Q&A: Handling queries when a hospitalist hands off a case
Q: How should organizations handle unanswered queries when the hospitalist originally queried hands off the case to another hospitalist?
A: Ideally, the hospitalist who receives the query would answer it right when they receive it. Implementing a “no response” audit and tracking the number of times a query is sent as well as who it is sent to can help with this. If your hospitalists typically change on Tuesday, the hospitalist who receives a query on Monday should answer. If they don’t, however, a query should be resent to the hospitalist picking up the case. It then becomes that new hospitalist’s responsibility to respond.
This can lead to a great deal of frustration for the new hospitalist on the case and they may reply that, since they didn’t document the diagnosis being queried, they don’t want to answer the query. In this case, the query should go back to the original documenting hospitalist. The exception to this is if the new hospitalist begins copy/pasting the original provider’s notes. Then, clarifying the documentation becomes the new hospitalist’s responsibility.
If a different hospitalist discharges the patient, then the retrospective query goes to the hospitalist who completed the discharge. Coding departments may resend outstanding queries to the hospitalist who writes the discharge summery, particularly if they include the diagnosis in question in their discharge documentation.