we will not be at home but in a building about 1 mile away from the hospital...so 2 RNs at the hospital and 3 about 1 mile away. The concern isn't being separated from the coders but from our CDS peers.
    Cindy
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    Gotcha. From an employee perspective, it sounds like all cons and no pros to me. At least in a work-at-home system there are some clear work-life beni's.


    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404
  • fishdl@shands.ufl.edufishdl@shands.ufl.edu
    edited May 2016
    I attended the ACDIS Conference and the excellent "CDI From Home" presentation by Kaiser Permanente's Michelle Callahan & Jillian Fore. Their story was also featured in the April 9, 2012 issue of For the Record. In addition to all the obvious considerations when deciding to implement remote CDI functions, they also addressed ways to minimize the isolation factor and losing the team connection.

    I believe as we all move toward a complete EHR, the way we do business will change - whether working from home or at an off-site location. We went live with our EHR over a year ago and now spend very little time on the floors. My team took over the coding room after our coders went home to work. The benefits are - we can bounce things off one another, we have dedicated workspace with dual monitors, and we have easy access to the physicians. The disadvantages are - being able to hear every conversation in the room, and not working with our Residents, Interns, & Fellows since we are only able to send queries to the Attending physicians.

    My goal is to find an effective and efficient way to get back on the floors to increase face-to-face time with our docs, but still have an office onsite to prepare for our time on the floors and to get together for meetings, etc. It would also be important to have space for orientation and training of new CDI Reviewers

    We have been using IM for several years so we have the capability to have “real time” conversations - regardless of location, but I believe meeting at least monthly would be necessary to maintain the feeling of being a team.

    Hope things work out well for you and your team.
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