need your help

Unknown
edited May 2016 in CDI Talk Archive
PLEASE help me! I just got 'invited' to a meeting with the CFO and Director of Quality for Monday morning. My suspicions think we are going to be asked to take over Core Measures. Will you please help me do a quick survey by sending back a YES or NO if your CDI program has the additional responsibility of concurrent review for core measures?

Thank you so very much for your help with this request.


Linnea Thennes, RN, BS, CCDS
Supervisor, Clinical Documentation Improvement
Centegra Health System
815. 759-8193
lthennes@centegra.com

Comments

  • robert.hodges2robert.hodges2
    edited May 2016
    No. QM owns that here.

    Robert


    Robert S. Hodges, BSN, MSN, RN, CCDS
    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


    "Patriotism is easy to understand in America; it means looking out for
    yourself by looking out for your country" Calvin Coolidge
  • tpeytontpeyton
    edited May 2016
    yes I do review core measures but I am the only CDI and I do not make it a priority if our census is high



    Tracy M Peyton RN, CCDS
    Bradford Regional Medical Center
    Upper Allegany Health Systems
    116 Interstate Parkway
    Bradford, PA 16701
    814-558-0406
  • lsipos@monument.healthlsipos@monument.health
    edited May 2016
    NO! AND IF YOUR INSTITUTION IS LIKE OURS, THERE SIMPLY ISNT ENOUGH TIME TO DO WHAT WE DO AND THEN TAKE ON THAT ADDITIONAL RESPONSIBILITY. We have Quality Coordinators whose responsibility involves Core Measures~

    GOOD LUCK!

    Juli Bovard RN CCDS
    Rapid City Regional Hospital
  • dvitalone1dvitalone1
    edited May 2016
    NO!!!
    CDI needs to focus on CDI!!
  • bosankorbosankor
    edited May 2016
    No - Quality owns that here

    Roberta Bosanko MS, CDIP, CCS-P, CPMA, CPC-P, CEMC
    AHIMA ICD-10-CM/PCS Training Instructor
    Director, Finance ICD-10
    Hospital For Special Surgery
    535 E 70th Street
    New York, NY 10021
    bosankor@hss.edu
    212-774-2906 Office
  • megan.bartonmegan.barton
    edited May 2016
    Quality does core measures but we are going to start reviewing patient safety indicators very soon...this may be what they are wanting from you.
    Megan

    Megan Barton RN, BSN
    Manager Clinical Documentation Improvement
    Mercy East - 615 South New Ballas Rd. St Louis 63141

    ph: 314-251-6192 / cell: 636-373-1266 / fx: 314-251-3982
  • msjonesmsjones
    edited May 2016
    No, Quality reviews core measures @ our facility.

    Michelle Jones, RN
    Clinical Documentation Specialist
    HIMS Department
    252-209-3012
    msjones@vidanthealth.com
  • fishdl@shands.ufl.edufishdl@shands.ufl.edu
    edited May 2016
    No

    Donna
    Donna Fisher, CCS, CCDS
    Clinical Documentation Improvement Coordinator
    Shands at the University of Florida
    Ph: 352.265.0680 ext 48769
    fishdl@shands.ufl.edu
  • Unknown
    edited May 2016
    No. We have dedicated Quality people for that.

    Charlene
  • cynthia.a.goeweycynthia.a.goewey
    edited May 2016
    No, we do not do core measure reviews.
    Cindy
  • digardskdigardsk
    edited May 2016
    Do NOT take it over. We do selected elements we can "help" with, but are NOT responsible. It is too big to combine.




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  • sharon.cooper@owensborohealth.orgsharon.cooper@owensborohealth.org
    edited May 2016
    No - Quality Dept is responsible for Core Measures.


    Sharon Cooper, RN-BC, CCS, CCDS, CDIP
    AHIMA-Approved ICD-10-CM/PCS Trainer
    Owensboro Medical Health System
    Manager Clinical Documentation & Appeals
    P.O. Box 20007
    Owensboro, KY 42304-0007
    (270) 688-1277 Office
    (270) 316-9088 Cell
    (270) 688-2737 Fax
    sharon.cooper@omhs.org

    TEAM = Together Everyone Accomplishes More!
  • Unknown
    edited May 2016
    Same- Quality Department is responsible...
  • dallend@einstein.edudallend@einstein.edu
    edited May 2016
    No -we do not do core measures.

    Deborah A Dallen,RN, CCDS
    Albert Einstein Medical Center
    Phila PA 19141
    Clinical Documentation Coordinator
    Health Information Management
    215-456-8902
  • pmill@seormc.orgpmill@seormc.org
    edited May 2016
    Yes- we do core measures.
  • vanessa.falkoffvanessa.falkoff
    edited May 2016
    No, quality does core measures here.

    J


    Vanessa Falkoff RN
    Clinical Documentation Coordinator
    University Medical Center
    Las Vegas, NV
    vanessa.falkoff@umcsn.com
    office 702-383-7322
    cell 702-204-0054
  • carmella.gaycarmella.gay
    edited May 2016
    No, Quality does core measures here too.

