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Get to Know October’s Clinician of the Month: Denise Sexton

Posted on Tue, Oct 07, 2014
Get to Know October’s Clinician of the Month: Denise Sexton

EmCare has more than 10,000 clinicians serving communities across the country and we want to share their stories with you. Get to know these hard-working, difference-makers right here with our monthly “Clinician of the Month” blog post. This month's clinician of the month is celebrated in tandem with Emergency Nurses Week and features one of EmCare's many talented emergency nurses. Do you know a clinician who should be featured? Email!

Denise Sexton has 20 years of healthcare experience to EmCare partner hospitals, and over 15 years specifically in the emergency department and in leadership roles.

As a Divisional Director of Clinical Services for EmCare, Denise’s strength in leadership and diverse clinical skills provides a solid foundation for improving hospital operations, not only in the E.D, but also with services including hospitalist programs, observation units, operating rooms and critical care units. Denise uses her education and experience to o­ffer expertise and broad perspectives for E.D. and inpatient managers.

When she is not busy helping EmCare partner hospitals achieve their goals, Denise enjoys spending time with family, gardening and being outdoors.


Get to know Denise!


How do you fight burnout? If you love what you do then the risk of burnout is low. I truly love my job and enjoy every day of it. When I get stressed out, I go outside and work. I spend as much time as possible working in the garden and around the farm. I find that is my best stress reliever.

The one piece of healthcare advice I wish everyone would follow is ___. Take care of yourself. As healthcare providers we spend all of our time taking care of everyone else and forget that we need care too.

What’s been your proudest moment during your career? One busy night in the ED I took care of a patient who was going to die in a short period of time. His family was 6 hours away and was attempting to get there to be with him. I sat with him as much as I could and talked to him. As I kept in contact with the family I would go and talk with him to let him know that they were coming in hopes that he could hang on until they got there. They shared personal information about him with me so I could talk to him. Unfortunately he passed before they could arrive at the hospital. The family came after I got off shift but we had an area that they could sit with him until they were ready to leave. They sent the kindest letter to me afterwards about how much it meant to them that he did not die alone and that the updates and talking to him meant a lot to them. I still have the letter that they sent me.

I hope my patients remember me as ___.  I hope that the facilities I work with remember me as helpful and a great resource person to turn to when they need assistance.


Tips to Boost Your Documentation Process: Secondary Diagnoses

Posted on Wed, Sep 10, 2014

Good documentation is important for new physicians as well as veteran caregivers. While documenting can seem like a very straightforward skill, there are often “best practices” that can be utilized. As a hospitalist for EmCare at St. Petersburg General Hospital in St. Petersburg, FL I write a “weekly documentation tip” email to help physicians improve their clinical documentation. I also share these documentation strategies with the residents I teach.

by: Timothy N. Brundage, M.D., CCDs

Secondary Diagnoses

A secondary diagnosis is a condition that coexists at the time of admission, develops brundage.png subsequently or that affects the treatment received and/or length of stay of the patient. Remember that secondary diagnoses support the severity of illness (SOI) and show that your patient is as sick on paper as they are in the bed.

Secondary diagnoses are defined as those conditions that consume one of the following hospital resources:

• Clinical evaluation

• Therapeutic treatment Further evaluation by diagnostic studies, procedures or consultation Extended hospital length of stay (LOS)

• Increased nursing care and/or other monitoring

For example, if you are monitoring tele and continuing home amiodarone, DO NOT document “history of A. Fib.”This would meet the criteria for the secondary diagnosis of chronic A. Fib and coders cannot code a “history of.”

Timothy N. Brundage, M.D., CCDs is a Certified Clinical Documentation Specialist and Diplomate of the American Board of Internal Medicine.