How many hours/days after admission do you start reviewing?

cynthia.a.goewey

Do you start reviewing admissions 24 hours or 48 hours after admission? I see pro's and con's to both timeframes and am curious as to what the majority of the programs do.
Thanks,
Cindy

Cindy Goewey RN, BSN
Clinical Documentation Specialist
Coding Operations
Dartmouth-Hitchcock Medical Center
Phone: (603) 650-3891 / Fax: (603) 650-6787
Dartmouth-Hitchcock.org

cbarnes

We start @ 24 hours or sometimes the same day depending on how much info is available on the chart.

murpca2

We start reviews on hospital day two, follow up on day 4 and 7 and than every three days there after until discharge.

Cathie Murphree LPN, CCDS
Documentation Improvement Specialist/HIM
PeaceHealth St. Joseph Medical Center
2901 Squalicum Parkway
Bellingham, WA 98225
(360)788-6300 ext. 3429
Fax: (360) 738-6741
CMurphree@peacehealth.org
www.peacehealth.org

NormaB

Usually within 24 hours. Most of the time we have an H&P and admitting lab work. If the H&P is not here or it looks like there isn't enough information available - or we are waiting for the consulting physician to evaluate- I will wait.

If I wait too long there is the chance of missing a documentation opportunity before the patient discharges.

NBrunson, RHIA, CCDS

catladyrn

I start my reviews on hospital day 2, and review daily thereafter until discharge. Day one is just about pointless; there's nothing in the chart. There isn't always enough information to make a really intelligent assessment on day 2, but at least the shell is created and the followups are easier. The risk of waiting until day 3 or skipping a review day is that by the time you get to them, the patient may already be gone.

Renee


Linda Renee Brown, RN, CCRN, CCDS
Certified Clinical Documentation Specialist
Banner Good Samaritan Medical Center

robert.hodges2

I review the next business day, then every day as long as they are an inpatient.

Robert

Robert S. Hodges, BSN, MSN, RN
Clinical Documentation Improvement Specialist
Aleda E. Lutz VAMC
Mail Code 136
1500 Weiss Street
Saginaw MI 48602
 
P: 989-497-2500 x13101
F: 989-321-4912
E: Robert.Hodges2@va.gov
 
"The difference between the right word and the almost right word is the difference between lightning and the lightning bug." Samuel "Mark Twain" Clemens

laura.jansen

I review the day after admission or when there is an h&p on the chart & then daily thereafter as time allows.

digardsk

We start within the first 24 hours - sometimes on the day of admission.