Education and Communication with Physicians Angela Clayberg, BA, RN, CCDS CDI Manager Mary Washington Healthcare

Agenda MWHC Physician Communication 2015 Opportunities Preparation Challenges

Mary Washington Healthcare (MWHC) Mary Washington Hospital 437 Beds Level II Trauma Center 6 FT and 1 PT – CDI Nurses Total Medicare Visits = 8,900 89% Review Rate 34% Query Rate 89% Response Rate 84% Agreement Rate

MWHC - Stafford Hospital 100 Beds 1 FT – CDI Nurse Total Medicare Visits = 1,373 85% Reviewed 40% Query Rate 92% Response Rate 82% Agreement Rate

Physician Communication The Art of Physician Communication (2010 HCPro, Inc) Build relationships proactively Multifaceted education tactics Identify physician trends Different tactics for different MDs Ask the right question the first time Evaluate the physician communication process

Physician Communication “Physicians like to see, acknowledge, and be acknowledged for their specific contributions to the CDI process” Physician dashboard Response rate Agreement rate CMI Recognition Thank you cards Birthday cards Tomato plants Food

2015 - Year of Change for MWHC ICD 10 Implementation New CDI Manager Key highlights of 2015 January 2015 - 3M 360 software New CDI start February 2015 - eMD Queries March – eMD Queries turned off Summer 2015 – Module roll out September – Physician education & eMD Queries back on October 2015 - PQ change ICD 10 – Live

First Things First! Get the Associates ready for ICD 10 Preparation CDI/Coding Education Modules - online Classroom- Coding Manager Books/learning materials ICD 10 Newsletter – Coding Manager More Meetings ICD 10 Steering Committee ICD 10 Subgroup Clinical Documentation

Get the show on the road

ICD 10 Physician Education AHIMA Modules- email addresses Phone application MWHC Website – ICD 10 Resources link CDI availability in the MD lounge monthly Attend Department/Section Meetings Specialty presentations: Cardiology, Radiology, Ortho, Psychiatric, OB, Peds, etc. Specialty tip sheets and fliers Physician speaker – specialty presentations Monthly check up – monthly submission

Example of Education Opportunities - flier AHIMA Modules available July (12 months) Email Address needed! Phone app Guest Speaker – Dr. Horowitz – September 17th & 18th Presentations at Division / Section meetings 3M software enhancement for electronic queries process Boot Camp for physician office staff in June 2nd & 3rd Aug/Sept - session sponsored by Medical Society of Virginia, Richmond MWHC Website – ICD 10 Information – Available NOW Additional Offerings: Physician Lounge 2 hours 10th of each month Tip Sheets Fliers – lounge and “Doc Box” Electronic Board

Example - Atrial Fibrillation & Flutter 3 Categories Paroxysmal: ends spontaneously within 7 days, most last < than 24 hrs Persistent: last more than 7 days and may require electrical or pharmacologic intervention Permanent (Chronic): lasted > a year regardless of intervention attempts Atrial Flutter 2 Categories Type 1: typical (common) rate 240-340 beats per minute Type 2: atypical follows different re-entry pathway than type 1 and is faster at 340-440 beats per minute

Example - Physician Tips: When a diagnosis drops off your patients problem list write : Resolved, or Resolving Remember to document “POA” present on admission Document all treated diagnoses in the discharge summary

As the saying goes…

Challenges Email addresses Attendance – meetings and educational sessions Attention – pagers, calls, etc. Complaints – location, times, rules, etc. Compliance

Successes Support of Chiefs Electronic query process CDI attendance meetings

Questions