Spinal surgery represents a complex challenge for clinical documentation. Difficult to code and representing query situations that can be demanding, this is the area of focus for this episode of Modern Practice. Joining Dr. Tomas Villanueva is a leading expert returning to the podcast to talk about the challenges of spinal surgery documentation.

Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient

Guest: Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC Consulting Director Clinical Documentation Improvement Vizient

Show Notes:

[01:26] Around 1.62 million procedures per year

[02:22] Procedures on the increase (2.4 times the level of 15 years ago)

[03:54] The most common spinal diagnoses

[05:15] Often not caught by primary care

[06:20 Less common reasons for spinal surgery

[07:09] Reasons for planned surgeries—often a last resort

[08:45] Risks for avoiding surgery

Links | Resources:

To contact Modern Practice: modernpracticepodcast@vizientinc.com

Rachel Mack’s email: rachel.mack@vizientinc.com

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Years of medical school, residency and fellowships have proven to do little in teaching physicians how to care for themselves. Physician burnout is at an all-time high. On this episode, a physician who is a leading expert on physician stress discusses how to improve mental fitness in those who’ve given their lives to the care of others.

Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient

Guest: Cecilia Cruz, MD, MPH, CPCC, ACC Founder and Chief Executive Officer Marpe, LLC Board-certified emergency medicine physician Former co-chair of Quality Division of Emergency Medicine NorthShore University HealthSystem

Show Notes:

[00:34] Physician suicide

[02:44] Need connection

[04:03] What organizations need to do

[06:20] A learned skill and resource

[06:37] Mental fitness

[08:20] The Marpe approach

Links | Resources:

To contact Modern Practice: modernpracticepodcast@vizientinc.com

Dr. Cruz’s email: ceciliacruz@marpejourney.com

Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn

MARPE, LLC website: https://www.marpejourney.com/

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This episode of our award-winning podcast continues the discussion on why mental fitness is so crucial for physicians and other clinicians today and yet is a concept that physicians still tend to avoid or downplay. Physician training and medical school have not helped. Join us for this gritty discussion.

Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal Clinical Operations and Quality Vizient

Guest: Cecilia Cruz, MD, MPH, CPCC, ACC Founder and Chief Executive Officer Marpe, LLC Board-certified emergency medicine physician Former co-chair of Quality Division of Emergency Medicine NorthShore University HealthSystem

Show Notes:

[01:00] The in-box, EMR documentation and authorizations have only gotten worse

[01:40] If we don’t change, it’s all going to fall apart

[03:23] Examples from medical school and training—a lack of respect

[06:45] The EMR and the need for a 27-hour day

[08:05] Deficit of 40,000 primary care physicians by 2030 (AAMC)

[08:30] Emerging mental health issues and workplace violence

Links | Resources:

To contact Modern Practice: modernpracticepodcast@vizientinc.com

Dr. Cruz’s email: ceciliacruz@marpejourney.com

Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn

MARPE, LLC website: https://www.marpejourney.com/

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Though physicians spend years in medical school, residency and fellowships to learn how to care for patients, they spend little time learning how to care for themselves. Physician burnout, leading to physician turnover, is skyrocketing. On this episode, a physician who is a leading expert on physician stress, having gone through that stress herself, discusses how to improve mental fitness in those who’ve given their lives to the care of others.

Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient

Guest: Cecilia Cruz, MD, MPH, CPCC, ACC Founder and Chief Executive Officer Marpe, LLC Board-certified emergency medicine physician Former co-chair of Quality Division of Emergency Medicine NorthShore University HealthSystem

Show Notes:

[01:10] Physician heal thyself? Not happening!

[02:35] Weakness means not being the best

[03:31] An ingrained culture of perfectionism

[04:20] The burnout crisis

[06:40] Physician types affected the most

[07:30] Bigger burden on specialists

[09:13] Overcoming – awareness is only 20% of progress

Links | Resources:

To contact Modern Practice: modernpracticepodcast@vizientinc.com

Dr. Cruz’s email: ceciliacruz@marpejourney.com

Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn

MARPE, LLC website: https://www.marpejourney.com/

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On this episode of our award-winning podcast, Dr. Tomas Villanueva concludes his discussion on how organizations can approach quality metrics today – what metrics to choose and how to apply them.

Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient

Guest: Rick May, MD Senior Principal, Consulting Solutions Vizient

Show Notes:

[00:38] The burden of reporting

[02:09] Surgical quality and outcomes – technical vs. medical

[03:41] A focus on the systems

[05:00] Systems changes and results

[05:42] Engaging the physicians

Links | Resources:

To contact Modern Practice: modernpracticepodcast@vizientinc.com

Dr. May’s email: rick.may@vizientinc.com

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On this episode of our award-winning podcast, Dr. Tomas Villanueva continues his discussion on how organizations can approach quality metrics today – what metrics to choose and how to apply them.

Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient

Guest: Rick May, MD Senior Principal, Consulting Solutions Vizient

Show Notes:

[00:54] Importance clinical documentation

[02:40] Is it possible to eliminate all CLABSIs (or other infections)?

[04:40] Length of stay as quality metric

[05:10] Surgical complications and length of stay

[05:55] Length of stay and complication rates

[06:40] The most heavily weighted metric

Links | Resources:

To contact Modern Practice: modernpracticepodcast@vizientinc.com

Dr. May’s email: rick.may@vizientinc.com

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Concerning quality measures in healthcare organizations, a common complaint is, “I've got so many people looking over my shoulder, pulling our data in, ranking me, rating me, everything else, and there is no way I can keep track of literally the hundreds of metrics for which we’re accountable.”

On this episode of our award-winning podcast, Dr. Tomas Villanueva welcomes back a leading quality expert to discuss how organizations can approach quality metrics today – what metrics to choose and how to apply them.

Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient

Guest: Rick May, MD Senior Principal, Consulting Solutions Vizient

Show Notes:

[01:49] Why measuring quality is crucial

[02:17] If you do quality well, financial success follows

[02:57] Quality attracts staff

[03:46] Has quality improved overall in healthcare?

[04:42] Choosing the right metrics – 500 metrics exist overall

[05:58] Mishmash in timing of measures – complex and “all over the map”

[08:03] Realistic rate of improvement (hint: it’s not 10%!)

[08:53] Impact of under-capturing documentation

Links | Resources:

To contact Modern Practice: modernpracticepodcast@vizientinc.com

Dr. May’s email: rick.may@vizientinc.com

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This episode of the award-winning podcast examines the importance of risk adjustment. Dr. Tomas Villanueva leads the discussion on the impact of this crucial aspect of documentation that can affect hospital outcomes.

Moderator:

Tomas Villanueva, DO, MBA, FACPE, SFHM

Senior Principal, Clinical Operations and Quality

Vizient

Guest:

Erica Braun, MS, RN, CCDS

Senior Consulting Director, Clinical Documentation Improvement

Vizient

Show Notes:

[01:29] Defining risk adjustment – maintaining an apples to apples comparison

[02:41] Capturing comorbid conditions to the highest level of specificity

[04:08] Capturing the low-hanging fruit

[05:47] Case mix index issues

[07:44] Severity of illness and risk of mortality

[08:52] Addressing query fatigue

Resources:

To contact Modern Practice: modernpracticepodcast@vizientinc.com

Erica Braun’s email: erica.braun@vizientinc.com

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