CDIs and LOS information

sbourquesbourque
in CDI Talk Archive
Do the CDI staff at your facilities provide LOS information on the working DRGs to the case managers, UM or staff responsible for working with the LOS and physicians to try and discharge as close as possible to the GLOS? IF so please provide the process. Do your CDIs participate in the case management meetings on each patient in order to provide up-to-date LOS info on each pt and identify gaps in the documentation?

Comments

  • sharon.cooper@owensborohealth.orgsharon.cooper@owensborohealth.org
    edited March 2016
    Our CDS's do not.

    Sharon Cooper, RN-BC, CCS, CDIP, CCDS, CHTS-CP
    AHIMA-Approved ICD-10-CM/PCS Trainer/Ambassador
    Manager Clinical Documentation/Appeals

    Owensboro Health Regional Hospital
    P.O. Box 20007
    Owensboro, KY 42304-0007
    Office: 270-417-4612
    Cell: 270-316-9088
    Fax: 1-270-417-4609


  • Linda_RhodesLinda_Rhodes
    edited March 2016
    Our CDI staff enter the Targeted Discharge date based on GMLOS on the CM Discharge Assessment flowsheet in EPIC. This is done when the Initial DRG is assigned and whenever the DRG is updated by the CDIS. The CM will consult with the CDIS if their expected discharge date is quite different from the Target date to determine any gaps or explain why we are in a certain DRG/LOS. The CDIS do not attend any formal CM meetings.

    Thanks,
    Linda


    Linda Rhodes RN, BSN, CCDS
    Manager Clinical Documentation
    Improvement
    New Hanover Regional Medical Center
    Wilmington, North Carolina 28402
    Office # 910-815-5544
    Cell " 910-777-8344
    e-mail : linda.rhodes@nhrmc.org

  • jrileyjriley
    edited March 2016
    We do participate. I create a "rounds report" by 7 a.m. every morning and calculate a preliminary DRG with LOS for each patient admitted the day prior. Physicians are aware that these DRGs are only tentative based on the limited documentation available to me. (we have a hydrid medical record and in many instances not a lot of info is on the chart the morning after admission). Providers and all other attendees, including the CDS's, receive this report prior to rounding. As cases are discussed the CDS's share information with the providers and care managers, and other clinicians. We have found this forum to be a great place to discuss documentation, discharge planning, CORE measures, PSI's. etc. Later, as they do their daily chart reviews, the CDS's update the initial DRG when they find CC/MCC dxs. This updated DRG appears on the following day's rounds report, thus making this a living document. Frankly, the providers weren't crazy about the report until we started updating it, due to the fact that admission information is so scant that the initial DRG and LOS were sometimes way off. It is now considered a useful tool and is widely used throughout the house.


    Judy

    Judy Riley, RHIT, CCS, CPC
    Coding/CDI Manager
    LRGHealthcare
    Lakes x 3315


  • sbourquesbourque
    edited March 2016
    Judy,
    Thanks for the information on this topic...can you send a blank rounding report so I can see what info is included?

    Suzonne Bourque, RHIA, CCS, CCDS
    sbourque@wkhs.com


  • Kay.blue@carolinashealthcare.orgKay.blue@carolinashealthcare.org
    edited March 2016
    We provide the 3M #13 report Working DRG LOS variance listing to the Case managers. Also, we have developed a tip sheet of the top 10 DRG's and GLOS
    by discharge unit for each nursing unit.

    Kay Blue
    CHS

  • martin.conroymartin.conroy
    edited March 2016
    DRGs with geometric LOS is reported twice daily(6:am & 2:pm) along with dx. & PCS. Report is automated from 3M. Our team rounds on selected units weekly for LOS rounds. We only round when physicians lead the LOS rounds. We do not do round on nursing or CM lead rounds. We do not attend CM meetings. We meet with coders and quarterly with the appeals team.

    Marty
    Temple Health

  • martin.conroymartin.conroy
    edited March 2016
    Patient Age Account Number Readmit Room Start Date Attending Physician Payer Cert Status Concurrent DRG Code Concurrent DRG Priority Reviews Target GM LOS LOS Current LOS Variation to DRG GMLOS Coder Comments Documentation Comments


    Marty

  • arozhkovskayaarozhkovskaya
    edited March 2016
    Neither do our CDIS.

    Anna Rozhkovskaya, RHIT, CCS, CCS-P
    Manager, Clinical Documentation Improvement
    Memorial Healthcare System
    Health Information Management Department
    2990 Executive Way, Miramar, Fl 33025
    (954)276-9957 Office
    (954)265-6974 Mobile 
    (954)441-9459 Fax



  • jrileyjriley
    edited March 2016
    Sure. I didn't create the format as I am not that skilled with Excel, my finance dept. did that for me. I work on the 2nd tab which is nothing more than a census report which I import every morning from our HIS system. I sort by DRG to pull up the new admissions without DRGs.

    The process is very clunky as we are EMR-challenged. I have to go into my HIS system's abstracting application to code and group each case. I then enter my preliminary DRGs in column M. When I enter the DRG in this column, the data in the yellow highlighted columns Q R and S instantly updates- I love my finance friends! After entering all DRGs I refresh the pivot table on first tab to update it. The pivot table is what the providers print and actually look at.

    We have 2 facilities which explains column A and the way the pivot table appears.

    The 3rd tab is the current CMS DRG table with weights and LOS data.

    What the CDS's do: To update DRGs as they do their reviews, the CDS's have to go into our HIS system, enter the new diagnoses and/or procedures in abstracting, and regroup the case to obtain a new DRG. They often call on the coders for help here. Any changes they make flow to HIS census report which I import every day so that the document is constantly updated.

    I hope I've explained it clearly, it's time consuming especially on a Monday morning, but it's the best tool we could devise with our limited software to help us get a handle on LOS and it has proven useful for other things as well.



    Judy Riley, RHIT, CCS, AHIMA-Approved ICD-10 Trainer
    CDI/Coding Manager
    LRGHealthcare
    jriley@lrgh.org


  • sbourquesbourque
    edited March 2016
    Do you use a grouper to get this report?

  • martin.conroymartin.conroy
    edited March 2016
    Yes we code in the 3M encoder

  • jrileyjriley
    edited March 2016
    Yes, I have to group the cases in our HIS system in order for the DRGs to remain on the report throughout the patient's stay. I also use my trusty 3M grouper.

    Judy Riley, RHIT, CCS, AHIMA-Approved ICD-10 Trainer
    CDI/Coding Manager
    LRGHealthcare
    jriley@lrgh.org


  • sbourquesbourque
    edited March 2016
    Thanks so much, Judy...

    Suzonne


  • sbourquesbourque
    edited March 2016
    What report do you use in 3m to pull all of the information listed below?

  • martin.conroymartin.conroy
    edited March 2016
    I do not run any reports. I rely on the IT team to run/automate all reports for me. It may be custom.
    I will ask if custom or canned.

    Marty

  • clemed12clemed12
    edited March 2016
    I am not sure I want you to be responsible to CM for that information.

    Diane M Clement RN MS CCDS
    Team Leader Clinical Documentation Management Program
  • martin.conroymartin.conroy
    edited March 2016
    Our IT department pulls information out of 3M/Clintrac into Midas and the report runs out of Midas. It is customizied by IT not canned out of 3M.


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