Re: role collaboration between Utilization Review andCDS

dbutler

For us, we rely on the ADT feed.
That being said, we also review obs status pts in beds -- the status may / does change later in the stay and often that would be too late to effectively review and impact documentation. Better to review and have the pt remain in obs status than to miss the chance to impact inpatient documentation because the status was changed late in the stay.

Don

>>> "CDI Talk" 1/23/2012 12:08 PM >>>
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
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sbeatty

Thanks, Don. We reviewed OBS patients for several years when we only reviewed Medicare and Medicaid cases. I advocating for moving to all payers, since I believe every patient deserves an accurate and complete medical record, and was finally able to convince our leadership of the same. Something had to go and for us, it was OBS cases. We are trying to get approval for additional help, at which time we hope to look at OBS again and selected OP cases. You're absolutely correct in the need to know early to be able to impact.