    Carmella
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    No, we do not. CURRENTLY. I was notified on Monday that our team with be transitioning from the Care Coord Dept to Quality. While there are many benefits to this move, I am concerned about this particular issue if it arises and will be fighting pretty hard against it if it is pushed.
    One of my biggest arguments will be that we have so many things coming our way. We (CDI) is expected to have huge involvement in ICD-10 and this not only means more queries, closer reviews, etc, but also is an entire additional level of knowledge our CDI staff with have to learn and understand. We are also planning on significantly expanding our program (hopefully at least doubling) in anticipation of ICD-10. I think its crazy to expect our staff (especially new staff) to be the experts on CDI, ICD-10, AND quality (CM), especially in regards to new staff that we will likely be training with no background in CDI.
    Let us know how it goes. I wish you the best!

    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
  • paxnerospaxneros
    edited May 2016
    No. Our QI dept. Is responsible for Core Measures.

    N Brunson, RHIA,CDIP,CCDS
  • ddraizeddraize
    edited May 2016
    I assist on a limited basis

    Diane Draize RN, CPUR,CCDS
    Clinical Documentation Specialist

    Ministry Door County Medical Center
    diane.draize@ministryhealth.org
    920-743-5566 ex 3143

    We earn trust by working together as One Ministry to keep PATIENTS FIRST in everything we do
  • amy.wickenhauseramy.wickenhauser
    edited May 2016
    Our Quality Dept is responsible for it, but we do assist with core measures.

    Thank you,
    Amy Wickenhauser, RHIA, RN
    Lead Clinical Documentation Specialist
    Advocate BroMenn Medical Center
    Phone: (309) 268-2769 fax: (309) 268-3956
    amy.wickenhauser@advocatehealth.com
  • Unknown
    edited May 2016
    We help them by noting if CHF/MI cases are discharged on appropriate meds and if not, that MD has documented reason why. We then track how many we saw and intervened on. We just started this in July and I must say it has been an arduous task that barely gets done. We are not "responsible" for any of it, just a second set of eyes. We will be dropping this task because I don't feel it is bringing any real value and causes my nurses- who are very type A- distress because they are not able to do it thoroughly. I agree with the rest of the crew, Core measures should be a separate labor pool!

    -Jane
  • dvitalone1dvitalone1
    edited May 2016
    We are a 3 facility system. 1 of our facilities has CDI doing core measures. Since she has been doing core measures the CMI dropped along with monthly financial impact because she is attending meeting after meeting and reviewing charts for just Core measures. And the CFO wants to know why the CMI dropped :)
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    The only way I see it functioning properly is with an experienced CDI team that already has a great grasp of all things CDI and therefore is able to easily add the additional knowledge needed to properly asses for QI. Then, I think you have to reduce case load significantly. I think sometimes its easy for people to think "well you are already in the record, this shouldn't take any additional time". It just isn't true.

    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
  • lprescottlprescott
    We have been part of such discussions here. CDS overlaps both Core Measures and medical necessity and those responsible for each piece certainly must work together. In speaking to your CFO it is important to stress the diffferences of what you do, recognizng how you can help but also pointing out that reviewing a chart for core measures requires a completely different focus and thought process than does CDI and how this will slow you down and may lead to less efficient (i.e. successful) benchmarks in CDI.

    We do assist the Core Measures team in several ways. We identify accounts that will code to core measure that they might not have noticed or might fall short of their screening tools and we do much education with the physicians concerning how to document if they do not feel an account is CHF for example. (There is another thread presently on CDI talk about this). But Core measures is much larger than CHF.... AMI, pneumonia, SCIP etc. these would pull you from your CDS focus. Good luck.
    Laurie L. Prescott RN, MSN, CCDS
  • don.cdi.rn@gmail.comdon.cdi.rn@gmail.com
    edited May 2016
    NO -- quality does it
    We do work with quality to understand how documentation / coding plays into core measures, but we don't do reviews. (for example, why the ESRD non-compliant is coded to CHF)

    and DON'T
    -- will be a negative impact on CDI effectiveness, and
    -- strategically a strong threat to successful organization adaptation to ICD-10.

    Don
  • sabullocksabullock
    edited May 2016
    Katy,
    We moved to Quality 2 years ago and it is a great fit. Much more physician support. Yes we do get involved with Quality issues as it relates to concurrent documentation reviews (HAC for example) but the support has been tremendous. You will have to be firm with what you can and cannot do within the concurrent review process and query regulations.
    Good luck - I think this is probably a great opportunity for your department with a few challenges thrown in for good measure.
    Shelia

    Shelia Bullock, RN, BSN, MBA, CCM, CCDS, CCS
    Director, Clinical Documentation Improvement Services
    University of Mississippi Medical Center
    2500 North State Street
    Room S336
    Jackson, MS 39216
    T: 601-815-3079 I F: 601-815-9505
    sabullock@umc.edu
    www.umc.edu
  • sabullocksabullock
    edited May 2016
    No. However, we did help with a project to facilitate CHF pathway order sets being placed on the charts when we were in the paper world. If a patient coded to CHF we would put the order set on the chart and flag for physician - physician had choice of implementing or not. This did not help with all measures for CHF but did with some.

