Facility defined clinical indicators

stayrookgt@gmail.comstayrookgt@gmail.com
in Clinical & Coding
Our facility is looking into using Facility Defined Clinical Indicator policies for acute respiratory failure, sepsis, metabolic encephalopathy, and acute renal failure.  Would anyone be willing to share your Clinical Indicator Policies for each of these diagnoses?

Comments

  • rpinson@hcq1.comrpinson@hcq1.com
    The CDI Pocket Guide from ACDIS contains authoritative or widely-accepted clinical criteria/indicators for these and many other conditions most commonly encountered by CDI programs with a detailed discussion and specific current medical literature sources.  

    Like it or not, Sepsis-3 based on SOFA scoring  (no longer SIRS) has now become the authoritative diagnostic standard for sepsis since its adoption by the Surviving Sepsis Campaign in March 2017. AKI has been authoritatively defined since 2012 by the National Kidney Foundation KDIGO AKI consensus guidelines - RIFLE and AKIN have been superseded and replaced by it.

    Richard D. Pinson, MD, FACP, CCS
    Pinson & Tang
    CDI Educators and Advisers
    Authors of the CDI Pocket Guide
    www.pinsonandtang.com




  • afrady@hcpro.comafrady@hcpro.com
    I would say "don't like it" for SOFA.  While I embrace the definition, I reject limiting the assessment to only the 6 body systems assessed in the SOFA table.   Literature has well established that dysfunction in other body systems are also legitimate indicators of the perfusion problems associated with Sepsis and even the JAMA article itself indicated that those 6 areas of assessment were chosen based on having "the highest statistical correlation" for poor outcomes in their one study, using their one methodology..but without necessarily discounting other signs of organ dysfunction as false indicators.
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