Vol 26, Issue 1
Andrew Donohoe, MD Associate Chief, Clinical Operations at Chapel Hill
Inside this issue:¶
| Operations | 1 |
|---|---|
| Coding Corner | 2 |
| Announcements | 2 |
| Hospitalist Highlight | 3 |
UNC Division of Hospital Medicine¶
Hospitalist Happenings¶
VIEW FROM THE NINTH FLOOR¶
Good day and happy July!¶
We've probably all had the experience of 'cleaning up orders' for a patient who's been here in the hospital for some time. Even a stretch of time in the ED can result in unnecessary order debris which just sits there and festers until the nurse pages Night 2 at three in the morning asking why there's still an active 'cardiac monitor' order. Indeed…why?
A recent RCA concluded that order debris was a real threat to missed or delayed action by nurses and it's easy to see how this may ultimately result in harm to the patient. A brief browse through SharePoint tells me that we have never really attempted to establish a Best Practice for this but I think it's worth discussing. We reviewed some ideas during this week's Operations Meeting (now open to anyone who would like to join) and would like to propose the following:
Order Cleanup Initiative¶
- Please take a moment to purge unused/expired orders before going off service. The off-going provider is in a better position to quickly assess which orders remain relevant than the oncoming attending. It would be reasonable to connect this with your current workflow of updating the hospital course before you go off service.
- Please purge orders if you are the accepting physician receiving the patient from another service. Common examples are patients admitted from the Emergency Department or transferring to our service from the MICU or surgery service.
This does not mean that you have to go through and individually select to continue/discontinue each order. Continue to choose 'Continue All Unselected' from the top of the order panel, just be sure to scroll through and toggle 'discontinue' for any unused order.
As noted above, our Division's Operations Meeting is now open to anyone who is interested to attend. Angela sent an updated invite to the group in the beginning of July. Meetings occur every Monday at 12:30 and (typically) last about 30 minutes. Please feel free to join if you have any items you'd like to discuss or even if you just want to get a pulse on current issues.
CODING CORNER: Obesity¶
Summer is in full swing and so is the coding corner! T oday's topic is obesity. As we well know , obesity has a profound impact on inpatient care, often leading to longer hospital stays and increased complications during treatment. Care also necessitates specialized equipment and additional staff training.
But did you know documenting obesity also impact reimbursement and the mortality index? Body Mass Index (BMI) of 40 or greater is considered a comorbid condition (CC) when documented alongside a diagnosis of morbid or severe obesity.
What does this mean for us?
A BMI alone is not enough -we need to document morbid/severe obesity and the impact that obesity has on the patient's hospital stay.
To help me (and all of you of course) I have created an EPIC dotphrase to help with this documentation (please feel free to steal it from me or create your own!):
.morbidobesity which states 'Obesity significantly strains hospital resources, leading to increased healthcare costs, extended patient care times, and heightened demand for specialized medical equipment and staff. Complicates care, contributes to morbidity, mortality.'
That's it for now happy summer and happy documenting!¶
Announcements¶
Mukhtar Adem - July 4th¶
Melissa Pabalan - July 5th¶
Emily Sturkie - July 9th¶
Nick Piazza - July 14th¶
Will Kwan - July 16th¶
Babette Stern - July 21st¶
Brandon Pyles - July 22nd¶
Upcoming DHM Faculty Meetings¶
Noon -1:00 | PECR3 & Webex
July 16th: Hospitalist Humanities w/ Rimma Osipov & Jess Guidici July 23rd: State of the Division w/ Dave Hemsey
Congratulations to those celebrating a landmark in years of service!
5 years -Ann Marie Kumfer
10 years -Ashmita Chatterjee , Michael Craig , Will Kwan, & Raquel Reyes
15 years -Ria Dancel , Leo Marucci , John Stephens, & Christine Williams
Amy Tierney, MD Assistant Professor of Medicine¶
Hospitalist Highlight¶
Dunstan Akolbire¶
'I am from Ghana - born and raised. My family is Catholic, and I was part of a religious organization known as the legion of Mary that is purposed on compassion for the ill and less fortunate of society, as such weekly hospital visits were a norm for me in my late teens. I wanted to do more than just visit sick people, so I decided to become a physician. My favorite thing about being a physician is meeting and getting to know different people.
I obtained my Bsc Human Biology and Bachelor Medicine, Bachelor of Surgery at the Kwame Nkrumah University of Science and Technology in Ghana. That is where I met my wife Doris, and we have been together since. She is a pulmonary/critical care fellow at UNC. We have three children: 10, 5 and 3 years old. I love dogs but cannot have one because someone I live with has a phobia for dogs (it's Doris, don't tell her I said so). I used to play guitar but was never really good at it. Nowadays I love to play scrabble, and pencil sketch.'
Welcome to the team, Dr. Akolbire!¶
Cuteness Corner!¶
Keva Southwell's daughter, Lucy, made an appearance at Hillsborough, where she is following in her mom's footsteps as a future hospitalist.
Sending well wishes and congratulations to Katie Lane and family for welcoming Miles Robert Lane into the world!
Please email Sharon Baker ([email protected]) if you would like to recognize a fellow peer, share a personal work achievement, family/coworkers photos, or submit an announcement to be featured in future newsletters.