Emergency Room and Critical care coverage

Comments

• cynthia.a.goewey

  July 2013 edited May 2016

  We do not cover the ED. Currently I cover the ICU pts (everything but cardiac and CT surg as another nurse has them). I review the admissions daily.
  Cindy
  
  
• gail.eaton

  July 2013 edited May 2016

  I cover critical care and review daily
  
  Gail Eaton RN PCCN CDS
  Clinical Documentation Specialist
  St Joseph Health
  2700 Dolbeer, Eureka, Ca, 95501
  Office: 707-445-8121 ext 7555
  Cell: 707-267-0279
  
• don.cdi.rn@gmail.com

  July 2013 edited May 2016

  We tried ED several years ago, focusing on the patients with admit orders. UR is not part of our scope.
  We found that there was limited information (we did have EHR at the time with HP, PN, etc.) and therefore found a lot of double work when the patient hit the floor. Others may have different experiences ...
  
  On critical care, if you are able to focus on mortality/etc profiling (ie, have the tools to KNOW what diagnosis will make a difference for each case), then I believe daily reviews would be useful. If not, most critical care patients have an abundance of relevant diagnosis fairly quickly.
  
  Don
  
  
• sabullock

  July 2013 edited May 2016

  We do not review in ED.
  
  We do review in all our critical care units. We find great teaching opportunities in these units. We are an academic medical center with rotating residents so this may be different in non-academic hospitals.
  We find sign/symptoms and the issue of versus. Also we are education on what is really respiratory failure (PSI issue) along with what is a true post op complication.
  
  If you are not currently in your critical care unit might be very worthwhile to do a pilot review to see if it is beneficial in your facility.
  
  Shelia
  Shelia Bullock, RN, BSN, MBA, CCM, CCDS, CCS
  Director, Clinical Documentation Improvement Services
  University of Mississippi Medical Center
  2500 North State Street
  Room S336
  Jackson, MS 39216
  T: 601-815-3079 I F: 601-815-9505
  sabullock@umc.edu
  www.umc.edu
  
  
• evanspx@sutterhealth.org

  July 2013 edited May 2016

  We review samples in ICU - can't review all every day due to staffing. Generally, it is very in ICU that patients have MI, Sepsis, ARF, etc, so not a great need to 'query' our ICU staff. Rather, what happens is that subsequent staff fail to endorse certain diagnoses treated and resolved in ICU, sometimes leading to a need to confirm.
  More opportunity for CDI at our site on the regular floors, again, IMO, because the organ failures are often clearly stated for ICU patients.
  
  
  
  Paul Evans, RHIA, CCS, CCS-P, CCDS
  
  Manager, Regional Clinical Documentation & Coding Integrity
  Sutter West Bay
  633 Folsom St., 7th Floor, Office 7-044
  San Francisco, CA 94107
  Cell: 415.637.9002
  Fax: 415.600.1325
  Ofc: 415.600.3739
  evanspx@sutterhealth.org
  
  
• lprescott

  July 2013

  We cover critical care on a daily basis. We started in the ED a few months ago, there is little on the record yet but I would make myself available tot he ED doctors, listen to their dictation and review their documentation as it was happenning. When reviewing labs etc I would verbally query. I only go time permitting, but feel if a person was in ED full time we really could influence change. Also if you sending someone to the ED have them "beef up" on E&M coding.
  Laurie L. Prescott RN, MSN, CCDS, CDIP
  lprescott@morehead.org