Guest Post: To obtain physician support simply engage and collaborate

by Heidi Hillstrom MS, MBA, RN, CCDS

As a 10-year veteran of a successful CDI program, I am accustomed to being asked, “How did you build your program?”  My response invariably is how vital it is to bring your physicians on board.

Before you respond, “But you don’t know how difficult this is with our physician group!” Or, “Get real Heidi! That isn’t going to happen here!” Let me assure you that obtaining physician support for CDI efforts is definitely achievable.

It all hinges on relationship building. This didn’t happen overnight, for us of course.  Once they understood there was no implied criticism of their documentation ability or attempt to tell them how to practice medicine, a lot of the initial hostility disappeared.

First, be visible to your doctors. Whenever possible, perform your reviews on the units.  Greet them by name.  Don’t be afraid to enter into general conversations that are occurring. It doesn’t have to involve documentation.  The performance of a favorite sports team can be a great conversation starter. During these conversation moments, you will have opportunities to discuss clinical documentation, but keep it brief and to the point.

Second, be respectful of your physicians’ limited time.  I requested to be included on the agenda of their staff meetings.  Personally, I never tell a physician I’m there to provide them with “documentation education.”  They are well educated, and this can be perceived as being condescending. Instead, I tell them that I am here to provide them with the most recent documentation “information” that impacts their practice.

I found formal power point presentations tend to lose their attention fairly quickly.  Rather I present an informative agenda tailored to their particular specialty and encourage open discussion.  I ask them to share their expertise in understanding the clinical indicators for a diagnosis.  This is really where the collaboration begins.

Be prepared to listen to their frustration with the documentation process without becoming defensive.  A little empathy can go a long way. It is crucial to follow up with any questions they may have.  Finally, ask them for their input on how the CDI clinicians can improve their communication process.

Once I became more than a faceless documentation query, building a relationship became much easier.  Now, I am often approached on the units and contacted, by physicians, with additional documentation questions and or concerns. Friendly conversation became natural. My template or note became a message from me.  My queries are more likely to get a response.  In fact, once the physician and clinician relationship grew and clinical documentation is now a collaborative effort, I am often greeted with, “Hey Heidi, is that question for me?” once they saw a query form in my hand.

In closing, I am pleased that I have gone from a physician fiend that they avoided to a friend who physicians seek out.

Editor’s Note: Hillstrom, at the time of this article's original release, was Clinical Documentation Manager at St. Luke’s Hospital in Duluth, MN.