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Documentation Tip: Heart Failure - Framingham Criteria

Posted on Wed, Aug 24, 2016
Documentation Tip: Heart Failure - Framingham Criteria

Our recurring series of documentation tips for clinicians.

By Timothy Brundage, MD

Reduce risk of denial for CHF admissions using the Framingham Criteria for CHF diagnosis.  

Document these each and every time along with the following:
 

  • Acute/Chronic (both)
  • Systolic/Diastolic (both)

Framingham Criteria:

Major
 
  • Acute pulmonary edema
  • Cardiomegaly
  • Hepatojugular reflex
  • Neck vein distension (JVD)
  • Paroxysmal nocturnal dyspnea or orthopnea
  • Rales
  • Third heart sound gallop

Minor
 
  • Ankle edema
  • Dyspnea on exertion (DOE)
  • Hepatomegaly
  • Nocturnal cough
  • Pleural effusion
  • Tachycardia (>120bpm)

* Heart failure is diagnosed when two major criteria or one major and two minor criteria are met.

Reference: http://www.aafp.org/



Dr. Timothy Brundage is a hospitalist for EmCare at St. Petersburg General Hospital in St. Petersburg, Fla. Dr. Brundage earned his bachelor’s degree in chemistry and molecular biology at the University of Michigan, his M.D. at the Wayne State University School of Medicine and completed his residency in internal medicine at the University of South Florida College of Medicine. Subscribe to Dr. Brundage’s weekly documentation tips, or ask him about specific documentation issues, by emailing him at DrBrundage@gmail.com.

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Featured Recruiter: Victoria Wrede

Posted on Mon, Mar 07, 2016
Featured Recruiter: Victoria Wrede

Looking to make a career change? Meet recruiter Victoria Wrede!

Name: Victoria Wrede
Position: Recruiter – Hospitalist & Anesthesia
Division: South
Location: St. Petersburg, Fla.

Education: Associate Degree, Certified Hospitality Supervisor

Years with EmCare: 6 years

Years in the recruiting field? 4 years

Why did you decide to become a recruiter? Before changing career paths into healthcare, I spent more than 20 years working in the hospitality industry. Healthcare and hospitality are similar, since they both function 24 hours a day and require a high level of customer service. I started with EmCare in 2010 in the scheduling department and transferred into recruiting after almost two years. The intent was to learn more about the hiring process and to see if I could help make a difference with staffing.

How does your experience enable you to connect candidates with the right positions? As a result of years in customer service, I'm able to connect with candidates and identify the best demographic area and program structure to fit their lifestyle or goals.

Describe one of your greatest professional accomplishments. My first year recruiting with EmCare I had a Chief Resident who only wanted to work at one specific location in a highly desired demographic area. She was initially declined for unsubstantiated reasons. I was an advocate for her and was able to get her the job. To this day she is still at the same facility and has been an asset not only to that program but has worked at other facilities when we were short staffed.

What makes EmCare attractive to candidates? EmCare has been focusing on growth in other service lines, including Hospital Medicine, Anesthesia, Radiology, and beyond. The longevity and reputation of the company attracts well-qualified providers.

Describe your ideal candidate. A candidate who knows what demographic area and program structure they are focused on is ideal. “Job clickers” or indecisive candidates who don’t know where they want to go can be frustrating and time consuming.

How important is the “relationship” between recruiter and candidate? The recruiter builds trust with the candidate and that is the foundation for a solid relationship.

What do you like most about working at EmCare? The best part about working at EmCare is the staff. I have met some very dynamic people who have influenced me tremendously both personally and professionally.

What do you enjoy outside of work? I enjoy spontaneous trips to major sporting events and theme parks with my family. I recently went to the Orange Bowl in Miami and then to Phoenix for the Fiesta Bowl in one weekend excursion.

What’s your favorite inspirational quote? “Real integrity is doing the right thing, knowing that nobody’s going to know whether you did it or not” Oprah Winfrey

What qualities make a successful recruiter? A successful recruiter follows through and has the best interest of the candidate and practice in mind.

Why should physicians and advanced practice providers join EmCare? EmCare is a physician-led company, which means our decision makers have paid their clinical dues and manage from experience.

What should residents do now to prepare themselves for future hiring opportunities? Identify your short-term and long-term goals post residency. Stability and a clean record will help candidates get their ideal positions.

What “insider tips” do you have for anyone applying to EmCare? Turn your paperwork in a timely manner. Communicate with your recruiter regarding your intentions. The ideal position might not be available today but the more we know, the sooner we can contact you when the opportunity arises.

How should a candidate follow up after an interview with you? Within a few days of the interview it's essential that you provide feedback on the experience so we can relay the information to administration and our leaders. This will allow us to advocate for you if it's a position you are interested in.

Where do you look for candidates, both in-person and online? Do you use social media? Yes social media is a great tool. I make a lot of connections at conferences, job fairs and residency dinners.

Tell me about your ideal candidate. What kind of clinical and educational experience is in demand now? The Hospitalist field is growing rapidly and certain skill sets are in high demand, such as the ability to perform procedures, run codes and exhibit leadership. An ideal candidate will tell me about their strengths so I can help market them to leadership. Flexibility and willingness to be a team player is also an asset.

Why should a provider want to work for EmCare? What’s different or unique about the culture, the opportunities, or the work itself? Our company is always looking ahead to next big healthcare trend which will provide optimal patient care. We offer many opportunities to help achieve your personal and professional goals.

How would your co-workers describe you? Hard working, diligent and non-conventional.

Tell us something that most people at work don't know about you. I am very sarcastic but that is an inherited trait.

What was the last book you read? I only read newspapers and magazines, short and to the point.

What personal accomplishment are you most proud of? My greatest accomplishment by far has been raising my two children: Austen, 17, and Alexis, 16, and by giving them the stability, opportunities and experiences I wasn’t afforded as a child. The cycle can be broken.

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