Emergency Room and Critical care coverage

rmhosler1

We are reviewing our assignments and I was wondering if anyone is
covering the ER? If so, could you provide pros and cons.

I was also wondering if you cover Critical care on a daily basis or do
you have some other way of covering critical care patients?

Thanks in advance for your feedback.



Mary A Hosler, RN, MSN
Clinical Documentation Specialist
Alumnus CCRN
McLaren Bay Region
1900 Columbus Ave.
Bay City, Michigan 48708
(989) 891-8072
mary.hosler@mclaren.org

"The difference between the right word and the almost right word is the
difference between lightning and the lightning bug."- Samuel "Mark
Twain" Clemens

cynthia.a.goewey

We do not cover the ED. Currently I cover the ICU pts (everything but cardiac and CT surg as another nurse has them). I review the admissions daily.
Cindy

gail.eaton

I cover critical care and review daily

Gail Eaton RN PCCN CDS
Clinical Documentation Specialist
St Joseph Health
2700 Dolbeer, Eureka, Ca, 95501
Office: 707-445-8121 ext 7555
Cell: 707-267-0279

don.cdi.rn@gmail.com

We tried ED several years ago, focusing on the patients with admit orders. UR is not part of our scope.
We found that there was limited information (we did have EHR at the time with HP, PN, etc.) and therefore found a lot of double work when the patient hit the floor. Others may have different experiences ...

On critical care, if you are able to focus on mortality/etc profiling (ie, have the tools to KNOW what diagnosis will make a difference for each case), then I believe daily reviews would be useful. If not, most critical care patients have an abundance of relevant diagnosis fairly quickly.

Don

sabullock

We do not review in ED.

We do review in all our critical care units. We find great teaching opportunities in these units. We are an academic medical center with rotating residents so this may be different in non-academic hospitals.
We find sign/symptoms and the issue of versus. Also we are education on what is really respiratory failure (PSI issue) along with what is a true post op complication.

If you are not currently in your critical care unit might be very worthwhile to do a pilot review to see if it is beneficial in your facility.

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

evanspx@sutterhealth.org

We review samples in ICU - can't review all every day due to staffing. Generally, it is very in ICU that patients have MI, Sepsis, ARF, etc, so not a great need to 'query' our ICU staff. Rather, what happens is that subsequent staff fail to endorse certain diagnoses treated and resolved in ICU, sometimes leading to a need to confirm.
More opportunity for CDI at our site on the regular floors, again, IMO, because the organ failures are often clearly stated for ICU patients.



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

Manager, Regional Clinical Documentation & Coding Integrity
Sutter West Bay
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

lprescott

We cover critical care on a daily basis. We started in the ED a few months ago, there is little on the record yet but I would make myself available tot he ED doctors, listen to their dictation and review their documentation as it was happenning. When reviewing labs etc I would verbally query. I only go time permitting, but feel if a person was in ED full time we really could influence change. Also if you sending someone to the ED have them "beef up" on E&M coding.
Laurie L. Prescott RN, MSN, CCDS, CDIP
lprescott@morehead.org