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

2. Agenda MWHC Physician Communication 2015 Opportunities Preparation
Challenges

3. 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

4. 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

5. 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

6. 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

7. 2015 - Year of Change for MWHC
ICD 10 Implementation
New CDI Manager
Key highlights of 2015
January M 360 software
New CDI start
February eMD Queries
March – eMD Queries turned off
Summer 2015 – Module roll out
September – Physician education & eMD Queries back on
October PQ change
ICD 10 – Live

8. 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

9. Get the show on the road

10. ICD 10 Physician Education
AHIMA Modules- 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

11. Example of Education Opportunities - flier
AHIMA Modules available July (12 months)
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

12. 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 beats per minute
Type 2: atypical follows different re-entry pathway than type 1 and is faster at beats per minute

13. 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

14. As the saying goes…

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

16. Successes Support of Chiefs Electronic query process
CDI attendance meetings

17. Questions