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RN Auditor/Coder
Yes - it is auditing patient charts while they are either still in the hospital or have gone home. The purpose is to gather data mainly for The Joint Commission or The Center for Medicare and Medicaid Services (CMS). They want to see that hospitals are providing the "right" care to patients based on a particular disease or medical problem, such as those with heart attacks, those who smoke or those that come in for a surgery - in order to improve their outcomes. They have measure sets, such as "AMI - Heart Attack" and the indicators are the specific actions the clinician needs to complete, such as "Did the patient receive an aspirin within 24 hours of arrival to the hospital". If they did, they pass the measure, if not, it is considered a failure/variance and the hospital gets dinged by either TJC or CMS for it. Collecting core measures (both inpatient and outpatient) are required federal programs, and with CMS, some indicators have financial impact for the hospital on how well they do on core measures. Also, the hospital data collected is publicly reported, so patients can look at how well a hospital is doing on core measures, to make an informed decision if they want to seek care at that hospital. Clinical core measures are one of the indicators of quality care in a facility. Core measure abstraction is interesting and very detailed work. It is a great way to support quality care in a healthcare organization.
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RN Auditor/Coder
We are not yet concurrent, but we have taken months of core measure (CM) retroactive abstraction down to about being only 2 or so weeks behind. This has become easier in the last 6 months as many of the CMs have been removed, per CMS. We just have to wait for our online vendor to drop in the cases to the web tool so we can begin abstraction. Unfortunately, our EHR is not quite robust enough yet for us to complete realtime abstraction. We do have CMRNS who concurrently review charts on the floor to do do realtime education and have clinicians complete documentation and ordering to meet the measures. We're getting there - I hope this is helpful ?
- RN Auditor/Coder
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Quality Improvement Specialist (Nurse)
Hey nurses, I've been a nurse for 19 years and have been in the quality improvement department for nearly a decade. My questions to you all are, in your hospital: Do you have any contact with people in the Quality department? Do you know what the quality improvement nurses actually do? If so, what irks you about them? And if so, what, if anything, do you learn from them? As a quality staff nurse, I know that managers know us, but unfortunately feel transparent to floor and clinic nurses. I've always been curious about how we're perceived out there Be honest I want to know!
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ASU's Online Master's in Health Innovation Program
I am currently a quality improvement and informatics nurse, and am very interested in moving into the specialty of nursing innovation leadership. Of all advanced nursing practice tracks, I feel it is the most natural next step for me. Has any nurse out there completed, or are currently in, the Arizona State University (ASU) Master's in Health Innovation (MHI) online program? Looks like a great program that I'd like to get more information about. I'd appreciate any insight you may have. If so, questions: In your opinion, what is the quality of the program? How long did it take to complete? How did it change your job or did you move into another position because of it? If so, what is the position and do you like it? Thanks!
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Masters in Informatics and Job help?
As for school: I attended the MSN in Informatics program at Walden University. I felt is was a good program (completely manageable with work) and it is accredited. In fact, many of their faculty are trailblazers in the Informatics specialty. Right now it looks like they are offering a lot of scholarships and reduced tuition rates. Nursing informatics resources: I highly recommend starting with 2 national organizations - HIMSS (Health Information and Management Systems Society) and ANIA (the American Nursing Informatics Association). While both have membership costs, there are many articles with survey results and white papers available out there from the organizations that speak to job descriptions, functions and satisfaction and the future outlook for nursing informatics. There is so much to do in this specialty, and from what I've seen the future is very bright for those who enter the field. There is also a national board certification for Informatics Nursing from the ANCC. Good luck!
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So excited!!!
I was a CDS in a prior position and really liked it. I had stepped away from the bedside, but felt that I was able to keep current on nursing practice by having my nose in charts all day, which I enjoyed. My training was with a major vendor who developed one of the original DRG systems. This may be different for you (as it was a few years back), but you will learn coding basics and MS-DRG-related rules that will support the type of documentation you will be looking for and encouraging Clinicians to use. You will gain a whole new knowledge set and different perspective on healthcare in this role. It should also be interesting with the transition to ICD-10. Best wishes!