geographic/unit-based model

katysuegood@gmail.comkatysuegood@gmail.com
in CDI Talk Archive
For those of you who have a unit-based CDI team that covers a specific area can you answer a couple questions?

1. How many beds does each CDI cover?

2. Does this vary depending on unit type (ICU vs med/surg)?

3. How do you handle scheduled PTO

4. How do you handle unscheduled leave (sick)

5. Do you cover weekends?

I am working on a plan to move to this format and would appreciate any advice, warnings, or other words of wisdom :)

Thanks!

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

Comments

  • paxnerospaxneros
    edited April 2016
    I will prefice my comment by saying at no time have we ever had more than 2 CDI covering our entire hospital. We have 3 positions but have had a hard time keeping it filled due to Salary range and finding experienced candidates for our demographics. So except for maybe a 1 1/2 total combined time - it's been 2 FTE's for the house.

    So...with that said:


    1. How many beds does each CDI cover?

    We have around 340 beds. However, we only review M'Care, M'Caid, Tricare & Blue Cross - all DRG payers. And we do not review Women & Children. This cuts the census down somewhat.

    Each morning we print a census of "CDI Patients" and split the new admissions as evenly as possible. However - we also have units we cover. But some units have a quicker turn-around time (Surgical/Ortho) and some have slower turn-around times (Pulmonary/Medical). So splitting the new admissions evenly assists in everyone getting some knowledge of other areas as well as just helps out with workload.

    With 3 CDI it averages around 10-12 new admissions daily. With 2 CDI 12-17 new admissions daily.

    2. Does this vary depending on unit type (ICU vs med/surg)?

    Yes - typically we all get a "Big" floor - Medical, Pulmonary, Cardiac - and we fill in w/smaller floors. The Units (SI/MI/CV)have 18 beds. Neuro is a small unit and Ortho/Surg moves quickly - you could say these are Medium-sized units.

    3. How do you handle scheduled PTO

    If there are 3 positions employed and one has PTO - it's divided by two. If there are 2 positions employed - someone gets to cover the entire CDI population. Needless to say, you basically review admissions and formulate queries. That's all you can do.

    4. How do you handle unscheduled leave (sick)

    See above for PTO.

    5. Do you cover weekends?

    Not anymore. And Mondays are rough. Sometimes we come into 60 new admissions!! And yes - they ALL have to be reviewed if possible. Some of the admits on Friday are being discharged on Monday so we miss some of those.

    When we did - it's actually too much work for one person in 8 hours. Saturday (Friday admissions) was and still is our busiest day because typically physicians fill the house up on Friday with people they have been dealing with in their offices "all week". We have had anywhere from 10 admits to 30 admits each day. Ten is "do-able" but not 30. Again, all you can do is review and issue queries. You actually need someone who wants to work weekends - 10 - 12 hours Saturday and Sunday. They can always followup on queries on the floors if there are not enough admissions to review.

    Our program is going through changes at this time. So I imagine much of it will change. But for the first 6 years of our program this is the way it has been managed.

    Thanks,

    Norma T. Brunson, BS, RHIA, CDIP, CCS, CCDS
  • cmclose@saintfrancis.comcmclose@saintfrancis.com
    edited May 2016
    1. How many beds does each CDI cover? There are ~150 beds total (children's hospital). I cover 4 units (out of 5) of the children's hospital. Census can be between 30-60 pt's without NICU. (Due to staffing, I omit NICU currently due to they have good documentation practice/template compared to other areas)
    2. Does this vary depending on unit type (ICU vs med/surg)? No as there is only me currently. In the future with program expansion then yes it will vary probably.
    3. How do you handle scheduled PTO. When I am gone, no one covers. (Interestingly enough, adult hospital CDI currently has 9 CDI and a CDI manager with 1 CDI position and 1 supervisor position vacant.)
    4. How do you handle unscheduled leave (sick). Same as PTO~ no one covers.
    5. Do you cover weekends? No. Mondays are hectic with all the admits from over weekend and on Monday so I try to review new admits with the longest LOS or "complex" diagnosis (such as a chronic pt) because I can only do so much. Currently the program focuses on capturing of CC/MCC, maximizing DRG on each reviewed case since there is only me; not as much emphasis on SOI, etc. (but I have queried for SOI, clinical indicators to support a dx, confirm/revise a dx, etc. without CC/MCC impact).
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