Staff in more than one facility

Hi - I manage two teams of CDS - 1 team from an AMC with 12 CDS and 1 team from a community hospital with 2 CDS. The community hospital is a part of our health system and the two CDS there are employees of the community hospital. One of the two CDS from the community hospital is retiring and we are changing the paymaster so the new CDS will be hired by the AMC as this allows to hire remotely, hence a much larger pool of applicants and hopefully someone with experience as well as looking ahead to being able to provide coverage when one of the CDS is on vacation. My question is do any of you have experience with this? If so do you have separate teams for each hospital or do you combine the teams and CDS members do reviews for both hospitals? Do you provide vacation coverage when needed?


  • I apologize as I have posted this twice.

  • I manage a system with 7 acute care hospitals, each had their own CDI staff. As each hospital and CDI team came into the system they became part of the system wide CDI team, but continued to focus reviews on "their" facility first.

    We went 100% remote with the pandemic and have not brought staff back in house, as productivity , KPI's , provider relationships/engagement, and education are strong with virtual tools.

    In January this year I centralized the team fully- meaning everyone works off one worklist, taking the next record by admission date ( oldest to newest) no matter the location of the patient. This has distributed the workload more fairly and provided learning opportunities and skills expansion for those CDI who worked in the smaller hospitals- now they all can review and query on any record no matter how complex. It also assures that the largest hospitals are not doing initial reviews on 7 day cases when the smaller hospitals are working on 2 day cases, balancing the review work and decreasing the number of days to first review. PTO coverage can happen from anywhere, mortality reviews can be done by experienced CDI from any facility, and all CDI have become more familiar with providers at different facilities.

    It has been a big win for us.

    Some suggestions:

    Make sure your standard work is aligned, including query process and followup /escalation processes.

    change management to allay anxieties and explain the "why", providing CDI education on more complex surgeries, etc that the smaller hospitals do not see.

    Provide all team members with a clear escalation policy with key contacts in each facility. ( CDI MD advisors, hospitalist chiefs, chief of departments, etc.)

    Best of luck!

  • Thank you so much; sounds like it has been very successful for you. We were already hybrid prior to the pandemic but now both teams are remote 100% of the time and we to have not experienced any change in our metrics.

    I do have the same processes at both hospitals so it would be a pretty easy transition if we head in this direction in the future. Thank you so much for sharing your experience.

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