Journal excerpt: Ambulatory CDI efforts: Get thee to the ED

What drives a CDI department into the crazy world of the ED? Well, like other areas, the reasons are often as varied as facilities themselves—and the transition may be easier for some departments than others.

“The ED program was something that the institution wanted when the [CDI] program was being rebuilt,” says Bernadette Slovensky, RN, MSN, CCDS, medical coordinator for CDI at Stony Brook Medicine in Stony Brook, New York. In fact, one of Stony Brook’s ED physicians was a major force behind the process.

Just like starting a CDI program from scratch, the process goes more smoothly when administration is on board—after all, convincing physicians of the need for CDI is difficult enough on its own.

For some programs, though, the CDI specialists themselves may be the lifeblood of expansion efforts. Such was the role of Jessica Stevenson, RN, CDI specialist at Yampa Valley Medical Center in Steamboat Springs, Colorado, a 32-bed nonprofit facility. Like many professionals at small facilities, Stevenson wears many hats. One hat, labeled “bill reviewer/auditor,” brought ED documentation improvement deficiencies to her attention.

“We were already in those ED charts and realized there might be an opportunity to educate the physicians specifically,” she says.

So, Stevenson ventured into the ED with her one other CDI cohort. Beginning with education, they chipped away at the documentation opportunities found during bill reviews.

For programs looking to expand into the outpatient arena, the ED is often the best starting place. However, the ED offers its own unique challenges even for the most enterprising CDI specialists. Learning from those who have gone before, hearing their stories and tips, helps to clear some of the fog.

Editor’s note: This article was published in full in the May/June issue of the CDI Journal. To download the journal in its entirety, click here. To read this article in full, click here.