Query sent to multiple providers

AngeliqueDaigle@yahoo.com

Hi group, I need an opinion please. I am acting as interim CDI lead (I am a traveler) at a large teaching facility. The CDI nurses here are in a habit of sending a query to multiple physicians (attending/residents) at the same time. I questioned this practice, pointing out that they may get conflicting answers, which then requires another query. They say that since patients are being seen by different residents all the time, they never know who to send it to. It is done to facilitate a "quick" answer. I wanted to show them something official that prohibits us from sending to multiple physicians, unless one physician requests it be forwarded to another. Has anyone come across a similar situation? Any ideas on where I might find some supporting "official" documentation for my case?

Thanks,

Angelique Daigle BSN, RN, CCDS

Angelique.Daigle@yahoo.com

CDI Lead (interim/contract)

St. Joseph Mercy, Oakland

Pontiac, MI

don.cdi.rn@gmail.com

I'm not aware of official guidance (such as the query brief) that indicates queries can not be sent to more than one provider.

Agree with the concerns about potential conflicting responses -- depending on the technology in use, that potentially can be mitigated.  With most traditional residency models, the attending usually does not turn over as often as documenting residents, so the final determination may be a lower risk for conflict.

Don

evanspx@sutterhealth.org

I see issues sending one query for the same topic to more than one provider - most concerning is the potential for differing responses, and the attendant dissonance that would introduce.  In our model, we are fortunate to have a very active group of Hospitalists, and they answers queries promptly.  I'd advise to send one query to one MD for one clinical issue, but, as Don stated,  nothing states this as a Best Practice.   Paul Evans, RHIA, CCDS

lspryszak

I review for a large tertiary facility.  I often send the query to the last (most recent) provider whose specialty is associated with the pending query, e.g., renal queries to nephrology, etc. My best responders are the nurse practitioners or physician assistants, and at times, the resident.  My process is to follow-up with an email reminder (secure) if no answer is received by the next day.  Often, if I send the query to the attending, they request that I send to the query to the NP or PA.  Since our query process is so time-consuming, I will often send it to the NP (or PA) and copy the attending the first time around.  My response rate is close to 100% and I haven't had a problem with contradictory responses. 

Amy_Stremming_1992

Our policy is to send to the attending to prevent conflicting responses.
If the documentation in question is from a consult, we obviously send to the consulting attending.