    We also developed a method to alert regarding pneumonia to facilitate some real time review with those - when we were in the paper world.

    Our electronic health record took away those added chores - but created new ones.

    I would advocate against taking on this responsibility, but suggest ways that if the hospital has some opportunities what you might do to help out in securing documentation concurrently - but not won the core measure review process.

    Shelia Bullock
  • teresa.russoteresa.russo
    edited May 2016
    No!

    Thanks, Teresa


    Teresa Russo RN,CCM
    Documentation Improvement Coordinator
    Phone: (210)358-8608
    Fax: (210)358-0622
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    Thanks for your insight Sheila. I see many positives to the move too. We already work with quality extensively and I have found they are our best "in" with MD's. They provide a forum to engage in conversations about how documentation impacts physician "reports cards"; SOI/ROM, LOS, Complications, etc. They have been great. We have helped them in learning how codes are assigned and that kind of documentation we need to support dx.
    I hope it will be a great move. I just also hope we don't lose the "CDI" focus.

    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
  • mdomineseymdominesey
    edited May 2016
    Core measure review requires a completely different set of skills than CDI. Yes, we COULD do Core Measures, but we should NOT do them. Core measures review looks at what is in the record - they do not think about diagnoses that could be better specified or if there are diagnoses missing. Our job as CDIs are so very important and it may be appropriate to say that if CDI Practitioners did Core Measure Review - it is a misappropriation of their specialized skill set. Trying to not be "uppity" about this - but CDI requires critical thinking, ability to analyze for missing elements, as well as the ability to think of a clinical picture independently of the docs. These particular skills are not really needed for Core Measure review where they look for the documentation of the diagnoses (CHF, PNA, MI, CVA/TIA, Sepsis, etc) and then track the application of the elements measured or to educate the physicians on the elements measured. We look for so many more things - do they really want us looking at just these Core Measure things?

    That being said - I do not track Core Measures, but I include "Reminders" in all of my queries, I educate the physicians on the diagnoses and how to be as specific as possible, and I participate in Core Measure "Rounds" to contribute to the interdisciplinary team at the point of service. I have had many positive comments about my participation and I have even received phone calls at home on the very few days I work from home during the rounds for questions about how these things will be coded and how it can be documented better/differently.

    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
  • mary.a.dunnmary.a.dunn
    edited May 2016
    That's a door you don't want to open. You will never be able to close it!
    It will negatively impact your CMI.
  • Linda_RhodesLinda_Rhodes
    edited May 2016
    No, Core measures fall under the Clinical Outcomes Dept. We may
    collaborate regarding individual cases , but the responsibility lies
    with them.
    Good Luck!
    Linda


    Linda Rhodes RN, BSN, CCDS
    Manager Clinical Documentation Improvement
    New Hanover Regional Medical Center
    Wilmington, North Carolina
    Office # 910-815-5544
    Cell " 910-777-8344
    e-mail : linda.rhodes@nhrmc.org
  • wchenneywchenney
    edited May 2016
    I agree whole heartedly---don't go there!!!


    Wendy R. Chenney RN BSN
    Manager Clinical Documentation
    Parma Community General Hospital
    Office: (440) 743-4533
    Fax: (440) 743-4552
    Pager: (440) 675-5929
  • debra.stewart@halifaxregional.comdebra.stewart@halifaxregional.com
    edited May 2016
    Linnea,

    We were given that responsibility over a year ago here, we are just following: MI's, CHF, SCIP, it has taken much of our time and to tell you the truth I do not believe we should be doing this, but was directed to us that we would do this. I will just put it like this---others here do not fully understand our JOB as a CDS and a so thing like that happens-when they don't understand what you really do-totally!! Hope that makes sense!! All I can say-" Fight it" !!!! lol sorry.

    Deb
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited May 2016
    We do not have prime responsibility for Core Measures, and for all of the reasons cited in this thread.


    Paul Evans,

    Paul Evans, RHIA, CCS, CCS-P, CCDS

    Manager, Regional Clinical Documentation & Coding Integrity
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell: 415.637.9002
    Fax: 415.600.1325
    Ofc: 415.600.3739
    evanspx@sutterhealth.org
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited May 2016
    We alert the floor RN and Core Measure RN that CHF, MI or PNA is more than likely to be coded as the PDX AND we see that no Core Measure Process has been implemented...so, we assist the Core Measure Team, but are not responsible for the metric.

    Paul Evans, RHIA, CCS, CCS-P, CCDS

    Manager, Regional Clinical Documentation & Coding Integrity
    633 Folsom St., 7th Floor, Office 7-044
    San Francisco, CA 94107
    Cell: 415.637.9002
    Fax: 415.600.1325
    Ofc: 415.600.3739
    evanspx@sutterhealth.org
  • afloydafloyd
    Quality maintains CORES at our facility. We do however, assist when we can by notifying them of records that have CORES concerns if they have not reviewed the record. TOO much for CDI to take on.

    April Floyd, RN, CCDS
    Director of CDCI
    Anderson RMC
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