I hope you enjoyed the Doctor’s Day buffet breakfast and lunch on March 30. I want to extend a thank you to the Administration for the delicious meals and for the physician fleece jackets donation.
– CDI– Clinical Documentation Improvement has now been rolled out. As you may know, there is a bigger emphasis on accurate documentation. This is not just coming from the hospital but also from governmental regulations like MACRA. Whether we like it or not, documentation now impacts physician reimbursement. In addition, accurate documentation reflects the severity of illness which we should get credit for in the form of length of stay should be observed to expected mortality. I would encourage you to respond to the queries you may receive in your inbox or as questions posed within the progress notes. Many of you reading this may be rolling your eyes that this is another demand on your time and contributing to burn–out, and I understand the frustration. I share the same frustration and this is difficult to message. I hope that as we become more accustomed to the use of accurate terminology, this will become more second nature and the queries will drop off. But this takes attention and a group effort. Please read the detailed explanation below by our CDI Physician Champion, Dr. Beth Gong.
– Language interpreters– As a reminder, foreign language interpretive services are available by person and by phone. I encourage you to take advantage of these services since we do have a multi-cultural patient population. From a patient safety standpoint, we are identifying that the use of an interpreter can play an important role in preventing falls.
–Wellness and Burnout– please see the article below by Dr Hass. In addition there is an all day presentation “The Science of Burnout” in Berkeley on April 29th . If you wish to learn more and to register, please see the link below.
Until next time, be well,
Donna D. Tigno, M.D.
President of Summit Medical Staff
Co-Director of Critical Care at Summit Medical Center.
In the past year there has been noticeable improvement in physician clinical documentation.
By this I mean that our documentation is more precise as more of us indicate Acuity, Co-Morbidities, Linkage and Specificity for each diagnosis. (I call this mnemonic “the other ACLS”).
For example: in the case of your patient with COPD who uses oxygen at home and is a CO2 retainer who is admitted because of increasing dyspnea, worse ABG, unchanged CxR, you would document “acute on chronic hypoxemic and hypercarbic respiratory failure due to an acute exacerbation of COPD”.
In order to build on this improvement trend, Sutter has contracted with Nuance Corporation to assist physicians with ongoing clinical documentation optimization. The service is in the form of CDI queries—these are similar to the existing Sutter CDI queries, with a somewhat simplified format. For now, you might see both types of CDI queries. You will find these queries in the “progress note” section in EPIC. The important thing is to answer the queries promptly, so remember to check your inbox for unanswered queries before you go off service. (CDI queries are usually generated while the patient is still in the hospital, whereas coding queries are sent by coding personnel and are created after discharge).
I cannot overstate how much physician documentation matters—it’s the way we convey how ill our patients are and verifies our treatments and our patients’ clinical progress. Our documentation also affects assignment of proper DRGs, severity of illness and risk of mortality scores and observed:expected calculations and other quality metrics.
CDI queries can serve as educational reminders to make sure our documentation is as accurate and complete as possible.
From Merry Beth Gong, MD, CDI Physician Champion
The Well-Being Committee’s mission is provide education on self-care and better physician-patient communication and to identify and alleviate institutional causes of stress and burnout. If you have any ideas, please let me know.
We want our medical center to do a better job of supporting us after stressful cases and those with poor outcomes. We are meeting with ” big Sutter” to bring in an established program here to help us with this. We will keep you updated on our efforts!
We are co-sponsoring an event that is sure to be fun and relaxing; it will also help build camaraderie and resilience among those who go. Here is the promo for it:
One Day Mindfulness Retreat for Physicians: Saturday, May 6, 2017 – “Responding to physician burnout”
This retreat introduces mindfulness to physicians who are facing burnout and want to learn this approach for their own health and well-being and that of their patients, colleagues, and families. The retreat will be held at Green Gulch Farm in Muir Beach, CA, with ample time for conversation, rest, and time outdoors. Led by StressCare instructors, Karin Pfluger and David Weinberg, and Jack Edelen, MD. Co-sponsored by the ACCMA.
Here is further info and signup info: http://stresscaretraining.org/events/one-day-mindfulness-retreat/
Also feel free to join John Mouratoff, MD and Scott Lee, MD at our 5 p.m. mindfulness sessions every Wednesday.
