Meet a Member: From trauma chart sleuthing to CDI

Shannon Huth, MSN, RN, CCDS, was working as an emergency department nurse in Southern California when she discovered her talent for chart reviews. She was asked to enter trauma data for county reporting, and realized how much she enjoyed analyzing the charts and learning the codes. As she was getting ready to move to San Francisco for graduate school, a full-time clinical documentation position opened up at a local hospital.

The job advertised for nurses with a knowledge of ICD-9 codes—so, naturally, Huth applied. Three and a half years later, Huth continues her work as a CDI specialist at San Francisco General Hospital (SFGH), in a CDI program she helped build from the ground up. She recently became the education manager for the electronic documentation system at her facility, and creates educational videos and handouts to help with training.

She recently graduated from the University of San Francisco with a master degree of science in nursing, with a focus on clinical nurse leadership. She is also a member of the California ACDIS chapter.

In her free time, Huth enjoys baking and spending time with her friends and family, including her mother, a licensed vocational nurse; her father, a CNC programmer; and her grandmother, a retired registered nurse. She also has a 13-year-old teacup Chihuahua named Max.

CDI Journal: What did you do before entering CDI?
Huth: I was a registered nurse in the ED in a small community hospital in Southern California. I’ve worked almost every healthcare position in the hospital, including as an ED technician, a certified nursing assistant, a licensed vocational nurse, and a clerk.

CDI Journal: Why did you get into this line of work?
Huth: While working as a registered nurse in the ED, I was asked to enter the trauma data for county reporting. This was something I only did a few times per month, but I really enjoyed reviewing the charts and cataloging the findings. Over time, the codes began making sense, and I would inquire why certain diagnoses and injuries were coded differently. A few years later, I was getting prepared to move to San Francisco with the goal of starting graduate school and finding a job. SFGH had advertised a full-time position for a clinical documentation specialist. I was more than excited to interview and, ultimately, build the first-ever CDI program at SFGH, with another nurse and a physician. The more traditional daytime hours allowed me to work full-time and complete my master’s degree over the last two years.

CDI Journal: What has been your biggest challenge?
Huth: Starting any new program in a large academic institution can be challenging. As initiatives come and go, we have made the effort to make sure that CDI is involved and aligned as much as possible. Also, working at a public hospital and trauma center means a diverse range of services and patient populations. We spend a lot of time researching the specific needs of the services and customizing education, which goes a long way.

CDI Journal: What has been your biggest reward?
Huth: Any time a provider uses “severity of illness” or “mortality index,” I am a happy CDI specialist. As the CDI program has grown, we have been able to expand into many other areas of interest, such as implementing a new electronic documentation system and quality projects. We have presented a poster at a national quality conference and received an award from the San Francisco Health Commission. Throughout my master’s program, I was able to discuss CDI and its importance in healthcare to my professors and classmates. My final project was code monitoring and education for PSI 15, which was a very unique topic at a nursing school.  

CDI Journal: How has the field changed since you began working in CDI?
Huth: When we started our program, many of the materials found on ACDIS and other sites were focused on CC/MCC capture and reimbursement. While that is an important foundation for CDI, I am happy to see more quality-related materials becoming the focus. I look forward to seeing the impact of ICD-10 and begin reviewing data for additional improvement.

CDI Journal: Can you mention a few of the “gold nuggets” of information you’ve received from colleagues on “CDI Talk” or through ACDIS?
Huth: ACDIS has been my go-to for all things related to CDI. The quarterly (now bimonthly) journal is my favorite, and I usually read it the same day it is published. I review the “CDI Talk” board daily for any interesting concerns or issues in our field. I don’t have the time to read the entire IPPS report or other reports—ACDIS makes it easier for me to stay up to date on things happening that impact my work.

CDI Journal: What piece of advice would you offer to a new CDI specialist?
Huth: You don’t have to know everything. That’s impossible. Take the time to understand your resources: people, books, ACDIS, Coding Clinic, etc. The coding staff I work with have amazing experience and expertise that I could never match, [so avail yourself of the expertise that already surrounds you]. But as a nurse, I do bring a different and valuable perspective to the table.

The key is working together. It is also important to be flexible. Your hospital or organization’s needs may be different than the standard, but know the foundation of CDI to begin the process. The climate of healthcare is changing drastically, and so will your job.

CDI Journal: If you could have any other job, what would it be?
Huth: I would be a baker! I enjoy baking and decorating cookies and cupcakes for my family and friends. My mother and I have had our Christmas cookie tradition for many years now, and they are a hit. I would love to own and run a food truck focused on desserts.

CDI Journal: What was your first job (what you did while in high school)?
Huth: I worked at McDonalds. I learned many customer service skills!

CDI Journal: Tell us about a few of your favorite things.

• Vacation spots: Yosemite is my new favorite, but I also love Costa Rica and Nicaragua!
• Hobby: I’m working on this one … my hobby is figuring out what hobby I like.
• Non-alcoholic beverage: Iced coffee. Black Medicine, based out of Oakland, is my current fave.
• Foods: I love anything from The Chairman—it’s the best food truck in San Francisco. Almost all food trucks here are amazing.
• Activity: Hiking in the Redwoods, exploring the Bay Area, reading books for fun, and watching Netflix.