The medical staff policy has been changed to grant additional flexibility with regard to daily rounds for inpatients at Nebraska Medicine.
- If an advanced practice provider (APRN, PA, CNMW or other dependent advanced independent practitioner as designated in the NMC bylaws) performs the daily rounds and completes the progress note, the note may be cosigned by the attending physician without an attestation.
- Please note: It is the attending’s discretion whether to see the patient based on the patient’s illness, clinical course and situation
- If the attending physician does not round on the patient and provide face-to-face services, then the APP should be the sole billing provider for the day.
- If a patient is hospitalized for long-term care only due to discharge planning issues, the attending physician may designate the patient as such and decrease the frequency of daily rounds. This designation can only be made by the attending physician, and if the attending physician changes, the new attending physician is responsible for validating the designation.
- Step 1: If a patient is only in the hospital for long-term care and discharge planning, add “Discharge Planning Issues” to the Problem List
- Step 2: After evaluating the patient, if the attending physician determines the patient is stable and has no acute issues that require daily rounding, add the Smartphrase “.longtermstatus” to the end of their note. Click here for more information on the .longtermstatus SmartPhrase.
- Once this is in the chart, the patient no longer requires daily rounding and can be rounded on with less frequency as needed by their clinical situation. They must be seen at least once per week.
- If the attending of record changes, the new attending should re-evaluate and replace the attestation on the chart.
- If the patient has a change in status and requires acute care, the team needs to return to daily rounding as appropriate.
- Even if the patient is not being seen on a daily basis, the attending physician and the care team are responsible for the patient.
