Cardiac surgery poses unique challenges with its risks for patients, its potential complications and the difficulty in capturing the details in thorough documentation. On this episode, we discuss those challenges and how to approach them effectively.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guest:Rachel Mack, MSN, RN, CCDS, CDIP,  CCS, CRCConsulting DirectorClinical Documentation ImprovementVizient   Show Notes:[01:04] Uniqueness of cardiac surgery[01:30] Cardiopulmonary bypass and extracorporeal circulation[02:27] Postoperative issues[05:08] Cardiac surgeons and documentation[06:13] Intra-aortic balloon pumps and cardiogenic shock[07:50] Cardiogenic acute renal failure[08:31] Arrythmias and pacing[09:10] The end of the road in intervention[11:08] Document the reason for a patient’s deterioration Resources: To contact Modern Practice: [email protected] Rachel’s email: [email protected]   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidGoogle PodcastsSpotifyRSS Feed

The healthcare workforce is in a state of crisis: shortages of healthcare workers, rampant burnout, schedules in flux and outbreaks of violence in the workplace. On this episode, Tomas continues his discussion with a leading expert on the healthcare workforce on steps organizations can take to alleviate this crisis.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guests:Eric Burch, MBA, RN, FACHEExecutive PrincipalOperations and Workforce ServicesVizient   Show Notes:[00:32] Need for collecting and leveraging data[02:12] Reflecting the community in recruiting and retention[03:28] Addressing regulatory issues[06:10] Unions[07:06] Taking the pulse[07:35] Expanding the pipeline[09:23] Fostering wellness and resilience[10:52] Short- and long-term strategies   Resources: To contact Modern Practice: [email protected]  Eric’s email: [email protected] Subscribe Today!Apple PodcastsAmazon PodcastsAndroidGoogle PodcastsSpotifyRSS Feed

Before the Covid outbreak, the healthcare workforce was already in a state of crisis. Covid made it much worse. On this new series of our award-winning podcast, we examine the varied causes behind workforce challenges and shortages of nurses, physicians and other related disciplines. We’ll also explore steps we can take to alleviate this crisis. Joining is us a leading workforce expert to provide an overview.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient   Guests:Eric Burch, MBA, RN, FACHEExecutive PrincipalOperations and Workforce ServicesVizient   Show Notes:[01:21] The workforce issue and the pandemic[02:04] Drivers of the crisis[04:19] Changing the traditional model[05:48] Potential technology role in alleviating the crisis08:[08:47] Recruitment and retention approaches[11:22] Leadership and retention   Resources: To contact Modern Practice: [email protected]   Eric’s email: [email protected]  Subscribe Today!Apple PodcastsAmazon PodcastsAndroidGoogle PodcastsSpotifyRSS Feed

On this episode, Tomas continues examining an area often overlooked in documentation – chronic fatigue and debilities. Joining him is a leading expert on clinical documentation improvement. She will demonstrate how crucial this area is to reimbursement and patient care, affecting as it does mortality, length of stay and other indicators.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guests:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting DirectorClinical Documentation ImprovementVizient   Show Notes:[00:37] Additional conditions in the Vizient variable[04:57] Impact on direct costs[05:46] SDOH Coding guidelines and subsequent reluctance to document[04:50] Under-documented medical conditions and their ramifications[09:08] Barriers to capturing this Vizient variable and use of queries[11:10] How correct documentation can benefit patient care down the line   Resources: To contact Modern Practice: [email protected]  Rachel’s email: [email protected]     Subscribe Today! Apple PodcastsAmazon PodcastsAndroidGoogle PodcastsSpotifyRSS Feed

An area often overlooked in documentation can be crucial to reimbursement and efficacious care, and that is the realm of chronic fatigue and debilities. Joining Tomas is a leading expert that will explain the importance of accurate coding for these patients.. Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guests:Rachel Mack, MSN, RN, CCDS, CDIP,  CCS, CRCConsulting DirectorClinical Documentation ImprovementVizient   Show Notes:[01:07] Defining chronic fatigue and debilities[02:27] G, R and Z codes[03:19] Codes that capture Vizient variable for chronic fatigue and debilities[04:50] Under-documented medical conditions and their ramifications   Resources: To contact Modern Practice: [email protected] Rachel’s email: [email protected] Subscribe Today!Apple PodcastsAmazon PodcastsAndroidGoogle PodcastsSpotifyRSS Feed

This episode of our award-winning podcast continues an examination of the recent updates to the coding guidelines released by the Centers for Medicare and Medicaid Services (CMS). Knowing these guidelines is crucial to practices and healthcare organizations for accurate reporting and reimbursement. Two leading clinical documentation experts join Tomas in this critical discussion.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guests:Sheila Bowlds, MBAAssociate PrincipalClinical Documentation ImprovementVizient Jim Tamburini, BS, RHIT, CCS, CCS-P, CDIPSenior Consulting DirectorClinical Documentation ImprovementVizient   Show Notes: [00:35] Increase to DRG relative weights and to reimbursement` [02:54] Changes to coding guidelines [05:37] Codes involving social determinants of health (SODH) [07:06] Documenting SDOH [08:48] Other changes   Links | Resources: To contact Modern Practice: [email protected] Sheila’s email: [email protected] Jim’s email: [email protected] ICD-10-CM Official Guidelines for Coding and Reporting: https://www.cms.gov/files/document/fy-2024-icd-10-cm-coding-guidelines.pdf   Subscribe Today! Apple PodcastsAmazon PodcastsAndroidGoogle PodcastsSpotifyRSS Feed

