role collaboration between Utilization Review and CDS

sbeattysbeatty
in CDI Talk Archive
I'm interested in a brief description of how CDS at other hospitals team with their staff responsibile for certifying the patient status, whether that be designated UR nurses or case managers, etc. How do your CDS know what has been determined to be the IP medical necessity for the stay (IS/SI)? Thanks

Sandy Beatty

Comments

  • sharon.colesharon.cole
    edited May 2016
    We (CDIS and CM) document using Allscripts. When the CM puts in SI/IS, we have access to that when we open up that patient's documentation record.

    Sharon Cole, RN, CCDS
    Providence Health Center
    Case Management Dept
    254.751.4256
    srcole@phn-waco.org

  • sbeattysbeatty
    Thanks Sharon. We have CDS, UR and CM all as different roles. Each of us documents in a different software. It makes our work a challenge. Do any of you have rounding or some other mechanism to compare notes with these staff responsible for SI/IS?
  • kmckaigkmckaig
    edited May 2016
    We have morning huddle with the case managers and sw's to discuss the patients principal diagnosis, GMLOS, if they are continuing to meet inpt criteria and dc plan. All of the CDS' were case managers first so we have a feel for SI/IS anyway.


    Karen McKaig, BSN, RN, CCM, CPUR, CCDS
    Case Manager
    Clinical Documentation Specialist
    Baxter Regional Medical Center
    Mountain Home, AR 72653
    870-508-1499
    kmckaig@baxterregional.org


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