Re: number of charts review
Does any body know how many charts a CDS has to review per day? how to assign patients chart to a CDS?
thanks,
Sincerely,
Mohammad Ahmed, M.D, CCS,
Clinical Documentation Specialist
Bronx Lebanon Hospital Center
Health Information Management
1650 Grand Concourse
Bronx, NY 10457
Phone: 718-518-5119
Fax: 718-518-5634
Email: mahmed1@bronxleb.org
thanks,
Sincerely,
Mohammad Ahmed, M.D, CCS,
Clinical Documentation Specialist
Bronx Lebanon Hospital Center
Health Information Management
1650 Grand Concourse
Bronx, NY 10457
Phone: 718-518-5119
Fax: 718-518-5634
Email: mahmed1@bronxleb.org
Comments
(http://www.hcpro.com/acdis/details.cfm?topic=WS_ACD_JNL&content_id=265437)
There is really is not a single 'fixed' answer -- there are a number of variables (such as staffing exclusive to CDI, do they also review for quality & core measures, when do they initiate reviews, is the focus purely financial / completeness / mixed, etc.). From the Report on page 18, the great majority of responses for NEW charts per day were in 6-10, 11-15 & 16-20. The volumes for re-reviews per day were mostly in the same brackets. Seems to me that the total of cases reviewed per day (new & re-reviews) is in the neighborhood of 20 to 35. That also matches up with my anecdotal experiences.
As far as assigning cases, I've heard of a variety of models (again based on staffing -- the more CDS's, the more specific or focused one can be, if only 1 or 2, then collaboration seems to be best).
There is an older ACDIS on-line poll that addressed this question (can't remember if it has been repeated more recently):
http://www.hcpro.com/acdis/view_readerpoll_results.cfm?quiz_id=963
2/08 (approximate date)
How are cases assigned to your CDI specialists?
73% by floor
5% by physician
12% by service line / department
1% first come, first served
9% Randomly
Seems to me there is great value in 'partnering' one CDS for the majority of cases with one service line -- developing relationships IMHO is one of the keys to success. Not sure whether this might have changed over the past few years. I also can't recall hearing of any other models.
Don
Donald A. Butler, RN, BSN
Manager, Clinical Documentation
PCMH, Greenville NC
dbutler@pcmh.com
Never give in. Never, never, never, never--in nothing, great or small, large or petty--never give in, except to convictions of honor and good sense. Never yield to force. Never yield to the apparently overwhelming might of the enemy
Sir Winston Churchhill
You must also consider the experience level of your CDI team. The more experienced the CDS, the quicker they are at reviews. You also need to consider what Donald Butler referenced.
As many here will tell you, it takes several months for a new CDS to "get up to speed" and be able to handle a full caseload of patients with completeness and accuracy.
If staffing is not commensurate with the CDS' skill level and responsibilities, your team will become frustrated, burn out and leave the program. Or best case scenario, will only be going through the motions to meet unrealistic targets.
"If staffing is not commensurate with the CDS' skill level and responsibilities, your team will become frustrated, burn out and leave the program. Or best case scenario, will only be going through the motions to meet unrealistic targets."
One must adjust expectations, goals, guidance, projects, etc. as staff and program develop. It's an ongoing fine tuning.
As well as the flip side -- how does one keep your 'expert' CDS engaged, excited, passionate & interested. One of the reasons I started the thread about "Career & Personal Professional Development for theExpert CDS".
Also related to an upcoming blog post I recently completed attempting to outline what a 'failed' program might look like.
As far as getting up to speed -- addressed specifically by 2 on line polls --
Up to speed 6-12 months: http://www.hcpro.com/acdis/view_readerpoll_results.cfm?quiz_id=1811
and orientation / training period 30 to 120 days: http://www.hcpro.com/acdis/view_readerpoll_results.cfm?quiz_id=2163
I've suggest a poll on how long to become an expert.....perhaps we'll see that posted.
Don
Donald A. Butler, RN, BSN
Manager, Clinical Documentation
PCMH, Greenville NC
dbutler@pcmh.com
I don't think expertise is measured by longevity, although in any specialty, it takes time to develop. I've been at it 2 1/2 years and am not even close to being an expert. Every time I start to think I know it all, I learn just how far away from knowing it all I truly am.
Renee
Linda Renee Brown, RN, CCRN, CCDS
Certified Clinical Documentation Specialist
Banner Good Samaritan Medical Center
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I would agree, I think it is very similar to nursing in that, when you
think you know all there is to know about caring for patients. ...then you
need to move on. There seem to consistently be a new diagnosis or
procedure, or coding rule that comes out ............... one of the
aspects I love about this job! I don't know if it ties in but I have my
new staff on orientation for one full year.
Thank You,
Susan Tiffany RN, CCDS
Supervisor Clinical Documentation Program
Guthrie Healthcare System
case management, I'd tell folks they would start to feel comfortable at
about six months and start to feel like they really knew what they were
doing after a year.
"Expertise" is something to strive for, but because of the changes is
very hard to achieve. However, I do consider myself pretty competent
though after a few years of doing this now. I know I'm not an expert.
Robert
Robert S. Hodges, BSN, MSN, RN, CCDS
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