Member Insight: Quality reviews at Penn Medicine

by Natalie Negro, BSN, RN, MPH, CCDS

Our inpatient CDI program has had at least some hand in quality since I first began working in CDI in 2013. I remember being handed a paper with a table of Agency for Healthcare Research and Quality (AHRQ) indicators during orientation. At that time, however, we were definitely still focused on DRG validation and accurately capturing the principal diagnosis, CCs, and MCCs primarily. Vizient risk models, as well as patient safety indicators (PSI) and hospital-acquired conditions (HAC), were aspects of quality that sparked interest and drove Penn to develop a team of retrospective quality-focused CDI specialists to review special cases with the goal of overturning inappropriately coded PSIs/HACs and accurately capturing mortality ratings on death cases.