PPT-The Importance of Documentation

ARIZONA TREAT AND REFER PROGRAM A monitored community specific and clinically grounded effort to enhance the healthcare continuum for Arizonans Documentation is not generally viewed as glamorous but instead is viewed as BORING. Day, Egusquiza, President. AR Systems, Inc . Lori Rathbun, VP Finance. Mercy Network, IA. . 1. Why have Clinical Documentation Improvement?. A consistent ‘set of eyes’ on the record . Concurrent review, with direct feedback-fragmented. Cheryl Bernknopf R.N., BScN. Assistant Director Centauri Summer Camp. Co- Chair OCA Healthcare Committee. Board Member of the ACN. PURPOSE. To provide the multidisciplinary team with a structured note format for documenting. Telana . Fairchild. Nurse Practitioner Students. UMass - Worcester, . Graduate School of Nursing. N/NG . 603B. 1. Narrative. Focused. Flow-sheet. By exception. Problem . oriented. Types of Documentation. 1. Please turn your cell phones off or to vibrate mode.. Welcome to.... ICD-10 Coding. No Recording of ANY TYPE allowed. . Mind expansion in process.... About Dr. Mario Fucinari, DC, CCSP, MCS-P. Certified Chiropractic Sports Physician (CCSP). ethical, legal and clinical issues. Margaret . BROWN. Research . Fellow, Hawke Research Institute, University of South . Australia. Ravi RUBERU. Geriatric . Registrar, Royal Adelaide . Dr. Andrew Wallace PhD . BEng. (hons) . EurIng. andrew@cs.umu.se. Overview. Documentation. Javadoc. More documentation. Documentation. Document your program. For others. For yourself. Programs change over time. Laura Triplett, Director, HIM. Roseann Kilby, Clinical Informatics Analyst. Becky Crane, Clinical Risk Manager. 367 Bed Community Health System in Quincy, Illinois . 2,000 Employees. 240+ Physicians. California Department of Aging. Documentation Rule #1. Documentation. Utilizing the Participant Form Checklist. Official Document or . Business Record. Confirmation of . Signature and Date. Make sure that forms are . Case . Examples & . Highlights. When Documentation Gets in The Way of the Defense. Presented By: . Joanne . Gulliford Hoban. Morrison . Mahoney, LLP. Case #1 – Emergency Department . Example of documentation in ED by both MD & RN. RCPA Conference. October 8, 2014. Agenda . Behavioral Health Services Cultural Overview. Current Regulatory Environment – New Compliance Challenges. Function of the Progress Note. Defensive Maneuvers – Audit Proof Documentation. Physician Program Overview. Our CDI program works to ensure the documentation in the medical record captures the true acuity of our patients. Accurate documentation will reflect appropriate severity of illness and risk of mortality to support resource intensity and length of stay for our patients. . ICD 10 Documentation Specialty Introduction ICD 10 is being mandated by CMS. Compliance date is set at October 2015. ICD-9 Diagnosis Codes = 14,000 ICD-10 Diagnosis Codes = 69,000 ICD-9 Procedure Codes = 3,800 For Charter Educators . Sara . Hardner. Leon. Powell & Leon, LLP. Austin, Texas. The Objectives of Effective Documentation. The primary objective for creating effective employee documentation is to:. Graphic Documentation Systems in Mural painting Conservation (GraDoc) in November 1999. Published proceedings of this seminar became a widely accepted document addressing purposes, requirements, and m