query escalation process

mulled2

How does everyone get their queries answered timely? Who is responsible to "hunt" down the provider to answer the query. Anything you are willing to share will be greatly appreciated.

Also, is there any repercussions for providers that don't respond?

Thanks 

lprescott1

I am not working in it every day but a few things we did to help promote query response. providers were monitored in monthly report cards for query rate and response rate with an expectation of 85% answered.

CDI who wrote the query is responsible for 'closing the deal'- we measure dhow quickly that happened- <24 hours, 24-48 hrs etc. if not closed by discharge ti was a shared responsibility- but I lean towards if you thought it was important to ask- you should assure it is answered.

bawolfy@yahoo.com

day 0 = query placed on the chart
day 1 = follow for response
day 2 = contact provider  
day 3 = follow for response
day 4 = escalate (manager or designated post-discharge CDI)
Once the patient is discharged, the query is followed by 2 designated post-discharge CDI who sit in the Physician Lounges (we have 2 larger hospitals) and review queries for accuracy/understandability and "hunt down" physicians.  They perform other tasks as well. 
If they have difficulty getting responses, they request my (or our Managers) help.  Usually a text or call from me does the trick.  Occasionally I have to escalate to the CMO or Department Chairperson - and I always include the clinical, quality and financial impact (if applicable).  We do have a suspension policy for queries that mirrors our other required medical record documents, but it extends out so long, we don't count on that to get timely results.  We track our monthly stats, and in April our response rate was 99% and we averaged 3.9 days between date of query issue and date of response.  
Beth Wolf, MD
Roper St. Francis Healthcare
Charleston, SC