Observation Patients

With the increasing importance placed on medical necessity, we are researching the idea of reviewing observation patients. My question is, are there any other facilities that are looking at observation patients concurrently and if so, how do you track these reviews without altering all of your other data since they are not DRG based? We use JATA Guide software and cannot figure out a way to track our work without altering all of our other inpatient data.

Comments

  • edited May 2016
    We also use JATA, currently we do not review observation pts. The only people looking at this pts are the casemgrs.

    Tracy M Peyton RN, CCDS
    Case Management
    Bradford Regional Medical Center
    Upper Allegany Health Systems
    116 Interstate Parkway
    Bradford, PA 16701
    814-558-0406
  • I review all patients but use my own Access database.

    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
  • We use the same software, which as you know is geared toward "impact" queries, and which downgrades your metrics if you review patients whose queries can't make a measurable financial impact. I am not looking to review observation patients, but I would like us to review patients who don't pay on the DRG model (because they still have an effect on our SOI/ROM and LOS), but am running into the same issue as you. I did some trial patients, created a log, put a special tick on their names in Guide so I could pull that data out of the reports.

    If you are reviewing observation patients for medical necessity, you'd probably be better off not using the Guide software and just either using whatever case management uses for their admission and continued stay reviews, or creating a spreadsheet with your data. It shouldn't be too hard to develop a simple query form.

    Would be interested in hearing what you finally decide to do and what implementation model you use.

    Renee


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

    We ran into the same issue when we wanted to start reviewing patients with short LOS, diagnosis of CHF, AMI, etc. that did not fall into the DRG-based payment system or they were self-pay. I called JATA and they added a Payer option of "other" that we could use for these patients. They set up the blended rate and baseline CMI at 0 so our numbers would not be affected. The only impact that is recorded is that the chart was reviewed and if we did any clarifications. No financial, RW, or CMI impact.

    Kristen
  • Kristin,

    Thank you so much!!!!!!!!

    Renee


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