Guest post: Making waves as a new CDI specialist

by Kyle S. Boyd, LPN

Starting out in CDI can be daunting. You have to learn the Official Guidelines for Coding and Reporting, learn about MCCs and CCs, how to exclude patient safety indicators (PSI), how to use Coding Clinics, learn new computer programs—the list goes on and on. On top of all that, the CDI profession, much like the nursing and coding professions, is constantly changing. Most seasoned CDI professionals will say that it takes about a year for a new CDI specialist to feel comfortable and knowledgeable.

Thankfully, there are plenty of resources out there to help you get up and running, from the ACDIS’ Boot Camps and Apprenticeship program, to the ACDIS Pocket Guide, and hopefully your CDI program has a strong orientation and mentorship process in place.

With that being said, I want to talk about how you as a new CDI professional can be of service to your program, and help the profession as a whole despite having so much to learn. Even the newest newbie can use the power of asking “why,” approach a problem as if the solution were easy, and bring up new ideas in the right way.

Ask why

The easiest way to affect change is simply by asking why a policy or procedure is in place. As the proverbial “low-person-on-the-totem-pole,” it can be intimidating to ask supervisors, directors, or even peers, why something is done the way it is. However, that is exactly how change, and progress are made.

As humans, we tend to get stuck in our habits, and time can drift by without any examination of our policies and processes. Now, most of the time there will be a logical reason for a process, policy, or procedure, and learning about the reasoning behind it will help you understand your program more. Sometimes, though, you might get answers such as “We have always done it that way” or even “I don’t know.”

These types of answers will make you think and may lead your manager or director to consider the situation, too. Maybe that policy or procedure needs to be updated or revisited. And maybe you are the person to take that project on, to research current industry standards, talk to your colleagues, and bring suggestions forward. This is not meant to have a negative connotation. It’s simply a way to identify improvements, and any manager should appreciate that as long as it’s brought up in a helpful way. 

Approach problems head-on

If you identify an opportunity for improvement in your department, then you need to have an idea for solutions in mind before you present the problem to decision makers. Start by asking yourself, “What would this look like if it were easy?”

For example, if you’re having a problem with provider engagement, the easiest way to engage providers would be if they came to you. From that point, you can start brainstorming ideas of how to get providers to come to you. Consider these questions:

• Can you present at their monthly meetings?
• Hold lunch-and-learns at places where they normally congregate?
• Is there a faster way for them to ask you questions?

The solutions that present from asking yourself what the solution would be if it were easy will not always be doable. More often than not, however, it will provide an excellent jumping off point for developing smart practical solutions. 

Bring up new ideas

You have now come up with a great solution or revised policy, maybe even discussed it with your peers and you want to present it to your supervisor, manager, or director. First thing to remember is this: Don’t get too excited. Especially in larger organizations, changes can take time to implement.

Secondly, stay flexible. There are likely factors you’re not aware of at the management level that will require you to alter your thinking or be open to changes to your solution.

Third, be as specific as possible and bring as many details and images as you can. We are visual creatures and will always be more open to changes that we can visualize. Even if you get shot down or told that your idea will be addressed at a later date, don’t be discouraged. Find the appropriate line between being overbearing and being a positive force for change in your organization. This will help you improve yourself, your department, and your organization. Now go out and start asking questions.

Editor’s note: Boyd is a CDI specialist at Parkview Medical Center in Pueblo, Colorado. Contact him at kyle_boyd@parkviewmc.com. Opinions expressed are those of the author and do not necessarily reflect those of HCPro, ACDIS, or any of its subsidiaries. Want to write for the ACDIS Blog? Contact Associate Editor Carolyn Riel today!