Meet a Member: No other job she’d rather have

Sharon Giovanni, RN, CCDS, LNC, is a CDI specialist at St. Luke’s University Health Network in Nazareth, Pennsylvania.

ACDIS Blog: How long have you been in the CDI field?
Giovanni: I started working in the CDI department in 2012 in the St. Luke’s University Health Network.

ACDIS Blog: What did you do before entering CDI?
Giovanni: I was a critical care nurse most of my career, specifically in the post-anesthesia care unit (PACU).

I started my career as a med-surge nurse in a major teaching hospital in Philadelphia. When I relocated, I took a position in the local hospital PACU working 3-11 and on-call, caring for emergency cases. I worked for 26 years at this hospital with some time in critical care as a float nurse in the ED, medical intensive care unit (MICU) and surgical ICU (SICU), but mostly in the PACU.

After 26 years, I took a position in a surgery center and gained experience in operating room nursing, IV conscious sedation for plastic surgery, and gastroenterological procedures. After raising three children, I started a business as a legal nurse consultant which I found to be quite interesting. I found myself missing critical care and needed more stability in income.

I took a position in St. Luke’s as a weekend PACU nurse. I covered trauma, critical care areas as an extra hand in patient care when there were no cases to recover in the PACU. I found this to be a great way to keep my clinical skills sharp and eventually transitioned to full time in PACU.

ACDIS Blog: Why did you get into this line of work?
Giovanni: We had a new CDI program in the network that was just started about a year before I applied and accepted the position. It seemed to align well with my legal nurse consulting work. My youngest child was in college and this job would allow me to explore my career in nursing without the physical stress of critical care and call shifts.

ACDIS Blog: What has been your biggest challenge?
Giovanni: Learning about coding and how it impacts the quality of care and revenue cycle.

ACDIS Blog: What has been your biggest reward?
Giovanni: Working with the coders to compliantly code the medical record and correctly reflect the severity of illness (SOI). The coders often seek my advice in coding non-CDI records. I work with coding management and physicians to mitigate patient safety indicators (PSI) and hospital acquired conditions (HAC) in the network, by making sure the codes reflect the clinical conditions which might exclude PSIs.

Through my communication with the Agency for Healthcare Research and Quality (AHRQ) on PSI measures and the growth of our network, I have received requests from AHRQ for recommendations of codes to be removed from the measures that do not fit criteria for OR procedures.

I also educate the CDI team and physicians on PSIs and documentation. I review records for other quality measures in specific service lines to ensure we capture the correct severity and educate both quality managers and physicians in documentation. Every day I help to exclude a PSI or compliantly and accurately reflect the resources used to care for our patient. It is so rewarding. 

ACDIS Blog: How has the field changed since you began working in CDI?
Giovanni: I see the CDI role more involved in PSIs and HACs in the last two years. Quality measures were not a part of CDI four years ago and now they are becoming more important with public reporting and reflections on individual hospitals in the network and overall performance.

CDI professionals have a huge role in driving Medicare reimbursements and network financial growth. Our healthcare system has expanded and built two new hospitals and are working on the next. We have acquired two other hospital systems in the past two years, as well. So much of that growth can be traced back to the accurate reflection of SOI and quality of care that we provide that can be directly measured with our CDI data.

ACDIS Blog: Can you mention a few of the "gold nuggets" of information you've received from colleagues on the Forum or through ACDIS?
Giovanni: Many times what I see in this role is confirmed in the Journal or on the website. Taking the CCDS certification really helped me to move to the next level in this career. ACDIS is a resource I use to validate and explore what others are finding in their hospital systems.

I have also enjoyed the ACDIS Radio discussions and use the Journal to keep up on the news in the CDI world. My goal is to attend a conference in the future.

ACDIS Blog: What piece of advice would you offer to a new CDI specialist?
Giovanni: Embrace your role and be proud that you have the opportunity to improve the quality of care reflected in the patients’ record.

ACDIS Blog: If you could have any other job, what would it be?
Giovanni: This is it. As a child I always wanted to be a nurse. My aunt was a nurse and she was my greatest influence and back patter in my nursing career. I enjoy the CDI role so much I do not want to retire but look forward to maybe traveling in my future and possibly be a volunteer when intellectually cannot perform this role!

ACDIS Blog: What was your first job?
Giovanni: I worked in a blouse mill. I knew I couldn’t do that for the rest of my life. I also babysat a lot and since I was the oldest of five, I had a lot of chores and had to help out in the care of my younger siblings. We were dairy farmers and I helped care for the animals and learned how to cook and sew. Loved 4H Club.

ACDIS Blog: Can you tell us about a few of your favorite things?
Giovanni: My grandchildren. I also love reading a good book and traveling with our friends.

• Vacation spots: Florida, Caribbean, North and South Carolina
• Hobby: Reading and antiquing 
• Non-alcoholic beverage: Lemon water
• Foods: French fries
• Activities: Walking/hiking

ACDIS Blog: Tell us about your family and how you like to spend your time away from CDI.
Giovanni: I’ve been happily married to my best friend and soulmate for 39 years. We have two grandchildren, two children married, and the third is getting married in the summer 2019. I’m so proud of all my kids and the choices they have made. And, I love to spend time with my friends to too.