Modern Practice Podcast

Mental fitness for physicians, Part 2

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, SFHMSenior PrincipalClinical Operations and QualityVizientGuest:Cecilia Cruz, MD, MPH, CPCC, ACCFounder and Chief Executive OfficerMarpe, LLCBoard-certified emergency medicine physicianFormer co-chair of QualityDivision of Emergency MedicineNorthShore 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/
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, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Cecilia Cruz, MD, MPH, CPCC, ACCFounder and Chief Executive OfficerMarpe, LLCBoard-certified emergency medicine physicianFormer co-chair of QualityDivision of Emergency MedicineNorthShore 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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Mental fitness for physicians, Part 1

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, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Cecilia Cruz, MD, MPH, CPCC, ACCFounder and Chief Executive OfficerMarpe, LLCBoard-certified emergency medicine physicianFormer co-chair of QualityDivision of Emergency MedicineNorthShore 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/
Subscribe Today!
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The impact of sepsis diagnosis and documentation, Part 2

This episode continues examining effective coding and documentation for sepsis cases and the impact accurate coding practices can have on clinicians and hospital operations. Paying attention to those who have sepsis present on admission (POA) is crucial to the process.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Linda Wiseman, BSN, RN, CCDSSenior Consulting DirectorClinical Documentation ImprovementVizient
Show Notes:
[00:50] Sepsis is one of the highest-denied DRGs; what documentation needs to include
[01:16] Coding guidelines to follow
[02:05] Is bacteremia sepsis?
[02:22] Present on admission (POA) – need to document even if sepsis only suspected
[03:51] Avoiding denials for sepsis
[04:58] Need to pay attention to “minimal” co-morbid conditions
[05:51] Sepsis due to graft or device
[07:12] Viral sepsis underdiagnosed
[08:37] Sepsis, expenses and fear of denial
[10:35] Need to link any organ involvement believed due to sepsis
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Linda’s email: linda.wiseman@vizientinc.com
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The impact of sepsis diagnosis and documentation, Part 1

For decades, clinicians have known that effective intervention in sepsis cases relies universally on early diagnosis. Yet, despite this fact, sepsis remains a tough challenge.  One in three patients dying in the hospital will have sepsis. Even more importantly for documentation, 87 percent of patients in the hospital with sepsis had it before admission. This episode examines ways to improve both diagnosis and documentation for sepsis patients in order to improve care and reduce the ill effects on clinicians and hospitals.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
Guest:
Linda Wiseman, BSN, RN, CCDS
Senior Consulting Director
Clinical Documentation Improvement
Vizient
Show Notes:
[01:16] Differing criteria
[01:48] Need to document early
[02:38] Two classifications
[03:10] SOFA/Sepsis-3
[03:36] SIRS criteria
[04:53] SOFA criteria
[06:13] What to document on admission
Links | Resources:To contact Modern Practice: modernpracticepodcast@vizientinc.com
Linda’s email: linda.wiseman@vizientinc.com
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Surviving cardiac arrest

Simon Henley was on a video call with his manager when he suddenly disappeared from the screen. He had fallen to the floor with a cardiac arrest. Not to be confused with an acute myocardial infarction, cardiac arrest is usually fatal, requiring a defibrillator and immediate CPR to revive the patient. On this episode, Simon tells his harrowing story, one with a touch of the miraculous, in how he survived those crucial first minutes and embarked on the road to recovery.
Host:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Simon Henley, MBA, CMBB
Director, Global Market Growth
Defibrillator Solutions
Medtronic
Show Notes:
[00:34] Simon’s background
[01:08] An avid runner
[01:32] The call
[03:06] Every minute a cardiac arrest goes untreated drops survival rate by 10%
[04:06] No previous symptoms
[05:40] Rehabilitation
[06:38] Dealing with emotions and with recurring cardiac events
[10:02] Changed perspective
[10:55] No guarantees
Links | Resources:To contact Modern Practice: modernpracticepodcast@vizientinc.com
Simon’s email: simon.henley@medtronic.com
Sudden cardiac arrest: symptoms and causes (Mayo Clinic): Click here
Heart attack and cardiac arrest (American Heart Association): Click here
Cardiac care management (Medtronic): Click here
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Benefits of improved clinical communication: a success story, Part 3

