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Quick Reads - September 2017

In this edition of Quick Reads, a look at the new Sepsis Bundle, tips on how to keep Length of Stay trending downward, and an update on Physician Recruitment.


Sepsis Core Measures

The sepsis core measure is an important quality initiative that assures prompt recognition of sepsis and standardized care. This approach has been associated with reduced mortality and reduced length of stay for sepsis patients.

To meet the requirements of this measure:

  • Please use the severe sepsis order set.
  • For septic shock patients, complete a severe sepsis note after the patient receives a fluid bolus.

As part of the surviving sepsis campaign, we are working to ensure compliance with the Sep-1 bundle core measure. This is to facilitate prompt recognition of sepsis and standardized care of sepsis. Currently we are complying with this measure 15% of the time. We would like to see this used with greater than 70% of our patients.

For your convenience, a severe sepsis / septic shock order set is present in Conemaugh Connect. To comply with this core measure, please use the order set when clinically appropriate. For septic shock patients, please write a severe sepsis note after the fluid bolus is completed. This note can be found under the note tab. 


Length of Stay Trends and Tools

We are pleased to report that Length of Stay (LOS) has improved over the last 6 months but there is still work to be done. We are looking for continued improvement with a goal of less than 0.5 variance from Acute LOS to Geometric LOS. Currently that variance is at 0.68.

One of the biggest impacts we can have on LOS is to round early and complete H+Ps early. There are other interventions we should consider as well.

Way to Decrease Length of Stay

  1. Optimizing documentation particularly by answering CDMP queries. This can raise your predicted LOS by documenting the degree of illness of your patients.
  2. Communicating with Case Managers: Before leaving the floor while rounding, briefly touch base with case management regarding your discharge plan.
    1. Is discharge anticipated in the next 1-2 days?
    2. Is this patient anticipated to go home or need placement?
    3. For patients going home, is home health, oxygen or other durable medical equipment needed?
  3. Communicating with families: Families can make physicians and case management aware of barriers to discharge, and anticipate a date of discharge.
  4. Communicating with specialists: If you are waiting for a test result or opinion for discharge, communicating with the specialist directly can reduce length of stay. Consider getting the “Doc Halo” app to facilitate HIPAA compliant communication between physicians.
  5. Performing tests and procedures after discharge when this can be accomplished safely.
  6. See patients in the morning so that care can be coordinated with case management and other consultants. Our hospital rules and regulations state that patients should be seen within 12 hours or before noon if the patient is admitted in the evening.

Click here for a look at Acute LOS and Geometric LOS trends.


Physician Recruitment – We Need You!

Eight new physicians have been welcomed into the Conemaugh Health System in the past three months and seven more are onboard to start in the next three months. We currently have 32 searches open and 18 candidates are scheduled for a site visit in the next three months.

While we are pleased with all of this activity and success, we always need your help! You are our best physician recruiters! With your wide network of physician colleagues, if you know a physician who may be interested in joining Conemaugh, please contact us! Email recruitment@conemaugh.org.

As we continue to make strides in physician recruitment, your support is appreciated and greatly needed!  When a candidate visits our facility, you may be asked to attend a dinner or meet with the candidate in an effort to put our best foot forward. If asked, please make every effort to participate. You, our physicians, play a significant role in attracting other high-quality, talented physicians to our facilities and our community!

Thank you for your continued support!

Click here for our most recent physician recruitment activity and newest physicians.