RE: RE:[MARKETING] [EXTERNAL] Querying more than one physician
I agree with you Katy. The original email stated that the provider was queried, they indicated they were not going to defer to the consultants and the CDI physician advisor had talked to the provider. To me, that means as a CDI you've done your job and you're done.
If you have a disagreement between an attending and a consultant, absolutely query, but if the attending sticks with their "unable to determine" then I would not query again and would certainly never query a different provider hoping for a different answer which would then have to go back to the attending.
Ethics fall into play in my opinion in following a compliant query practice and querying based on the clinical indicators present, but also realizing that the attending provider has the final say. As I stated above, if you disagree then escalate it through your policy, and if they still disagree you’re done. You’ve done your due diligence and followed your query policy. But to query again or to query a different provider on the same issue after that, then you are fishing for a diagnosis and I don’t feel that is a compliant query practice.
Just my two cents.
Robert
Robert S. Hodges MSN, BSN, RN, CCDS
Clinical Documentation Improvement Specialist
Secretary, Nursing Professional Standards Board
Aleda E. Lutz VA Medical Center
1500 Weiss Street, ATTN PAS-136
Saginaw MI 48602
989-497-2500 x13101
Robert.Hodges2@va.gov
VA Core Values: Integrity, Commitment, Advocacy, Respect, Excellence (“I CARE”)
VA Core Characteristics: Trustworthy, Accessible, Quality, Innovative, Agile, Integrated
"The difference between the right word and the almost right word is the difference between lightning and the lightning bug." Samuel "Mark Twain" Clemens
If you have a disagreement between an attending and a consultant, absolutely query, but if the attending sticks with their "unable to determine" then I would not query again and would certainly never query a different provider hoping for a different answer which would then have to go back to the attending.
Ethics fall into play in my opinion in following a compliant query practice and querying based on the clinical indicators present, but also realizing that the attending provider has the final say. As I stated above, if you disagree then escalate it through your policy, and if they still disagree you’re done. You’ve done your due diligence and followed your query policy. But to query again or to query a different provider on the same issue after that, then you are fishing for a diagnosis and I don’t feel that is a compliant query practice.
Just my two cents.
Robert
Robert S. Hodges MSN, BSN, RN, CCDS
Clinical Documentation Improvement Specialist
Secretary, Nursing Professional Standards Board
Aleda E. Lutz VA Medical Center
1500 Weiss Street, ATTN PAS-136
Saginaw MI 48602
989-497-2500 x13101
Robert.Hodges2@va.gov
VA Core Values: Integrity, Commitment, Advocacy, Respect, Excellence (“I CARE”)
VA Core Characteristics: Trustworthy, Accessible, Quality, Innovative, Agile, Integrated
"The difference between the right word and the almost right word is the difference between lightning and the lightning bug." Samuel "Mark Twain" Clemens