JHM Weekly Inpatient Newsletter: Click here.
JHM Weekly Ambulatory Newsletter: Click here.
ICD-10 Go Live Support: Be Ready for New Billing Code System on Thursday, October 1
If you need help with Epic, call any of these individuals:
Karen Joyner 301-896-3532
Hideat Tewolde 301-896-3058
Cheryl Pacis 301-896-3058
Cindy Stone 301-896-7278
Adrienne McDaniel 301-896-3521
Angela Dews 301-896-2541
Helpful look-up sites to look up ICD-10 codes:
For clinical documentation or coding questions, Submit them here to the Coding & Clinical Documentation Help Desk online. (Live help hours: M-F, 8:00 a.m. to 4:00 p.m.)
For other ICD-10 resources, click here
Preparing for the “Severe Sepsis and Septic Shock Management Bundle Measure.”
Sepsis is one of the leading causes of hospital admission, morbidity, and mortality. As a consequence, starting October 1, the Centers for Medicare and Medicaid Services (CMS) will implement the “Severe Sepsis and Septic Shock Management Bundle Measure by collecting data on how hospitals provide care to patients admitted with the diagnosis of severe sepsis or septic shock. These patients already receive extraordinary care here at Suburban Hospital. Thus, all we have to do is accurately document our efforts.
In summary, patients with severe sepsis admitted to the hospital will need to have a lactate measured, cultures drawn and antibiotics administered within three hours of meeting all the criteria of the diagnosis. In addition, a follow-up lactate will need to be measured within six hours if the initial value is greater than 2 mmol/L. The ICU team will manage patients with septic shock.
Meeting these goals may seem cumbersome. Therefore, Suburban Hospital has formed a Suburban Sepsis Working Group (SSWG) to assist with this process. The SSWG comprises representatives from the clinical staff, nursing, pharmacy, respiratory and Epic support for the purpose of meeting our patient-care goals. If you are the Attending of a patient who is flagged by Epic as possibly having severe sepsis, a Rapid Response will be called. The Resource Nurse will then notify you of the alert and begin treatment. If any hurdles arise in meeting our goals, the Resource Nurse will contact a member of the SSWG to further assist you.
The mechanism(s) by which Epic will function will take the form of a BPA (Best Practice Advisory) and Sepsis Navigator. These tools have not yet been released. Information on how Epic will assist with this function will be provided in future Progress Notes.
Please email me any question or concerns you may have at email@example.com. I will reply expeditiously and post answers here in Progress Notes.
Mauro Sarmiento, MD
Requirements for Mycobacterial (AFB) Cultures
On November 1, 2015 the Laboratory at Suburban Hospital will be modifying the requirements for Mycobacterial (AFB) Cultures. We will no longer accept swabs as they do not provide adequate specimen for mycobacterial recovery. In order to obtain optimal recovery, it is best to send biopsy material or fluids representative of the infectious process. Swabs are not recommended when multiple media must be inoculated and are not indicated when a large volume of sample is required to recover a pathogen.
Following are some general guidelines for specimen requirements:
- Sputum or other liquid respiratory samples: a minimum of 5 mL in a sterile, leak-proof container
- Aspirates and fluids: 10 ml is optimal, send in a sterile, leak-proof container (1 mL is the minimum volume)
- CSFs require 5 mL (CSF collection tubes).
- FNAs: 1 mL in optimal (we understand that this may be difficult to get and we will make allowances but we definitely need more than a partial drop in the bottom of a specimen container).
- Bone marrow aspirates: Inoculate an AFB blood culture bottle.
- Tissues should at least be visible to the naked eye. Thumbnail-size is ideal. It is best to add a little sterile saline (5 or 10 mL) to the container to keep the specimen moist during transport.
Although it may seem that collecting a swab is the only choice for some body sites (i.e. middle ear), washing with sterile saline and collecting the washings provides a quality specimen.
The cover story, featuring Dr. Eric Park, explains to our community what a hospitalist does. Also, there’s a story about a patient who collapased during a badminton game and was given CPR by a fellow community member and a woman who experienced a stroke while on the phone with Dr. Puneet Ghotra, an NIH stroke researcher. There are updates about Breast Cancer Awareness Month fundraising activities, the quarterly WellWorks™ list of programs and services, and a notice about three upcoming Facebook chats.
You’ll find New Directions on the hospital’s website here and in waiting rooms around the hospital.
Registration Now Open! Suburban Hospital Cardiovascular Symposium
Featuring the Annual Mark F. Weinstein Memorial Lecture
The symposium offers providers an opportunity to learn about the latest advancements in heart disease prevention, imaging, and interventions. It will feature cardiovascular specialists from Johns Hopkins Medicine and the NIH Heart Center. Click here to learn more.
Saturday, Oct. 17, 2015 | 7:30 am – 1:00 pm | Suburban Hospital Auditorium
The Annual Mark F. Weinstein Memorial Lecture presented by Marcus Chen, MD, NIH/NHLBI: Innovations in Cardiac CT
Breakfast and Lunch will be served.
To register, please call 301-896-3939 or email firstname.lastname@example.org.
If you have any questions about the symposium, please contact Michelle Christ at 301-896-3678 or email@example.com.
Suburban Hospital designates this educational activity for a maximum of 4 AMA PRA Category 1 Credit™.
Suburban Hospital Grand Rounds:
Is Dentistry the Missing Link to Your Patients’ Health Problems?
Friday, October 2, 2015 | 8-9 am | SH Auditorium
Speaker: Stanley Dorrow, DDS
Click here to see the objectives for this presentation.
Call 301-896-3869 with questions.
The October 2015 Grand Rounds schedule is here.
Johns Hopkins Medicine Department of Surgery Grand Rounds
Life Preservation at the Inception of the Age Wave: Guidelines for the Caring of the Aged Requiring Treatment for Colorectal Cancer
Thursday, October 1, 2015| 7:30-8:30am | Hurd Hall |Live via Streaming Video
Patrick H.D. Colquhoun, MD
Department of Surgery
Schulich School of Medicine
University of Western Ontario
Live via Streaming Video | To watch this week’s presentation from your computer, click here.