ACDIS update: Regulatory Committee releases quality-of-care concerns map

The role of CDI in quality management programs is often overlooked, but unquestionably crucial to accurately reflecting a patient’s severity of illness and affect measures of length of stay, morbidity, and mortality. It’s also critical to ensure patients receive a clear and concise clinical diagnosis so cases can be properly classified as subject to specific quality measures. CDI specialists also play an important role in their ability to medical record documentation for evidence of hospital-acquired conditions (HAC), patient safety indicators (PSI), and medial or surgical conditions that are present on admission.

Because of their unique mix of clinical and coding skills, CDI specialists are uniquely qualified to perform these vital tasks. While everyone involved in healthcare has an interest in providing quality care, many quality management initiatives are based on regulatory requirements from CMS. As these programs originate from federal initiatives, the ACDIS Regulatory Committee has designed a road map to assist CDI programs with their quality efforts.

The quality map provides CDI specialists with tips, techniques, and up-to-date resources to augment your quality programs. The Hospital Value-Based Purchasing section will help you to capture measures of mortality, hospital-associated complications, and Medicare spending per beneficiary more accurately. 

The map also includes help in working with the HAC Reduction Program and capturing PSIs, and it provides direction to ensure that readmissions are appropriately assigned within the Hospital Readmission Reduction Program. 

A further section illustrates how CDI professionals can enhance Inpatient Quality Reporting measures such as payments and excess days in acute care. Finally, there are links to sites where these quality measures are available for public review.

The quality map has been placed on the ACDIS website for the use of the CDI community. The map can be accessed under the “Thought Leadership” tab in the “Regulatory Committee Insight” section.

We encourage your input and feedback on this quality map. Please let the committee know how it can be enhanced and improved to better serve your needs. If you’re intrigued by this work, and would like to help with revisions and updates, we’d like to hear from you as well. Please contact the committee via ACDIS Editorial Director Melissa Varnavas at mvarnavas@acdis.org. We look forward to hearing from you.

The ACDIS Regulatory Committee wishes to thank members Allan Frady, Susan Wallace, and Lori Drodge for their tireless work on this project.