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Cardiovascualar Dominates Most Frequently Billed DRGs

~ This entry was posted on Tuesday, April 21st, 2009 at 3:00 am

Posted By Carolyn Weaver, Executive Consultant

circ-2For a medical surgical hospital, cardiac and vascular continue to dominate discharges. Even in programs that I work with that do not have invasive heart and vascular procedures, cardiovascular accounts for 25% to 30% of discharges.

When reviewing the Modern Healthcare Supplement “By The Numbers”, there are six cardiovascular DRGs in the top twenty. There is only one cardiovascualr procedural code - PCI. The groupings are:

  • 30% Cardiovascular:  127 (Heart Failure); 143 (Chest Pain); (558) PCI; 138 (Conduction Disorders); 121 (MI); 14 (Stroke)
  • 20% Respiratory:  89 (Pneumonia); 88 (COPD); 79 (Respiratory Infection); 475 (Ventilator)
  • 15% GI:  182 (Gastroenteritis); 174 (Hemorrhage); 296 (Nutritional Disorders)
  • 10% Renal:  320 (Kidney and Urinary Infections); 316 (Renal failure)
  • 10% Infection:  277 (Cellulitis); 416 (Septicemia)
  • 10% Ortho/Rehab:  544 (Joint Replacement); 462 (Rehab)
  • 5% Psychiatric:  430 (Psychosis)

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Cardiovascular Bed Planning - ICU or Telemetry?

~ This entry was posted on Monday, February 16th, 2009 at 6:12 pm

Posted By Carolyn Weaver, Executive Consultant

CB052871Looking for beds? Ask yourself, “do I really need ICU beds or do I need telemetry for my heart and vascular patients?”  As I evaluate the efficieincy of cardiovascular programs, there are many ways to address the issue of ICU beds. Most places really need telemetry. So how do you expand the availability of telemetry?

Here are several questions for you to consider:

  1. What is your criteria for ICU? For many hospitals, unless the patient is critical, on multiple drips, or on a ventilator, the patient goes to telemetry or the step-down unit.
  2. Evaluate the reasons for divert or back-up in ICU - are there patients that could be moved to telemetry?
  3. Do you have too many steps in the process (e.g., ED, ICU, Step-Down, PCU, Telemetry)?
  4. Do you have dedicated units/beds for heart and vascular patients?
  5. Are there patients that are not heart and vascular who are occupying the telemetry beds? Should telemetry be expanded to other units or areas?
  6. How can you  involve the medical staff to make it work?

Any other suggestions to share?

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