Pre-conference recap: Sessions highlight best practices, quality

On Sunday, May 22, 2016, the 2016 ACDIS Conference started a couple of days early for roughly 250 attendees who participated in one of our three pre-conference sessions.

Multiple CDI teams filed into the “Building a Best Practice CDI Team” session, co-presented by Richard Pinson, MD, CCS and Cynthia Tang, RHIA, CCS.  Facilities were encouraged to sign up their entire team, bringing a broad range of CDI specialists, physician advisors, and providers to the interactive course. Instructors walked attendees through the 2016 CDI Pocket Guide—the “textbook” for the session—and worked through team building exercises and case studies.

Collaboration and cooperation between CDI specialists, coders, and clinicians is necessary, says Pinson, who stressed that each professional type should be involved in the development of processes and policies for documentation improvement. CDI professionals need to communicate and educate across the team effectively to support engagement of the medical staff in CDI efforts, Pinson says.

“This can come from evidence-based literature and consensus guidelines,” he says. “Having the power of these things [definitive support behind the published clinical and coding literature] is critical.”

Nearly 100 physician advisors joined James S. Kennedy, MD, CCS, CCDS, CDIP, president of CDIMD, Physician Champions based in Nashville and Trey La Charité, MD, physician advisor for the University of Tennessee Medical Center's clinical documentation integrity project and for coding.

On the first day of the pre-conference, Kennedy reviewed the principals of coding and documentation walking the audience through specific case studies for various diseases, touching on sepsis, malnutrition, respiratory failure, and renal failure, to name a few.

“What we do as CDI professionals represents good clinical care,” Kennedy says. “Your principal role as the physician advisor is to help drive home the message that capturing specific diagnoses in the medical record reflects the care provided.”

On Monday, the physician advisor portion split into two sessions. La Charité provided an in-depth look at the role of the physician advisor in audit defense, identifying strategies for engaging physicians, and provided tips for earning their support for documentation improvement efforts. He prefers the term “integrity” over “improvement” and says that’s the term he uses with his facility physicians.

One lesson he offered participants stems from the children’s classic Through the Looking-Glass by Lewis Carroll. La Charité recounts how the Red Queen tells Alice that in Wonderland, “[i]t takes all the running you can do to keep in the same place.” Being a CDI physician advisor and trying to stay on top of changing healthcare regulations, quality improvement measures, and shifting organizational priorities is often just like that but doing so keeps physicians invested in CDI efforts and ensures that providers will see not only the physician advisor but the CDI team as their resources to understanding how these changes affect them.

During the second session “Exploring the Physician Advisor Role at Vidant Health and Franciscan Alliance,” four presenters from two different facilities discussed the differing roles of the physician advisor at each system. They also talked about how to leverage advisors’ in an accountable care organization, with hierarchical condition categories, risk-adjusted payments, patient safety indicators (PSIs), hospital acquired conditions, and other quality metrics.

Boot camp instructors Laurie Prescott, RN, MSN, CCDS, CDIP and Sharme Brodie, RN, CCDS brought a special two-day edition of the CDI for Quality Boot Camp to this year’s conference. Participants worked through case studies to learn the basics of reviewing documentation involving Patient Safety Indicators (PSI) and hospital-acquired infections (HAI). Instructors also highlighted value-based incentive payments and the ins and outs of CMS quality programs.

Couldn’t make it to this year’s pre-conference boot camps? Check out a complete list of upcoming open registration boot camps to find one near you.