Eric Runkle

As a CDS for 2 years, I was responsible for concurrent reviews of accounts for multiple hospitals for the Advent Health Central Florida Division. Concurrent reviews included reviewing high-level patients mainly at our largest hospital in Orlando, but also any of the 7 other campuses in our division. Accounts at Orlando, included patients in the Neuro ICU, Surgical ICU, Cardiac ICU, PCU, Med-Surg, and Surgical units. CDS are responsible for up to 10 initial reviews and 10+ re-reviews daily.

In February of 2024, I was asked to step into a position within the CDI department as a Second Level Reviewer. SLR's responsibilities included Mortality reviews, PSI/HAC reviews, Low-acuity DRG reviews, and HRRP readmission reviews for CHF and Pneumonia readmissions.

Mortality reviews included sending clarifications for all MCC/CC's, risk-adjusting codes, HCC's, and the highest specificity of the codes prior to billing.

PSI/HAC reviews included reviewing accounts for potential exclusions for PSI's from the PSI 90 composite several HAC's monitored by Advent Health. Exclusions from POA status of secondary codes, clinical validation of codes triggering a PSI when needed, and reviewing the admission type for possible change from Elective to Urgent or Emergent for exclusion opportunities.

Low-acuity DRG reviews include reviewing for accuracy of the principal diagnosis and if a query is needed to change the principal diagnosis to move the account to another DRG. Low-acuity reviews also include sending clarifications for additional CC/MCC's, collaboration with coding for missed CC/MCC's that were documented but not captured in the final codes, sending clarifications for HCC's and risk adjusting codes, and opportunities to query for diagnoses that increase the SOI/ROM.

I have been part of a new pilot in our department for HRRP Pneumonia and CHF 30 day readmissions. These targeted reviews are done for possible exclusions in these two specific populations due to the high amount of these readmissions within the Advent Health Central Florida Division.

• Administered different therapies and medications in line with physician orders and treatment plan.
• Educated patients and answered questions about health condition, prognosis and treatment.
• Communicated openly and collaboratively with all healthcare staff to organize successful patient care.
• Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
• Answered codes quickly and orchestrated efficient, skilled medical care.
• Trained new nurses in proper techniques, care standards, operational procedures and safety protocols.

• Worked as a travel nurse in Texas, Michigan, and Florida in trauma centers and general ER's. Travel nursing helps mold a nurse to learn how to quickly learn new processes and policies while working in new settings every few months. Being able to learn and to adjust to different coworkers and physicians is a must and helps in the development in communication skills.
• Delivered outstanding care to patients with various diagnoses and managed care from treatment initiation through to completion.
• Administered medications and treatment to patients and monitored responses while working with healthcare teams to adjust care plans.
• Administered medications via oral, IV and intramuscular injections and monitored responses.

• Administered different therapies and medications in line with physician orders and treatment plan.
• Educated patients and answered questions about health condition, prognosis and treatment.
• Worked in a level 1 trauma center and collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
• Learned how to quickly assess patients and quickly use critical thinking to adjust to the ever changing conditions in patients in the trauma setting.
• Worked in both the adult and pediatric ER's.

• Worked within interdisciplinary health care team to develop, implement and make adjustments to patient care plans, individualizing strategies and methods to improve health and meet recovery goals.
• Cared for patients on a nephrology unit that specialized in peritoneal dialysis and also kidney and liver transplants.
• Managed up to five patients per shift and float to other areas of the hospital that may have a patient needing peritoneal dialysis.
• Managed patients that were often coming out of surgery from liver or kidney transplants and working closely with the transplant surgeons to meet recovery goals and educate patient's on their new and very strict medical and dietary regiments.

• Worked within interdisciplinary health care team to develop, implement and make adjustments to patient care plans, individualizing strategies and methods to improve health and meet recovery goals.
• Cared for as many as 15 patients at a time which included passing out medications, monitoring blood glucose levels, wound care, and ADL's.
• Called physicians with any abnormal lab results, radiology results, and changes in patient's condition.
• Cared for patients in a facility with both acute rehab patients and also cared for long-term patients in a nursing home setting.
• Performed various nursing interventions such as wound dressing, vital sign monitoring and specimen collection.
• Ordered, interpreted and evaluated diagnostic tests to identify and assess patient condition.
• Precepted and oriented new hires, providing guidance and mentorship when teaching on company policies, emergency procedures and nursing best practices.