Conference Update: Speaker Q&A

As you put the final touches on your itinerary, we have a couple more speaker previews that we’d like to share with you. This week, we spoke with Allison Clerval, RN, BSN, CCDS and Kathleen M. Shindle, RN, BSN, CCDS, who will present “A Matter of Life and Death: CDI Impact on Mortality Risk Adjustment.”

ACDIS:  Why is it important for CDI specialists to understand mortality risk adjustment?

Clerval: Our roles in CDI are continuously evolving. We recognized that our department had a unique opportunity to help physicians understand how documentation reflects their patients’ acuity in a way that made the value of CDI real to them. In-depth education regarding patient-specific scenarios demonstrated to them the value of accurate documentation. Gaining buy-in from physicians is a struggle for many CDI departments, and this process has changed the way the physicians view our CDI program. The physicians now hold each other accountable for making sure our queries are answered when we ask them.

ACDIS: How is your topic important for everyone in the CDI role, regardless of professional background?

Shindle: The ratio of observed to expected deaths is considered a measure of hospital quality. The focus for hospital reimbursement is quality of care versus quantity of services. Risk adjustment payment models makes it possible for hospitals and physicians to examine practice differences, and measure and compare patient care. One of our roles as CDI specialists is to make sure the acuity of our patients is represented in the documentation of the medical record. We strive to accurately reflect the quality of care the patient receives.

ACDIS: As an RN, how does your perspective differ from other professionals performing the CDI role?

Clerval: As an RN, I [don’t hesitate to have] critical clinical conversations with physicians. That function has always been an integral part of my career, whether at the bedside or reviewing charts. As a nurse, you spend the majority of your day making inferences. I infer that when the physician orders vitamin K for my patient with an INR of 3.5 that he or she is treating coagulopathy, whether it’s documented or not. I also find that to be the biggest struggle as an RN in CDI. I have to remind myself that there’s no inferring in the coding world. If it’s not documented, the diagnosis doesn’t exist.

ACDIS: What do you think is the most important quality for a CDI professional to have?

Shindle: Communication skills, leadership skills, clinical knowledge, and ethics… I find it difficult to choose one quality because I believe all these assets are of equal importance for the CDI role. As CDI professionals we manage, assess, and review a patient’s medical record to ensure all the information documented reflects the patient’s severity of illness. We preserve the accuracy, reliability, and completeness of the medical record. We sustain the highest level of ethical behavior, knowing what is right and what is wrong. We have to decipher when it is appropriate to query and when not to query.

ACDIS: Why do you think attending the ACDIS conference is important, and what are you most looking forward to?

Clerval: We have a unique role that is often hard to fully articulate to those outside of the profession. While other conferences address issues pertinent to CDI, there is nothing like the ACDIS conference to address real topics in our field. The presentations encourage so much conversation back at our facility. From addressing changing clinical criteria to finding more effective ways to communicate with our providers, the knowledge that you walk away with is incomparable. So much CDI knowledge circulates throughout the conference, even outside of the presentations. I’m looking forward to being surrounded by people who understand the joys and challenges in this career. CDI is not a career that everyone in the hospital understands, so it’s always interesting to compare stories with others who can relate. I’m looking forward to sharing my passion for CDI with people who are just as dedicated to taking the profession to the next level. I can’t wait to see what kind of information I’ll return home with.