Working Weekends/Holidays

megan.bartonmegan.barton
in CDI Talk Archive
I have a rather new CDI department. Currently we do not work weekends or holidays but are considering it. Can you please let me know if your CDS work weekends/holidays and your rationale?

Thank you,
Megan

Megan Barton RN, BSN
Manager Clinical Documentation Improvement
Health Information Management-Mercy East
Ph: 314-251-6192
Fx: 314-251-3982

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Comments

  • evanspx@sutterhealth.orgevanspx@sutterhealth.org
    edited May 2016
    We do not work weekends as we have only 2.9 FTEE for 3 campuses and we
    can't review 100% of our cases in any event. So, if we put someone on
    weekends, it would mean fewer cases would be reviewed during the week.
    We also allow 2 days for the medical staff to w/u patient and document
    before we review cases - closer than that has not been efficient in our
    practice.



    Paul Evans, RHIA, CCS, CCS-P, CCDS



    Supervisor, Clinical Documentation Integrity, Quality Department

    California Pacific Medical Center

    2351 Clay #243

    San Francisco, CA 94115

    Cell: 415.637.9002

    Fax: 415.600.1325

    Ofc: 415.600.3739

    evanspx@sutterhealth.org

  • vdavis2vdavis2
    edited May 2016
    Yuck... J but that is Vicki personally, not Vicki manager/productivity tracker...

    Vicki S. Davis, RN CDS
    Clinical Documentation Improvement Manager
    Health Information Management Department
    Alamance Regional Medical Center
    Office (336) 586-3765
    Ascom Mobile (336) 586-4191
    Fax (336) 538-7428
    vdavis2@armc.com

    "The difference between the right word and the almost right word is the difference between lightning and the lightning bug."- Samuel "Mark Twain" Clemens

  • lsipos@monument.healthlsipos@monument.health
    edited May 2016
    We too, do not work weekends, currently we only review about 60% of our Medicare cases with the 3 FTE CDI's that we have. I don't think we can justify a reason to supplement CDI's on Saturday and Sundays considering we aren't even seeing all of the patients we have now. Personally, I think one of the benefits of this position is that you get weekends off. For us, we only hire Nurses that have over 5 years experience, and I think that allows for those nurses who have "put in their time", so to speak-with years of nights, weekends and holidays to apply for and hold this position. Just my opinion.

    Juli Bovard RN CCDS
    Rapid City Regional Hospital
    Rapid City, SD

  • lsipos@monument.healthlsipos@monument.health
    edited May 2016
    AMEN VICKI! You said it in far few words than i! :)

    Juli Bovard RN CCDS
    Rapid City Regional Hospital
    Rapid City, SD
    jbovard@regionalhealth.com

  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    We don't at this point. We are currently a two (wo)man team, in the process of hiring a third. We are understaffed as is since we would require 4 FTE's to have full coverage so there's no real reason to justify holidays/weekends. In our case it would be really unfair as well as I am salaried and am not required to work holidays/weekends per my job description. Which would mean that my other CDS would be required to work all holidays if we wanted them covered. At this point, we both usually take all holidays off although occasionally one of us will choose otherwise. From a financial standpoint, the hospital would be paying the other CDS holiday pay too, which I think they would prefer to avoid. The "normal business hours" schedule is appealing and a good incentive to gain applicants for a CDS role as well.

    All things to think about....

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404

  • megan.bartonmegan.barton
    edited May 2016
    We have a 5 person team with 2 more coming on. Before I took over as manager the team was told that they should anticipate working weekends and any holidays that would leave a 3 day gap in reviews (ie: Memorial Day). We have a goal 85% coverage for two hospitals which we are currently meeting so I am trying to steer clear of having weekends/holidays mandated. Thank you for your input because it really helps!



    This email contains information which may be PROPRIETARY IN NATURE OR OTHERWISE PROTECTED BY LAW FROM DISCLOSURE and is intended only for the use of the addresses(s) named above. If you have received this email in error, please contact the sender immediately.
  • mary.a.dunnmary.a.dunn
    edited May 2016
    We currently do not work weekend or holidays. In my previous CDI position we did work weekends (no holidays). We found after 2 years of weekends that there was no impact with the physicians with having a CDI on the weekend. There were 6 CDIs. Eventually we gave up the weekends and there was no change at all in CMI or productivity.
    I agree with Vicky. Weekends are Yucky!

