Care team rounding without Phycian attendance

renmeyer@sbcglobal.net

Good morning

I was wondering if there are CDS's out there who does daily rounding with the care team (PT, pharmacy, Case manager and Charge nurse and SNF reps)?  This rounding would not involve any physicians.  If so, do you find it beneficial? And in what way?

Thanks so much!

Renee, RN, CCDS

shiloh.williams@ecrmc.org

Hi Renee,
My team rounded with the care team (with MDs) for several months. In the beginning, I was hoping it would be helpful to the CDSs to get perhaps a clearer picture of what was going on with the patient as well as give them a chance to answer questions or provide specific feedback. In reality, we found it was a waste of time for our CDSs for a number of reasons. The first being that we see a specific population within the census. We found that we spent a lot of time listenining to reports on patients who were not reviewed by CDI. We would correct documentation-related issues with these patients if we heard inconsistent stories or inappropriate diagnoses but this happened few and far between and really relied on the providers knowing the patient as we did not perform the detailed record review prior to the discussion. We also found that while we did see a rise in our verbal queries through this process, the provider was taking information from everyone (nursing needs, equipment needs, discharge needs, pharmacy needs, etc) that he/she would forget we had asked to specify the type of atrial fib present. We found we still had to go back and ask the question again a number of times. Lastly, our facility has varying degrees of collaboration between the provider's and the different departments. Thankfully, through a lot of hard work, we have had a really great relationship with our providers and they generally respect us for what we are trying to accomplish. We found that when we were amongst the care team, the situation quickly turned into an us (hospital departments) vs. them (providers). This is something we did not want to get involved in and found that it was easier to approach the provider at a later time on the floor. This ensured that our staff could speak with the provider directly regarding issues with documentation and maintain our positive working relationship. Hope this helps!!!

renmeyer@sbcglobal.net

Thanks for your input!  We have started rounding every morning but as I said, there are no physicians present.  Not sure what the benefit of this will be for improved documentation.  Guess we'll have to do it for a few months to determine the actual value. Currently, we feel it may be, as you stated, a waste of time.  If anyone else has some input how this type of rounding improved their program or efforts, or didn't, the that would be great!  Thanks again!

Renee, RN, CCDS