On this episode, Tom completes his discussion with a physician leader whose team has developed a tool for an oncology floor that has improved communication among clinicians. Based on the SBAR approach (Situation – Background – Assessment – Recommendation), the tool has seen phenomenal results.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
Guest:Devendranath (Dev) Mannuru, MD, CHCOMInternal Medicine HospitalistCDI and Quality Physician AdvisorSanford Hospital – Fargo
Show Notes:[00:40] Challenges[01:48] A clarification that improved participation[02:18] Metrics of success[04:25] Improving care means supporting the care delivery system rather than outcomes[05:08] Expanding the model to the whole hospital[06:00] With focus on quality, everything else falls into place
Links | Resources:To contact Modern Practice: modernpracticepodcast@vizientinc.comDev’s email: mannuru.devendranath@sanfordhealth.orgOncology Nursing SBAR – Final Copy (Sanford Hospital): Click hereNursing SBAR for Med-Surg Units – Final Copy (Sanford Hospital): Click hereInteract and impact framework (Vizient presentation): Click here
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Benefits of improved clinical communication: a success story, Part 2

For the first time on this award-winning podcast, a faithful listener is sitting in the guest seat as he shares an exciting tool his team has developed to improve communication on an oncology floor. Join Tom as he continues his discussion with Dr. Dev Mannuru on this SBAR-based tool (Situation – Background – Assessment – Recommendation) that has produced phenomenal results.
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal
Clinical Operations and Quality
Vizient
 
Guest:
Devendranath (Dev) Mannuru, MD, CHCOM
Internal Medicine Hospitalist
CDI and Quality Physician Advisor
Sanford Hospital – Fargo
 
Show Notes:
[00:55] Outcomes from the project – several metrics showing progress and success
[02:56] Effect on nursing turnover and morale
[04:10] Benefits of geographical/team rounding and use of tool
[04:51] Better questions asked during rounding – clarity for physicians and clinicians
[06:00] Whole team engaged
[07:28] Focus: length of stay vs team clarity
[08:58] Improved team approach to patient care
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dev’s email: mannuru.devendranath@sanfordhealth.org
Oncology Nursing SBAR – Final Copy (Sanford Hospital): Click here
Nursing SBAR for Med-Surg Units – Final Copy (Sanford Hospital): Click here
Interact and impact framework (Vizient presentation): Click here
 
Subscribe Today!
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Benefits of improved clinical communication: a success story, Part 1

This episode features a physician who is a long-term listener to the podcast and developed an exciting process with his clinical colleagues. He joins the program to discuss the tool that has improved communication among staff and patients on the oncology floor.
 
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
 
Guest:Devendranath (Dev) Mannuru, MD, CHCOMInternal Medicine HospitalistCDI and Quality Physician AdvisorSanford Hospital – Fargo
 
Show Notes:
[01:30] The Interact and Impact Project
[02:10] Rationale behind the initiative
[03:25] Gap analysis on the floor
[04:48] Assessment
[05:57] A unique tool
[06:44] Benefits of geographical rounding
[08:17] Engaging the team
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Dev’s email: mannuru.devendranath@sanfordhealth.org
Oncology Nursing SBAR – Final Copy (Sanford Hospital): Click here
Nursing SBAR for Med-Surg Units – Final Copy (Sanford Hospital): Click here
Interact and impact framework (Vizient presentation): Click here
 
Subscribe Today!
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Android
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Enhancing CDI interrelationships: the importance of a de-siloed approach, Part 3

This edition of our award-winning podcast finishes the discussion on how improving relationships with hospital staff, particularly clinical staff, can bring improvement in documentation. This can then improve patient care and reimbursement.
 
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient
 
Guest:Amber Sterling, RN, BSN, CCDSSenior ConsultantClinical Documentation ImprovementVizient
 
Show Notes:
[00:53] Copying and pasting – the need for editing
[03:40] Meaningful data as an effective motivator – measuring success
[08:06] Developing a relationship virtually versus onsite communication
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Amber’s email: amber.sterling@vizientinc.com
Vizient clinical documentation improvement site: Click Here
 
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Enhancing CDI interrelationships: the importance of a de-siloed approach, Part 2

On this episode, we continue examining how improving relationships with hospital staff, particularly clinical staff, can bring improvement in documentation, which can then improve patient care and reimbursement.
 
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
 
Guest:
Amber Sterling, RN, BSN, CCDS
Senior Consultant, Clinical Documentation Improvement
Vizient
 
Show Notes:
[00:42] Imprecise documentation and the need for partnership
[02:04] Communication about accurate DRG documentation
[02:36] Managing the utilization review process
[03:54] Outpatient documentation
[05:57] Breaking through silos with technology beyond in-boxes
 
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Amber’s email: amber.sterling@vizientinc.com
Vizient clinical documentation improvement site: Click here
 
Subscribe Today!
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Amazon Podcasts
Android
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Spotify
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