    Mary Dunn RN, MSM, CCDS
    Clinical Documentation Specialist
    Community Hospital
    Munster, Indiana
    219 513 2612
    mary.a.dunn@comhs.org



  • katysuegood@gmail.comkatysuegood@gmail.com
    edited May 2016
    I should mention that we now are 98% electronic for records and recently implemented a E-query system. The other CDS does have the option to log in and work from home a few hours on the weekends if she wishes. I don't track her hours personally but I think she often does 4 hours on Sunday which allows her to get a jumpstart on reviews for Monday. That beign said, it is not expected and she probably does this 50% of the time for a varying amount of time.
    I didn't really think about this in the original question since I do not do weekend reviews (although I'm sure I could if I wanted to take a different day off or something)

    Our Medicare coverage rate is 97% without having mandated weekends/holidays, so I don't really see the point.

    Katy Good, RN, BSN, CCDS, CCS
    Clinical Documentation Program Coordinator
    AHIMA Approved ICD-10CM/PCS Trainer
    Flagstaff Medical Center
    Kathryn.Good@nahealth.com
    Cell: 928.814.9404

  • don.cdi.rn@gmail.comdon.cdi.rn@gmail.com
    edited May 2016
    Some helpful on-line ACDIS polls:

    12/4/08 What are your CDI coverage plans for Christmas Day?
    82% Everyone's off, we'll review charts on the 26th
    3% Yuck, I'm working on the 25th
    2% A colleague got stuck working the 25th
    1% Not sure, too busy to think about it
    13% We're taking the whole week/several days off

    2/22/10 What are your typical working hours as a CDI specialist?
    80% Monday-Friday, eight hour shifts
    9% Monday-Friday, eight hour shifts, occasional weekends/holidays
    7% Four days a week, 10 hour days
    4% Flexible/whenever I can get physicians on the floor

    5/31/2011 Do your CDI specialists work holidays?
    10% Yes, we are fully staffed
    5% Yes, but staffing is reduced/minimal
    85% No, the CDI department is closed for holidays
    1% No, but we're working towards holiday coverage


    8/29/2011 Does your CDI staff work Monday through Friday?
    94% Yes
    6% No, we have a rotating schedule including weekends

    Don

  • dallend@einstein.edudallend@einstein.edu
    edited May 2016

    We do not work on weekends or holidays. We can work on a Saturday or Sunday if we want to make up a day (took a day off monday through friday and don't want to use vacation time).
    Debby Dallen,RN CCDS
    Albert Einstein Medical Center
    Phila PA 19141

  • paxnerospaxneros
    We have been working weekends for 4 years. Initially there were two CDI. We worked Tuesday - Saturday and Sunday - Thursday. When we added a 3rd position we began rotating the weekends with a day off. We have worked many different scheduling combinations.

    The idea behind weekends were to provide working DRG's for the Case Managers who were here on the weekends and especially on Monday when they all returned to work and issue queries.

    Unfortunately, we are very short-staffed for our weekend daily census. Average Census on the weekends is around 20 - 25 new admissions. We focus on M'Care patients only - no units. If for some reason the census is slim one day we try to complete everything on the list. Consistantly, the Cardiac Assignment is "shorted". Their census is very high w/Chest Pain. I usually focus on patients who either have non-cardiac diagnoses (but are still on the Cardiac floor) or Pneumonias, Respiratory conditions, etc. Still, this assignment is often shorted on the weekends.

    Do we issue queries? Yes - quite often. Do we see many physicians? No. And usually it is the covering physician. As I have expressed many times in the past, this is a hospital. As long as there are admissions, we will find something to query.

    The problem comes during the week when we take our day off. Because we are under-staffed we cannot assist each other with our assigments on our days off. So the weekend person is actually penalized. They come back to two days of work.

    I think when you are adequately staffed for your patient population and the work is not "burdensome" to the existing staff, weekends could be profitable. But when you are struggling to get the daily work done...

    It is a very slippery slope. Once you begin something it is difficult to abandon the process.

    Norma T Brunson, RHIA, CDIP, CCDS
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