Q&A: Physician engagement tips

Q: Can you provide some tips on how to educate physicians and encourage them to respond to your queries? My hospital is a teaching facility and the system is set up so that nurses can’t even call an attending directly. In most cases, we have to go through the residents who are training with the attendings.

A: This is a difficult task in a teaching hospital—the residents often only see the priorities handed to them by the attendings. If you can’t speak directly to the attendings, you’re going to have a tough time stressing the importance of answering queries and the like.

I would suggest pushing to be a part of the new resident orientation/education during their onboarding process. That’ll allow you to describe your purpose to them and explain how you can assist them with quality scores, mortality measures, etc. When the residents rotate to a new service line, it could also be helpful to touch base with them on the important documentation needs specific to their new specialty.

All that said, though, I wouldn’t give up on communicating with the attending providers, either. Medical staff meetings, services line meetings, etc., should give you some time to discuss what you do and how it will help them. And, of course, administrative support from the administration will also go a long way. A well-educated physician advisor who can reinforce your messaging will be helpful, too.

Lastly, the attendings should be benchmarked against each other, either blindly or openly. What are their individual query rates? Response rates? Case mix indexes? Mortality rates? Complication rates? Denials rates? And so on. Creating a sense of healthy competition never hurt anyone.

Editor’s Note: Laurie L. Prescott, RN, MSN, CCDS, CDIP, CRC, CDI education director at HCPro in Middleton, Massachusetts, answered this question on the ACDIS Forum. Contact her at lprescott@hcpro.com. For information regarding CDI Boot Camps, click here. To find out about HCPro’s eLearning courses for hospital residents, click here. To watch a free webinar from Prescott on this subject, click here. To read an article about starting documentation training with residents, click here. To read a case study about documentation training for residents, click here and click here.