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The two top physician concerns in general surgery patients post-operatively have been about pulmonary emboli (PE) and myocardial infarction (MI) with therapeutic measures for each of these potential conditions.   Interestingly, a recent study by Laurie Barclay, MD, from Methodist Hospital Research Institute of Houston, Texas reported that sepsis and septic shock are more likely to occur post-operatively. 

The study compared incidence, mortality, and risk factors for sepsis and septic shock with those for PE and MI in a patient population of 363,897 general surgery patients included from the 2005-2007  National Surgical Quality Improvement Program (NSQIP) data set.   Sepsis occurred in 2.3% of patients, septic  shock in 1.6% of patients while pulmonary embolism occurred 0.3%, and myocardial infarction in 0.2% .  The greatest proportion of patients were 60 years of age or greater in the septic shock group (70.3%) compared with 40.2% of those with no sepsis and 51.7% of those with sepsis alone.

Comparatively speaking, patients entering the hospital for emergency surgery had a higher incidence of sepsis (4.5% versus 2.0% in the elective admit population).  Risk of sepsis and septic shock were 6-fold higher in patients with other comorbid conditions and they had increased risks of mortality.

The study conclusions, based on record review of 363,897 patients, demonstrated that sepsis needed to be screened more acutely by general surgeons in order to prevent sepsis-associated morbidity and mortality in the their inpatient populations.


1.  Sepsis in General Surgery

The 2005-2007 National Surgical Quality Improvement Program Perspective

Laura J. Moore, MD; Frederick A. Moore, MD; S. Rob Todd, MD; Stephen L. Jones, MD; Krista L. Turner, MD; Barbara L. Bass, MD

Arch Surg. 2010;145(7):695-700.

2Archives of Surgery,  Vol. 145, No. 7, July 2010

Sepsis in General Surgery: The 2005-2007 National Surgical Quality Improvement Program Perspective

Remote medical coding and remote cancer registry have become very popular over the past decade in the HIM industry.  On a daily basis, our company receives inquiries for remote coding and remote CTR positions.  While there are many well-qualified professionals in the field, it should be noted that accurate coding and cancer registry abstracting are just the first of many ingredients that comprise a high level of customer service for our clients.  Familiarity with various computer systems and Information Technology security will certainly set you apart from your competitors while applying for remote positions.  Below is a brief checklist of some additional skills that we search for when evaluating remote HIM professionals:

       1.  Level of familiarity with HIPAA Privacy and Security Regulations and state-specific privacy

            and security laws and regulations.

       2.  Level of computer proficiency

       3.  Appropriate computer hardware (modern PC and secure, high-speed internet connection)

       4.  Level of familiarity with various hospital EMR and abstracting systems

       5.  Ability to professionally communicate with IT personnel and hospital IT help desk support

       6.  Time management skills

Please note that the above is by no means intended to serve as an all-inclusive list.  In order to provide our clients with the highest quality work product while maintaining optimum production levels, we are always searching for candidates with the above-mentioned skills.  If your department is seeking to engage an HIM Outsourcing firm for remote coding or remote oncology data management, be sure to inquire about the company's remote staff.  for example:

Does the company have an in-house IT Department?

How does the company screen its remote employee candidates?

What other in-house measures are in place to ensure the highest level of client satisfaction?

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