1. Value and Benefits to share with multidisciplinary teams
Working DRG
Value and Benefits to share with
multidisciplinary teams
Jennifer Cavagnac , CCDS
Dr. Vishal Tiwari MD FACP
Christine Scibelli MS, RN

2. Communicate to key parties the Working DRG GLOS
Goals
Communicate to key parties the Working DRG GLOS
Physicians :Anticipated DC order
Case management: Appreciation of LOS data for DC planning

3. Benefits Improved patient progress Patient satisfaction
Identifying early morning discharges
Opening beds for ED boarding
Patient satisfaction
Timely communication of patient needs
Robust provider handover
Accuracy for CMI, O/E, reduced LOS

4. Communication Process
IPOC rounds/Standard roundtable with teams
Triad meetings (case management, attending and CDI, UM)
Face to Face
Electronic accessibility
Ensure patient awareness of plan – patient satisfaction

5. ACDIS Forums – what can we learn?
Daily lists w DRG/GLOS and if there is Query to case managers
Meet with Physician Champion to discuss outliers weekly (whether it is medical, family, social, etc.). Track and present at UR meetings/hospitalists meetings
“Always be sure to note the DRG is subject to change”
“We have Meditech and we set it up to pull that information from abstracting onto the physician's rounding report…. It is updated to match most recent documentation of conditions and procedures.”

6. Technical Potentials MPage – CIS Wish: Worklist – patient list
Concept
Challenge – users must go in each case
Workaround – static reports and distribution.
Wish: Worklist – patient list
Interface to teletracking

7. Survey How many of you are sharing a working DRG? How many plan to?
How do you share this information?

8. S2 pilot

9. Exhibit “13a” Advantages to electronic formats – Automated! Accurate!
Financial Class
Med Rec Number
Name
Visit Number
Admit Dt
Attend MD
Reviewer
W DRG
W APR SOI
W APR ROM
W DRG Est Reimb
W DRG GLOS
LOS
LOS Variance
Current Room
Transfer MSDRG
Advantages to electronic formats –
Automated!
Accurate!
Available!
…..But is it integrated??

10. Important to know Data (DRG) is subject to change…
Interpretation can be dangerous without knowledge and education
Communication is the key
Appreciate:
Observation to INPT
Any status changes

11. Barriers to Discharge (but the DRG is right)
Insurance
Social determinants of health
Substance , housing, financial, transportation
Community resources
Patient support – family, VNA
Healthcare proxy, guardianship
Behavioral health/Geriatric health

12. Case study Working DRG info LOS management
Query management –Timeliness of response
Clear integration of patient awareness for discharge plan.

13. Case example After Pt ID Admit LOS GLOS DRG MD Q? Notes J.Doe 2/1 4
3.4
179
W.Smith
Yes
Pt needs arrangements for renal specialist follow up
After
4.5
178
DONE
Pt needs arrangements for renal specialist follow up – completed.
Discharge planned tomorrow am
J.Doe has Aspiration PNA and CKD noted a query is out for the CKD stage
(clinical indicators support stage 4) DRG could move to 178 and result in GLOS of 4.5

14. Questions/ Thoughts?