Leif Hass MD
Please click on link to review the Sutter Community Connect: MACRA (MIPS) is coming:
From Larraine Ewing, Sales Representative
Sutter Community Connect
Our next EPIC Upgrade will take place on April 11, 2017. Below are a few highlights. Training materials will be available closer to the release date. For additional details, please contact Patty Fitzgibbons, EHR Physician Liaison, at 510-325-9618.
From Patty Fitzgibbons, EHR Physician Liaison
The Midas RDE (Remote Data Entry) Electronic Incident Reporting System has come to ABSMC. The Unusual Occurrence Forms (pink sheets) are going away.
ABSMC is undergoing a system-wide implementation of MIDAS RDE. The Summit Campus is up and running as of March 1, 2017. The Alta Bates Campus will “go-live” on April 3, 2017 and Herrick is scheduled to go-live in May 2017.
Employees and physicians can access the system via the Intranet and enter and submit an incident in the Hospital Patient Safety Report portal. The Risk Management Team and the EHR–liaisons are available to train physicians. Look for us at your upcoming “Grand Rounds” and Specialty Department meetings.
For more information and assistance, please contact the Risk Department at (510) 204-6455.
Thank you for your support of this very exciting system implementation to promote patient safety and process improvement, and the overall patient’s experience at ABSMC.
The Risk Department,
Lois Wong, ABSMC Risk Officer, Cathy Werner, Risk Specialist; Fran Ohashi, Risk Specialist
S3 in collaboration with the HIM Leadership at each affiliate has been doing a work type consolidation in the Transcription system to deactivate work types that have not been used in years, to streamline the system and to standardize the work types across all the affiliates.
As a result, Alta Bates Summit has new dictation cards with a few new work types added including EEG, Behavioral Health Consult and Outpatient Consultation.
The cards were also updated to include after hour support information.
New dictation cards will be available at the HIM and Medical Staff Departments start 4/1/2017.
From Alisa Stinn, RHIT
Lillian Cavin, MD
1839 N. Governement Way Ste B
Coeur d Alene, ID 83814
Chandra Ellis, MD
3300 Webster St. Ste 1109
Oakland, CA 94609
Sharon Knight, MD
3838 California St. Ste 305
San Francisco, CA 94118
Mauricio Kuri, MD
2999 Regent St. Ste 401
Berkeley, CA 94705
From the Summit Medical Staff Office
I hope this newsletter reaches you in good spirits and in good health. Spring is around the corner, March 20, to be precise and although the rain has been much needed, I am looking forward to sunnier skies. Another important date to remember is Doctor’s Day which is March 30. Thank you all for your caring attitude and delivery of quality care for our patients at Alta Bates Summit Medical Center.
The Physician Engagement Survey results were released and although there are still areas that can be improved, overall the scores are much better compared with last year and show a significantly more positive trend. For more details please ask Dr. Ursi Boynton and Dr. Steve O’Brien.
The Wellness Committee continues to focus on physician burnout, stress and wellness. Here are dates to remember:
1) May 6th retreat at Green Gulch
2) April 29th at UC Berkeley – The Science of Burnout, What it is, Why it Happens and How to avoid it (see information below).
On a more serious note, as a reminder, if there are any changes to your attestation on the application and reapplication to the Medical Staff which pertains to malpractice lawsuits, medical board actions, restriction or suspension of your privileges or criminal activity other than a misdemeanor, including for instance DUI, please inform the medical staff office in a timely fashion. This has always been required in the Medical Staff Bylaws which is not new but can be overlooked and at times forgotten.
There is going to be construction to the ED parking lot and the timeline and details of this project will be announced as we get closer to the date. An important detail is that as construction ensues and as parking space becomes limited, the ED parking lot will be restricted to physicians who are on call, i.e. you won’t be able to badge in for access.
– New Appointments
Vice Chair of Emergency Department- Dr. Jeff Chen
Vice Chair of Anesthesiology Department – Dr. David Blacklock
As a reminder, if there are highlights you would like me to announce from your department, please let me know. We can include the information either in my President’s Report or as an article in the newsletter.
Donna D. Tigno, M.D.
President of Summit Medical Staff
Co-Director of Critical Care at Summit Medical Center
Please clink on link to register for the upcoming event, The Science of Burnout, What Is It, Why It Happens, and How to Avoid It: http://greatergood.berkeley.edu/news_events/event/the_science_of_burnout_what_is_it_why_it_happens_and_how_to_avoid_it#.WL2VcW_yvRZ
From Leif Hass, MD
Wellness Branch Co-Chair