Every year, the Centers for Medicare and Medicaid Services (CMS) makes revisions, additions and deletions to the coding guidelines that healthcare organizations and practices use for reporting, billing and reimbursement. The guidelines for 2024 include a number of new guidelines dealing with social determinants of health (SDOH) issues. It is crucial for practices to fully understand all the guideline updates for accurate reporting and maximized reimbursement. In the next two episodes, Tomas discusses the latest coding guidelines with two leading clinical documentation experts. Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guests:Sheila Bowlds, MBAAssociate PrincipalClinical Documentation ImprovementVizient Jim Tamburini, BS, RHIT, CCS, CSS-P, CDIPSenior Consulting Director Clinical Documentation ImprovementVizient Show Notes: [01:39] Background and explanation of CMS coding updates [03:19] When changes go into effect [03:37] Impact on providers and hospitals [04:42] Number of diagnosis and procedure codes added, deleted and revised [06:48] Specificity drives the documentation [07:26] Changes to complications/comorbidities (CCs) and Major complications/comorbidities (MCCs) [11:58] Changes to DRGs and MS-DRGs   Resources: To contact Modern Practice: [email protected] Sheila’s email: [email protected] Jim’s email: [email protected] ICD-10-CM Official Guidelines for Coding and Reporting: https://www.cms.gov/files/document/fy-2024-icd-10-cm-coding-guidelines.pdf   Subscribe Today! Apple PodcastsAmazon PodcastsAndroidGoogle PodcastsSpotifyRSS Feed

On this episode of our award-winning podcast, we finish our feature on an organization that has made huge strides in reducing Patient Safety Indicators (PSIs) throughout health system. We will discuss the phenomenal results of the initiative so far and what is planned for the near future at Sanford Health.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guests:Rachel Leyk, RN, CMSRN, CPHQImprovement AdvisorQuality and Safety – FargoSanford Health Devendranath (Dev) Mannuru, MD, CHCOMInternal Medicine HospitalistCDI and Quality Physician AdvisorSanford Hospital – Fargo Khaled Zreik, MDDirector, Critical CareAcute Care SurgeonSanford Health   Show Notes: [00:39] Use of data in managing PSI reduction [03:14] Results of a successful program [04:05] Lessons learned [08:15] Expanding and standardizing throughout the enterprise   Links | Resources: To contact Modern Practice: [email protected] Rachel Leyk’s email: [email protected] Dr. Mannuru’s email: [email protected] Dr. Zreik’s email: [email protected] PSI ACS Poster: PSI ACS Poster Final.pdf 2023 Quality and Safety Conference presentation: 2023-qsc-ppt-final presentation.pptx   Subscribe Today! Apple PodcastsAmazon PodcastsAndroidGoogle PodcastsSpotifyRSS Feed

On this episode of Modern Practice, we continue highlighting an organization that has made huge strides in reducing Patient Safety Indicators (PSIs) throughout health system.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guests:Rachel Leyk, RN, CMSRN, CPHQImprovement AdvisorQuality and Safety – FargoSanford Health Devendranath (Dev) Mannuru, MD, CHCOMInternal Medicine HospitalistCDI and Quality Physician AdvisorSanford Hospital – Fargo Khaled Zreik, MDDirector, Critical CareAcute Care SurgeonSanford Health   Show Notes: [01:06] Managing PSI notifications to staff – keeping it non-punitive [03:46 Escalation process versus peer review – addressing practice variation [05:12] Keys to achieving collaboration   Links | Resources: To contact Modern Practice: [email protected] Rachel Leyk’s email: [email protected] Dr. Mannuru’s email: [email protected] Dr. Zreik’s email: [email protected] PSI ACS Poster: PSI ACS Poster Final.pdf 2023 Quality and Safety Conference presentation: 2023-qsc-ppt-final presentation.pptx   Subscribe Today! Apple PodcastsAmazon PodcastsAndroidGoogle PodcastsSpotifyRSS Feed

This episode of our award-winning podcast continues the success story of how Sanford Health has reduced PSIs through a concerted, multifaceted effort throughout the organization. Tomas interviews members of the clinical team that guided the way.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guests:Rachel Leyk, RN, CMSRN, CPHQImprovement AdvisorQuality and Safety – FargoSanford Health Devendranath (Dev) Mannuru, MD, CHCOMInternal Medicine HospitalistCDI and Quality Physician AdvisorSanford Hospital – Fargo Khaled Zreik, MDDirector, Critical CareAcute Care SurgeonSanford Health   Show Notes: [00:34] Surgeon’s perspective [02:04 Role of nurse reviewer [03:18] Necessities for success [04:05] Importance of executive leadership; need to be non-punitive (the “gold nugget”) [06:37] Reliable software and establishing the stop bill process [08:15] Involving HIM, coding and the CDI team [10:36] Engaging the clinical staff   Links | Resources: To contact Modern Practice: [email protected] Rachel Leyk’s email: [email protected] Dr. Mannuru’s email: [email protected] Dr. Zreik’s email: [email protected] PSI ACS Poster: PSI ACS Poster Final.pdf 2023 Quality and Safety Conference presentation: 2023-qsc-ppt-final presentation.pptx   Subscribe Today! Apple PodcastsAmazon PodcastsAndroidGoogle PodcastsSpotifyRSS Feed