Simple Pneumonia and readmits

sharon.cole

Hello everyone,
We have recently noted an increase in readmits for Simple Pneumonia. These patients typically do not exceed their GMLOS. Is anyone else seeing this? If not, is your average LOS staying within parameters or are patients staying longer than GMLOS?

Sharon Cole, RN, CCDS
Providence Health Center
Case Management Dept
254.751.4256
Sharon.cole@phn-waco.org

terrierpride

I'm not sure exactly about our data on that but what you said makes me think about Oct. 1st when the CHF, AMI, and PNE guidelines go through for Value Based Purchasing. As CDI professionals I think we might want to encourage our Case Management colleagues and our providers to really treat as long as we can.

Kevin O'Neil, RHIT
CDI Specialist
Herrin Hospital

mdominesey

That’s an interesting conundrum - we would like to restrain costs, but to ensure that we do not have readmissions. Maybe crunching the data to maximize the treatment for the length of stay (LOS) and still trying to stay with the Average LOS?

On Monday I will start participating in daily multi-disciplinary rounds for CHF, soon to be other diagnoses.. ostensibly to educate and improve the specificity and clarity at the point of care. Should be interesting to assess the impact to my already full task load for a one-person shop!

Mark



Mark N. Dominesey, RN, BSN, MBA, CCDS, CDIP
Clinical Documentation Excellence
Sr. Clinical Documentation Improvement Specialist
Sibley Memorial Hospital
Information Technology
5255 Loughboro Rd NW
Washington DC, 20016-2695
W: 202.660.6782
F: 202.537.4477
mdominesey@sibley.org
http://www.sibley.org

megan.barton

We have pathways of care for specific Dx that have help our length of stay and readmission rates. I actually helped develop our first pathway for pneumonia. We have standardized orders for each day and a discharge process that makes sure each patient is being touched by a healthcare professional within days after discharge. Our length of stay decreased by over 2 days and our readmission rate went down 30%. In March our readmission rate was 0%!!
I don't believe keeping patients in the hospital longer is the answer. I believe it is providing the appropriate care in an efficient manner and making sure there are resources for the patient once they step out of the hospital doors.

Megan

Megan Barton RN, BSN
Manager Clinical Documentation Improvement
Health Information Management-Mercy East
Ph: 314-251-6192 / Cell: 636-373-1266 /Fx: 314-251-3982

Unknown

We are a hard working bunch of folks but it is oh so fun and rewarding
Good Luck and let us know how it goes.
Jamie

Jamie Dugan RN
Clinical Documentation Improvement Specialist
Baptist Health System
office:904-202-4345
cellular: 904-237-7253
Business Email-jamie.dugan@bmcjax.com
cdis.icd10@bmcjax.com

angelisa.romanello

Mark,
Do you have a nurse navigator or someone to call the CHF patients once they are discharged? It seems that lack of outpatient follow up and filling of prescriptions creates a large amount of CHF readmissions ...............that and Potato Chips according to one of our cardiologists.

Lisa Romanello, RN,BSN,FNS,CCDS
CDI Specialist
CJW Medical Center
Chippenham Campus
804-228-6527

mdominesey

Oh yes, we have a position we just created for this purpose alone - to follow-up with the patient by phone within 48 hours. And we are giving a digital scale to the patients that answer that they do not have one so they can establish the good habit of daily weights. (a good quality scale on a deal with the pharmacy in our medical building is in the mid-20s)

Mark


Mark N. Dominesey, RN, BSN, MBA, CCDS, CDIP
Sr. Clinical Documentation Improvement Specialist
Sibley Memorial Hospital
Information Technology
5255 Loughboro Rd NW
Washington DC, 20016-2695
W: 202.660.6782
http://www.sibley.org
mdominesey@sibley.org