Case Conferences

[amesly15]

State surveyors say we must document case conference notes on all clients. Case conference is to be between the Supervisor and the Primary Nurse. Notes are to include status, any new problems, changes, etc. My question is how do you document these case conference notes in other agencies? So I'll tell you I am a Supervisor and will not ask my nurses to do one more piece of paperwork. We discuss cases all the time but rarely document in the chart..now we will!

[KP RN]

Our agency does not require case conferences, per se. However, we do document interdisciplinary communication at least every fourteen days. Our skilled nursing visit notes have a line which is for IDC, we simply write the name and the discipline of the person we communicated and what was discussed.

[NRSKarenRN, BSN, RN]

Case Conference was a BIG problem at my agency 2 years ago til we came up with a 1 page flowsheet note which the Clinical Managers/supervisors complete.

Label the top " Case Conference"

Left side lists names of services+ we fill in who we spoke with:

Primary RN_________

PT________________

OT________________

ST________________

CETN______________

RD________________

Doctor______________

Right side of form lists major discussion topics with check off areas

___ Admission report. Primary DX:_________________

___ Additional services needed____________________

___ Home/ CG problems noted____________________________

__________________________________________________

___ Wound care reviewed and appropriate for Stage_____.

Supplies obtained from _________________________

___ Therapy reviewed. Goals _______________________

____________________________________________

___ Visit rescheduled due to

___ doctors appointment

___ outpt test

____ patient not available

____ agency/case management need : patient notified

____ lack of insurance authorization/approval

____ other_____________________________

___ Patient hosptialized at _____________ due to ________________

___ Hospital Discharge planing/case management notice sent

___ Discharge planning initiated

Tenative discharge date______________

Notes:_______________________________________________

________________________________________________________________________________________________________

This got us through state survey and JCAHO !

[amesly15]

Thank you so much Karen. Working on the form today.

How do you set up your schedule to conference on all clients?

At SOC, any time of need, recert, prior to d/c? My nurses carry caseloads of 20 and up...I can't figure out how to get these notes in every 14 days..on all clients?

Thanks again:)

[hoolahan, ASN, RN]

We had a "box conference" on all our cases q 2 weeks. Sat w super and rev'd all cases in our caseload (or tickler cards in our box.) I have never seen a supervisor document a case conference yet in my former agency. I am not sure how/if they do it at my current agency.

I didn't realize this was a JACHO requirement. What are they looking for? Evidence that the case was discussed w a supervisor?

Karen, your form looks more like a guide for a case manager to document ID communication. Are your supervisors following behind the case managers with all the disciplines as well?? I was always sure to document my own IDC, I just thought that was what CM's are supposed to do?? I didn't realize I needed to document IDC w super as well, but if I discussed a case w a sup, I did document it.

[renerian, BSN, RN]

I have seen mostly what Karen displayed. Always had team either every week or every other week. All members of the team signed off. Interdisciplinary.

renerian

[amesly15]

Medicare G tag 144--Coordination of patient services--

The clinical record or minutes of case conferences establish that effective interchange, reporting, and coordination of patient care does occur.

Our surveyer dinged us for no documentation.

[NRSKarenRN, BSN, RN]

I always case conferenced with nurses + PT on my team every two weeks. Each staff assigned different day--none on Mondays.

One week was just done via phonecall/voice mail other was done live monthly.

I managed 200+ office of aging long term clients + 25-30 insurance cases --- used an excell spreadsheet to keep track of patients and RN case managers. Every 3 months would check charts in file room to make sure nobody missed.

Every time I received report from therapies/RNs for visit auths, I filed out form. Made joint visit's on long term wound pts and any "problem clients" Instead of jotting those notes down in a notebook, I used the form., signed off and slipped into chart. Became second nature to me after 3 months.

[hoolahan, ASN, RN]

That's a good system Karen. Our notes have a spot for IDC as well. Any time I got a call from a therapist, doctor or super, I wrote it in there. I like your sheet better.

[renerian, BSN, RN]

Hoolahan your in ohio aren't you? renerian

[wcnurse]

we have case conference every wednesday morning regarding all patients with upcoming d/c or recert.