Collabrative efforts between CDI and Case Management

ddouthitddouthit
in CDI Talk Archive
Looking for ideas on how to make the most of our time together. CDI (HIM)and Case Management are going to begin meeting (not sure how often yet). I am unsure at the present time what our Case Management department goals are for meetings, but I thought I would get a head start.
Please share any ideas or programs that have worked well in collaboration with Case Management. Our facility is starting interdisciplinary team rounds on each of our floors and am hoping CDI will be invited to attend.
Thanks for any input.

Dorie Douthit
ddouthit@stmarysathens.org

Comments

  • lprescottlprescott
    I would suggest education of each others roles. Case management is pretty well understood as it has been a traditional role for nursing for a very long time. CDS is very new and i found that the CM at my hospital really had little understanding of DRGs, and billing issues related to status (i.e. how an obs is billed vs a inpatient) etc. The more we understand each others roles - the better we can support each other.
  • lprescottlprescott
    I would suggest education of each others roles. Case management is pretty well understood as it has been a traditional role for nursing for a very long time. CDS is very new and i found that the CM at my hospital really had little understanding of DRGs, and billing issues related to status (i.e. how an obs is billed vs a inpatient) etc. The more we understand each others roles - the better we can support each other.

    Laurie L. Prescott RN, MSN, CCDS
    lprescott@morehead.org
  • jolene.filejolene.file
    edited May 2016
    I agree, the first meeting should include an introductiion of each others roles. After that, I think a few established agenda items would be a good idea. Our CDI team & coders meet monthly. Our permanent agenda items include: review of minutes, case studies, monthly CMI report, RAC issues and Other discussion/comments.

    Our team has been working to improve the documentation in the record for discharge disposition code assignment. Case Management can help the coder tremendously by documenting the correct discharge/transfer information in their last note. The networking has been very beneficial.

    Jolene File,RHIT,CCS,CPC-H,CCDS
    Documentation Improvement Specialist-Coder
    Hays Medical Center
    jolene.file@haysmed.com

    IMPORTANT: This communication contains information from Hays Medical Center which may be confidential and privileged. If it appears that the communication was addressed or sent to you in error, you may not use or copy this communication or any information contained therein, and you may not disclose this communication or the information contained therein to anyone else. In such circumstances, please notify me immediately by reply email or by telephone. Thank you.

  • Unknown
    edited May 2016
    Happy Monday!
    I will be interested to see the replies you get on your great question. Our program is only a year old, we are offsite total EMR which I think can be helpful in some ways, and not so much in others (visibility).
    I am also wondering if there are other sites who are total emr and how they handle the visibility issue. We do educational meetings for our physician groups but there currently are only two of us up and running and able to do it an juggle other duties. thanks!
    As always could not make it without the feed daily! :)


    Jamie Dugan RN
    Clinical Documentation Improvement Specialist
    Baptist Health System
    Jacksonville, Florida
    phone office : 904-202-4345
    cellular: 904-237-7253

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited May 2016
    There is an excellent Power Point on this topic available in the ACDIS Library.

    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

  • sbainesbaine
    Dorie,

    I concur with the comments added to your post. Working in a silo approach helps no one. Each facility that has CDI should become an integral part of Case Management, Denials team, Financial support & Quality department teams and of course HIM.

    We often dont understand that CDIs are the cog in the wheel of the facility financial side of business. We extract data from each source and feed data to everyone.

    Case Managers should rely upon CDIs for validation of the PDX which gives them a length of stay. This benefits the CMs and Social Services for discharge planning. In addition, CDIs focus on clarity in the medical record and CMs focus on meeting criteria for the appropriate bed status along with approval of the stay.

    CMs can be hampered when reading H/Ps to determine the reason the patient is admitted. Getting a clear and concise medical record with the intent of admission helps determine medical necessity when the diagnosis along with treatment dont fit the typical screening criteria.

    As for other services, Quality in the medical record documentation improves CMS required documentation for Core Measures, Patient Safety Indicators when they are correctly reflected in physician documentation through the querying process of CDIs in a concurrent manner.

    The days of reviewing for quality after the chart is closed has come and gone. CDIs must reach into the future and build bridges into other areas such as Quality & Case Management to really complete teh medical record.This protects facilities Value Based Purchasing scores and reimbursement in the long run. It also improves physician profiling for severity of illness and risk of mortality.


    Sara Baine, MSN-Ed, CCDS
    SoutheastHEALTH Lead Quality Documentation Specialist
    President Heartland ACDIS
  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    Our hospital implemented daily 'discharge rounds' for the medical units which involve the charge nurse, hospitalist and case manager for each unit (they meet on each unit individually in the morning). They primarily discuss discharge issues and was supposed to be a way for case management and the MD to identify any discharge issues for patients that will discharge in the next few days so that they can be resolved quickly (and not slow down discharge). Our CDI's attend these rounds most days now. They can provide a GMLOS and hear what the plan is for the patient but it also serves as a great forum for them to talk to the MD's. We are fully electronic now and rarely on the floor otherwise so it provides a daily face-to-face. CDI's routinely query the provider verbally and/or remind them of outstanding queries at these meetings.

    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


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