Insights into CDI Workflow in EPIC at Pediatric Hospitals
Understanding the CDI workflow in EPIC at UCSF Benioff Children's Hospital Oakland and Children's Hospital & Medical Center, Omaha. Pros and cons of using EPIC for CDI, challenges in reporting and communication processes, and management of progress notes in coding. Dive into the actual note assessment and the unique aspects of pediatric care delivery.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
CDI in Epic Presented by: Karen MacArthur, RN, BSN, CCDS UCSF Benioff Children s Hospital Oakland, CA Marietta Morhardt, RN, BSN, CPN, CCM Children s Hospital & Medical Center, Omaha, NE
UCSF Benioff Childrens Hospital Oakland In the process of affiliating with University of California San Francisco Located in Oakland CA 190 Bed facility with 10,000 discharges/year Around 70% MediCal population
BCHO CDI Workflow in EPIC: Work Queues
BCHO CDI Workflow in EPIC: Dashboard Pros and Cons
Pros and Cons Pros: We don t have to move from a program to EPIC/no input of patient data It is in the chart and care providers can go to the record and/or reply to our queries Easy to see who is responsible for the query Cons: Must cut and paste to send to other providers Reports are difficult to build No place to record verbal query without sending inbox message
EPIC Physician Workflow Hold for screen shot of physician query
Question to the Group In Progress Notes, and other notes as well, we pull in the problem list. How do your coders handle these notes? Code NOT Code Query if it is not documented anywhere else?
Actual Note Assessment: ................undergoing induction chemotherapy with last chemo 9 on admitted for febrile neutropenia. Limited exam today due to patient discomfort and anxiety. However his fever curve is improving and his white cell count is improved today, along with his hgb following transfusion yesterday. Differential is most consistent with viral illness vs mucositis. Bacteremia less likely with a negative blood culture and stable VS. Will continue current treatment until his ANC increases. Active Problems: Speech delay Obstructive sleep apnea Pancytopenia due to antineoplastic chemotherapy Ewing's sarcoma Delay in development Febrile neutropenia Morbid obesity Mucositis due to antineoplastic therapy
Childrens Hospital & Medical Center Fast Facts Children s Hospital & Medical Center is the only full-service, pediatric healthcare center in Nebraska, providing expertise in more than 50 pediatric specialty services to children across a five-state region and beyond. We are home to Nebraska s only Level IV regional Newborn Intensive Care Unit and the state s only Level II Pediatric Trauma Center. Our regional heart center offers expertise in pediatric heart transplantation. Children s is recognized as a 2018-19 Best Children s Hospital by U.S. News & World Report in five pediatric specialties: Cardiology and Heart Surgery, Pulmonology, Gastroenterology & GI Surgery, Orthopedics, and Diabetes & Endocrine Disorders. In 2017: Total Patient Visits: 623,700 Patients: 138,500 Medicaid Patients: 46,500 50+ Outpatient Specialty Services 145 Beds 11 Regional Clinics In 3 States
Omaha Childrens Workflow Initial List gets reviewed by CDI Reconciler Goes to Subsequent List, which is reviewed by CDS. Date for re-review is determined by CDS s Query List keeps track of outstanding queries CDI Manager Review list is for final coding or if case needs special attention, i.e. SOI mismatch with encoder, coding issues, etc. When ready for matching up initial with final DRG, goes to Validation If discharged prior to coding being completed, or if awaiting response from practitioner in relation to coding will go in Discharge waiting for coding list
Pros & Cons of In Basket Queries Pros: 1. Goes directly to practitioner 2. Able to ascertain if it has been read or not 3. They are able to respond and ask further questions and/or clarify if needed 4. You can then respond in kind if additional questions Cons: 1. Can only send to one practitioner at a time 2. Doesn t directly send the reader to the problem list to amend or the progress note to address 3. If you need to send same query to another practitioner, and it has been read by the original recipient, you cannot cut & paste the query. 4. Have to add residents/APRN s to treatment team in Epic in order for them to see the query. (shows up in their to do list)
Dashboard (Childrens) Dashboard is still a work in process, trying to figure out what information is the most useful at a glance
